Category Archives: UNICEF

UNICEF_blog

A data revolution for children

Katell Le Goulven, the Chief of Policy Planning at UNICEF Headquarters explains why data is central to UNICEF’s work for children , as illustrated by the stories in this blog. 
  • The field of early childhood development is being redesigned thanks to recent evidence from neuroscience demonstrating how nature and nurture are inextricably linked during the early development of the human brain.

In Rukoro neighbourhood, Musanze, Rwanda, cell phones powered RapidSMS are being used to register and monitor expecting mothers. If there are any questions, complications or updates, health workers simply send a text to their local clinic and receive a response within minutes. 
©
 UNICEF/RWAA2011-00482/Noorani

 Learn more about UNICEF’s work on data for children and MICS.

Investments in data on children were bolstered a couple of decades ago by the World Summit for Children where world leaders committed to “establish appropriate mechanisms for the regular and timely collection, analysis and publication of data required to monitor relevant social indicators relating to the well-being of children”. And, later on, by the Millennium Development Goals.
Advancements since then have been significant. In 1990, 29 low- and middle-income countries had trend data on child malnutrition. Today 107 do, largely thanks to data collected via increasingly sophisticated household surveys.
More recently, the digital age ushered forth an era when the amount of data is rising exponentially; new data analytics allow us to answer different types of questions than was previously possible; and new technologies helps us do some of what we do, faster and cheaper.
Mobile data helped report 18 million births in Nigeria in 2011-12, and bring down the time to trace and reunify disaster-affected families in Uganda from weeks to hours. SMS surveys have helped reduce malaria medicine stock-outs by 80% in Uganda and young people are engaging in shaping decision making on HIV/AIDS in Zambia.
The recently coined “data revolution” refers to the potential of this ever-expanding and evolving data ecosystem to improve human well-being. These opportunities, however, will not automatically translate into something positive for all. To be sure, the data revolution also raises fundamental rights issues related, for instance, to having an identity and being accounted for, privacy, legitimate use, ownership, participation, and equity and non-discrimination.
These, in turn, question the suitability of our current data policies and governance structures.
People’s well-being should be at the heart of how these policies evolve. And particular attention should be given to children and youth because many risks affect them more specifically. Across the world, children and youth are growing up in a digital world, and data about them will be tracked for much of their lives. While data may help save the lives of many, others may not be aware that their interaction with technology is creating profiles that could impact their future.
A few days ago, I participated in a meeting of experts asked to prepare a report on the data revolution for the UN Secretary-General. During two days, specialists from the statistics, big data, open data, academia and the UN worlds brainstormed on the definition of the “data revolution” and its role to fill in persisting data gaps, to enhance accountability, to track progress towards sustainable development and to empower people.
While participants brought different perspectives to the table, all acknowledged the role of data as a key driver of sustainable development. Consultations held on the second day put the spotlight on the role of data for fostering openness and inclusion and unpacked the opportunities and challenges associated with big data.
These consultations continue online. You can join the conversation and help design a data revolution that works for the benefits of today’s children and of future generations. Submit your ideas here.
Katell Le Goulven is the Chief of Policy Planning at UNICEF Headquarters in New York.
This blog first appeared on the UNICEF Connect blog, here

Afghan Children Pay the Price of Brutal War

This blog by César Chelala highlights the issues that children are facing in Afghanistan, which heavily impact their health, education and overall well-being. The post is a part of Wikichild‘s series on under-5 mortality rates, along with it’s spotlight on the recent Save the Children report “State of the World’s Mothers 2013: Surviving the first day“.
Decades of insecurity and war in Afghanistan have provoked a heavy toll on children’s lives and well-being. An under-5 mortality rate of 199 per 1,000 live births as reported by UNICEF is among the highest in the world. That means that more than one out of every five children is dead by the time they are five. In addition, health and education systems suffer from lack of funds and qualified professionals, a situation worsened by the security situation.

The statistics are frightening. More than 60% of all child deaths and disabilities are due to respiratory and intestinal infections, and of vaccine-preventable diseases such as measles. Diarrhea kills tens of thousands of children every year. Many also die from severance of breast-feeding before time. An estimated 7.5 million children and adults are at risk from hunger and malnutrition, the latter affecting children’s growth in particular.

According to United Nations statistics, malnutrition among children has increased by 50 percent or more countrywide when compared to 2012. This is happening despite billions of dollars in humanitarian aid by Western governments. One of the most affected places is the malnutrition ward at Bost Hospital, in war-torn Helmand Province, but a similar situation can be found even at Indira Gandhi Children’s Hospital in Kabul.

Although it is difficult to pinpoint the causes for the increase in malnutrition levels, experts indicate several factors that contribute to it such as widespread poverty, difficulties in the implementation of feeding and therapeutic programs, and lack of breastfeeding. Despite low incomes, many mothers are lured by the beautiful pictures on milk cartons, and tend to believe that this milk provides better nutrition for their children.

Children in Afghanistan can also be affected by polio, since Afghanistan is one of only four countries in the world where the disease is still endemic. Despite high vaccination rates, however, there were 47 documented cases of polio in the country.

Some cities, such as Jalalabad, the largest city in eastern Afghanistan, located at the junction of the Kabul and Kunar rivers, are high risk areas for polio due in large part to the massive and continuous population movements from and into polio infected areas. In South Asia in 2000, over 40 percent of the confirmed cases of polio occurred in Pakistan and Afghanistan.

To control the spread of disease, UNICEF and the Department of Public Health in Nangarhar, one of Afghanistan’s 34 provinces, have launched the “Women Courtyard” initiative, aimed at providing local women with information about polio and other vaccine-preventable diseases, as well as such related issues as hygiene and waterborne illnesses.

While this is an important initiative, certain popular traditions still constitute a hindrance to its successful implementation. One such tradition is that babies cannot leave their homes before the 40th day after birth, a tradition which prevents many newborns from being vaccinated at the appropriate time.

To make matters worse, deadly attacks have targeted schools and impeded access to critical health care. According to Daniel Toole, UNICEF Regional Director for East Asia and the Pacific, “We have had attacks on villages and on schools by both anti-government elements as well as by coalition forces and international troops that have hit civilians.”

Just in the first four months of 2013 over 400 children were killed and maimed as a result of the protracted conflict. Statistics seem to show that 2013 may well have been the second most deadly year since 2001.

The result of this conflict is that not a single child growing up in Afghanistan today has known peace in his/her lifetime. Deteriorated mental health is one of the consequences of a permanent state of war. A UNICEF study has found that the majority of children under 16 years of age in Kabul suffer from psychological trauma resulting in serious mental health problems including psychiatric disorders and post-traumatic stress syndrome.

Children in Afghanistan are exposed not only to violence related to acts of war but also to violence resulting from accidents, beatings by close relatives or neighbors, or seeing close relatives being beaten or executed. A study published in the Lancet has pointed out, “In Afghan children’s lives, everyday violence matters just as much as militarized violence in the recollection of traumatic experiences.”

Daniel Toole remarked at a press briefing in Geneva, “Afghanistan today is without doubt the most dangerous place to be born,” a sad commentary on the beleaguered country.



César Chelala, MD, PhD, is an international public health consultant and 
the foreign correspondent for the Middle East Times International (Australia). He also is a co-winner of an Overseas Press Club of America award for an article on human rights.
This blog first appeared 11 January, 2014 on The WIP blog site
See related articles:
3

Child Well-being in 2013


Wikichild just wrapped up another exciting year in 2013, and we decided to kick off this year with highlights of the most popular blogs, events, reports and articles in 2013 regarding child well-being – Enjoy!

Top PROG BLOGS about child well-being


“Youth Unemployment and the OECD’s Action Plan”
on youth unemployment in Europe and the OECD Action Plan for Youth, which proposes how to tackle the issue.
“The U.S. versus the rich world in child well-being” is a comparison between the recently published 2013 KIDS COUNT Data Book on America’s child well-being with UNICEF’s 11th Report card on rich countries’ child well-being.
“Schools tackling obesity and malnutrition” Discusses what schools can do to tackle childhood obesity by establishing a healthier diet, increasing activity and educating about food and nutrition.
“Abstinence doesn’t do the trick” discusses the negative impact that adolescent pregnancies can have on the child, the mother and all of society.

 

Top REPORTS about child well-being in 2013

Global Employment Trends for Youth 2013








 

 

 

 

Top ARTICLES about child well-being in 2013




Top EVENTS about child well-being in 2013

World Toilet Day 19 November
World Day against Child Labour 6 December 

Also, to see what happened in the NEWS regarding child well-being,
check out the Wikichild MEDIA REVIEW.




 – Melinda George
Wikichild Co-ordinator

 

FGM: the Dynamics of Change

This blog, by Wikichild Co-ordinator Melinda Deleuze, is part of the Wikiprogress Series on the Wikiprogress Africa Network. This post provides a summary of the UNICEF report entitled “Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change.” 


When I first heard of female genital mutilation/cutting (FGM/C), I was mortified. Upon reading this UNICEF report, I realized that my previous impressions – that this practice it only occurs in small African villages and affects very few women –  were misconceptions. Only now is reliable data on FGM/C available, giving us a clearer picture about the practice, at least for all 29 countries where the practice is concentrated. The report addresses key questions: How many girls and women have undergone FGM/C? Where is the practice most prevalent? How does this concentration vary within countries and across population groups? 
This WHO report defines FGM/C as “all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons,” and the Organization categorizes the procedure into 4 types. In 2012, the UN General Assembly unanimously passed a resolution that banned FGM/C. Twenty-six countries in Africa and the Middle East have prohibited FGM/C by law; however, the legislation has proven ineffective. The practice remains widespread in 24 countries where FGM/C is illegal. 
There is a social obligation to perform the procedure and the belief that if one does not, then the consequences could include exclusion, criticism, ridicule, stigma or inability to find suitable marriage partners. Relatively few women reported concern over marriage prospects as justification for FGM/C, except in Eritrea and Sierra Leone. The primary benefit cited among men and women was social acceptance and preserving virginity.
In the 29 countries assessed, more than 125 million girls and womenalive today have undergone FGM/C, and in the next decade, another 30 million are at risk. There is a large variation in percentages of cut females across the countries. The countries are divided into 5 categories based on their prevalence levels of FGM/C. One in five cut girls live in one country: Egypt.
 
Variation among regions within a country can be striking, as seen in this map of Senegal (right).
The age at which the procedure is carried out varies across countries. In Somalia, Egypt, Chad and the Central African Republic, at least 80% of cut girls were between 5 and 14 years old. In Nigeria, Mali, Eritrea, Ghana and Mauritania, at least 80% of cut girls were younger than 5. Half of cut girls in Kenya were older than 9 when they had the procedure performed.
Initially, opposition towards the practice focused on health risks, which may have unintentionally encouraged medical professionals to carry out the practice. Traditional practitioners and, more specifically, traditional circumcisers usually perform FGM/C. Though, in countries such as Egypt, Sudan and Kenya, many medical personnel now complete the procedure. In Egypt, for example, 77% of procedures were carried out mostly by doctors, and around half of those procedures were performed at the girl’s home.
Ethnicitystill plays a strong role in some countries, as it may be a proxy for shared norms and values. Also, the practice remains to be a physical marker of insider/outsider status. This graph belowshows the degree of variability in FGM/C prevalence among ethnic lines by contrasting ethnic groups with the highest and lowest prevalence in countries.
Regarding religion, the practice is most prevalent among Muslim girls and women; however, it is also found among Catholic and other Christian communities. In Niger, for example, 55% of Christian girls and women have undergone FGM/C, compared to 2% of Muslim girls and women.
There is also a rural-urban divide, an incomedivide, and an education divide. In Kenya, for example, the percentage of girls in rural areas was four times that of those in urban areas. In most instances, daughters of wealthier families were less likely to be cut. In terms of education, the prevalence of FGM/C was highest among daughters of women with no education, and tends to diminish considerably as the mother’s educational level rises. The reason given for these trends is due to the fact that those in urban areas, in wealthier households, or with a higher educational level are more likely to interact with individuals and groups that do not practice FGM/C, shifting normative expectations around FGM/C as a result.
Supportfor the continuation of FGM/C varies across countries. In most countries (19 out of 29), a majority of girls and women think the practice should end (see graph below). Nevertheless, more than half the female population in Mali, Guinea, Sierra Leone, Somalia, Gambia and Egypt think FGM/C should continue. More men than women favored stopping the practice, especially in Guinea, Sierra Leone and Chad. When fathers were included in the decision-making, their daughters were less likely to be cut. 

FGM/C remains a complicated issue, and this reportdoes not give the whole picture; FGM/C is being performed outside these 29 countries, including  in Europe and North America. The fight against FGM/C has just begun. Stronger efforts will be essential in order to transform the cultural traditions and expectations ingrained in these societies. 

Fortunately, this report gives us a better understanding of FGM/C and, more importantly, an evidence base to begin measuring progress in this area. We know there have already been steps forward in terms of awareness, decreased health risks and legislative bans, but now we can track progress inside countries regarding specific population groups, procedures and attitudes. Hopefully, this evidence base will help us be more effective in promptly eliminating the practice.

Melinda Deleuze

*This week’s Wikiprogress spotlight is on the e-Frame Net (European Network on Measuring Progress).  

The U.S. versus the rich world in child well-being

This blog, written by Wikichild coordinator Melinda George, is a comparison between the recently published 2013 KIDS COUNT Data Book on America’s child well-being with UNICEF’s 11th Report card on rich countries’ child well-being. This blog is a part of the Wikiprogress Series on its well-being and progress networks.


Since last week’s launch of the Annie E. Casey Foundation’s 2013 KIDS COUNT Data Book, discussions about America’s child well-being, particularly concerning each states’ rankings, have been a hot topic. (For those of you who missed the highlights, read more here.) The Data Book examine trends of 16 indicators pertaining to 4 dimensions (economic well-being; education; health; and family and community). 
In April 2013, the United Nations Children’s Fund (UNICEF) Innocenti office of research launched its 11thReport Card on child well-being in rich countries. This report ranks the world’s 29 advanced economies in terms of their overall well-being, using 26 internationally comparable indicators separated into 5 dimensions (material; education; health and safety; behaviors and risks; housing and environment).
According to this UNICEF study, the U.S. was ranked 26th out of 29 in overall child well-being and was on the lower end for most dimensions and indicators. The Data Book recognises that when the data was disaggregated, the results were strikingly different, particularly the education data for the lowest-income students.
So, how do America’s states and races compare to 
the well-being of children in other advanced economies?
Between these two studies, there are 3 shared indicators (low-birthweight babies; child and youth mortality; teen births) and a 4th indicator where the observed age range differs by one year (teens not in education, employment or training; i.e. NEET rate). 

I’ve aligned the state and race data* with the rich countries implementing UNICEF’s 3 color system**, showing the first, second and third tiers. I also added a 4th color (the darkest) to indicate the states which are off the country charts. 


Low-birthweight babies
(% born below 2.5 kilograms or 5.5 pounds)


Regarding the percentage of babies born below 2.5 kilograms, Alaska is comparable to Norway, Idaho to Belgium, Georgia to Greece, and Mississippi is off the charts. A majority of the states are in the bottom third of the advanced countries. However, Hispanics and non-Hispanic Whites are in the middle, closer to Germany, while African Americans (at 13.2%) have a much higher percentage of babies below 2.5 grams than the average in Greece (around 9.5%). 

Child and youth mortality rate
(deaths per 100,000 among 1-19 year-olds)
We see the same trend in child and youth mortality rates as we did in the low birthweight percentages. The majority of states are in the bottom third of advanced countries’ rates, with only 5 states in the top two-thirds. However, the Asian and Pacific Islanders in the U.S. have the same rate as Sweden and the Netherlands.

Teen births
(per 1,000 15-19 year olds) 


Since the United States has the second highest number of teen births next to Bulgaria, it is not surprising that 21 out of 50 states are off the charts. There are no states in the top two-thirds of the rich countries; however, the Asian and Pacific Islanders are in the middle third, with the same number of teen births (11 births per 1,000 15-19 year-olds) as Greece and the Czech Republic.


NEET rate
Percentage of 15-19 or 16-19 year olds not in education, employment or training 



The percentage of teens in the United States neither attending school nor working varies a lot between the states. In comparing with the advanced country rankings, most states were in the bottom third, and 13 states were in the middle third. Also, Vermont and Wyoming have rather low percentages (4%) and are comparable to Germany. When the U.S. data is disaggregated by race, it also is more evenly spread, covering all three tiers of the advanced countries. American Indians have the lowest percentage (15%), only slightly lower than Bulgaria’s percentage. I must note that the UNICEF study observed teens 15 to 19 years old, while KIDS COUNT observed only 16 to 19 year olds in its study.

It’s unfortunate that there were not more shared indicators among the two studies and most of the shared indicators were related to children’s health. While the KIDS COUNT data is most likely very relevant to local policy-making, it cannot be compared internationally.
The Data Book recognises childhood obesity as a growing problem; however, the KIDS COUNT index regrettably does not include an indicator for childhood obesity as there is no 50-state data source available. In the 11thReport Card, the U.S. is almost off-the-charts for its childhood obesity rate in comparison with other rich countries. Comparable data is crucial in order to highlight the problem areas, share best practices, and tackle America’s childhood obesity. 

When considering America’s improvements and declines in child well-being, we should look across states, across races and across other advanced economies to get a better understanding of what success looks like. I hope that policy-makers will do the same when deciding where efforts should be spent.

*The data concerning the U.S. is available online at www.datacenter.kidscount.org
**The countries with grey bars have data for fewer than 75% of the total number of indicators used in the UNICEF study.

Melinda Deleuze

Can good governance solve youth unemployment?

This article by Robbie Lawrence, highlights how young people are very much part of the solution to youth unemployment. This post is part of the Wikiprogress Governance and Civic Engagement Series

“Education is our top priority but, once educated we want to be trained, enabled – and funded – to take action to address the challenges faced by our generation through youth-led development. We want, in Gandhi’s words, to ‘be the change’ we want to see in the world…” World Youth Congress, Hawaii, 1999

On the same day that the Bank of England upgraded its economic forecast, stating that inflation is expected to drop within the next two years, the Trades Union Congress reported that UK unemployment figures grew by 15,000 in the first three months of 2012 to 2.52 million. Rising employment numbers in the latter months of 2012 had offered a level of respite for the British government following a bruising financial year, however, today’s findings show that joblessness is still extensive.

The issue remains embedded among young people, with jobless rates soaring towards the one million mark and standing at 21.2% across the country. The TUC is concerned that while employment prospects for older workers have been improving, those for young people are far worse, and have deteriorated further since mid-2010. The damaging effects of unemployment on young people are well documented, and there is an increasing risk that the UK’s current 15-24 year olds will suffer lasting damage to their earnings potential and job prospects throughout their lives.

Global figures are equally gloomy. Over the last few years we have been inundated with statistics on the deteriorating situation in Europe (particularly Spain) for young job seekers and in Africa well over half of 15-24 year olds are currently out of work. According to a UN led report released last week, the weakening world wide recovery has further aggravated the youth job crisis and as a result the problem will continue growing over the next five years. The International Labour Organization’s ‘Global Employment Trends forYouth 2013: A generation at risk’ estimates that 73.4 million young people (12.6 percent) are expected to be out of work in 2013, and by 2018, this will have reached 12.8 percent.

Graph taken from ILO Report 2013

The report stipulates that young people face persistent unemployment, a proliferation of temporary jobs and growing discouragement in advanced economies; and poor quality, informal, subsistence jobs in developing countries:

“The economic and social costs of unemployment, long-term unemployment, discouragement and widespread low-quality jobs for young people continue to rise and undermine economies’ growth potential,” ILO – Global Employment Trends for Youth 2013 report.

Despite vocal concern around the issue, it seems that governments and organisations have struggled to find an effective means of combating youth unemployment. The recent World Economic Forum in Davos touched upon the subject on a number of occasions with some leaders suggesting that a global fund for unemployment be implemented. Yet there have been murmurings among critics that such steps are simply inadequate when faced with the ‘tidal wave’ of jobless young people sweeping the world’s nations. Lynda Cratton of the London Business School believes that in a similar way to global warming, the sheer complexity of the challenge renders it almost impossible to solve.

Following the release of ‘A generation at risk’ the ILO’s assistant director-general for policy José Manuel Salazar-Xirinachs stated, ‘These figures underline the need to focus policies on growth, massive improvements in training systems and targeted youth employment actions’. 


Two recent Wikichild Spotlight reports look at tackling youth unemployment through effective governance.


– Developed by UNICEF and Save the Children, Children’s Rights and Business Principles provides a comprehensive framework for understanding and addressing the impact of business on the rights and well-being of children. The Children’s Rights and Business Principles are built on existing standards and practices and helps to explain the opportunities for business of investing in children.  

– First published in Nairobi last year, UN-HABITAT’s State of the Field in Youth Development sheds light on how youth are positively impacting communities around the world. As part of wider series, this particular report stresses how young people can be beneficial to communities, and how local, national and international governments can implement, engage and support youth and youth led initiatives.

Both reports look to brand young people as ambassadors of change. ‘Children’s Right’s and Business Principles’ recognizes that children are among the most marginalised members of society, yet when provided with the agency to participate, they have shown that they can offer vital alternative viewpoints and make effective contributions. Similarly, ‘State of the Field’ emphasizes the need to have faith in the power of young people to contribute constructively to the good of society. It seems that both publications hope to change the attitude of governing bodies towards young people by showing that they themselves have placed youths at the center of their own projects. The ‘State of the Field’ report lists countless examples of how initiatives led by young people have positively benefited society.

Youth unemployment is undoubtedly one of the greatest challenges facing governments this century and will worsen as populations swell and education becomes more readily available. However, the two publications featured provide hard facts about how the integration of young people in a country’s workforce can catalyse economic prosperity. With the development of more projects similar to the ones mentioned in the ‘State of the Field’ it seems that we can go someway to combating the problem.   


Robbie Lawrence 
Wikichild Coordinator 

Governance Week in Review

This Week in Review by Robbie Lawrence is part of the Wikiprogress Governance Series

‘Good governance is the foundation on which a society is built, and thus it is indispensable for the development of a country.’ Dirk Niebel, German Minister for Economic Cooperation and Development

As you all know we are focusing on Governance this month, so today’s Week in Review will provide you with an insight into a number of key reports (and a video!) related to the subject. The article includes overviews of the current Wikichild Spotlight, UN Habitat’s State of the Field in Youth-Led Development, UNDP’s Global Consultation on Governance and the Post 2015 framework and Beth Noveck’s Ted Talk, ‘Demand a more open-source government’.  

First published in Nairobi last year, UN-HABITAT’s State of the Field in Youth Development sheds light on how youth are positively impacting communities around the world. As part of wider series, this particular report stresses how young people can be beneficial to communities, and how local, national and international governments can implement, engage and support youth and youth led initiatives. ‘State of the Field’ then goes further and identifies youth led organizations that need more support, financial and otherwise, that could in the future make the most difference. This framework of initiatives was first put in place at the World Youth Congress in October 1999 and since then has expanded to a global form of youth led participation.

Developed by UNICEF and Save the Children, Children’s Rights andBusiness Principles provides a comprehensive framework for understanding and addressing the impact of business on the rights and well-being of children. While most businesses are aware that ‘children are our future,’ the voices of young people are often ostracized when it comes to the corporate sustainability movement. The Children’s Rights and Business Principles are built on existing standards and practices and help to explain the opportunities for business of investing in children.  

The UNDP is currently running a global thematic consultation on governance in the lead up to the post-2015 framework. Similar to Wikiprogress, Wikigender and Wikichild online discussions, this is an open forum for individuals, policy makers, NGOs, UN staff and other stakeholders to discuss how governance can be used to tackle the most pressing issues (inequality etc) facing the post-2015 panel.  Make your voice heard!

The Human Development Report 2013 examines the noticeable transition in global dynamics catalysed by the fast-rising new powers of the developing world and its long-term implications for human development. The report series provides an overview of health, education and basic living standards across the world so that governments and decision makers can make more accurate and comprehensive decisions to boost progress.

What can governments learn from the open-data revolution? In this striking talk (below), Beth Noveck, the former deputy CTO at the White House, shares a vision of practical openness – connecting bureaucracies to citizens, sharing data and creating a truly participatory democracy.



We look forward to bringing you more Governance related articles in the coming weeks!

The Wikiprogress Team

From the Bottom to the Top: One Step to Improving Global Sanitation

This article by Robbie Lawrence, Wikichild Coordinator, considers how global sanitation can be improved in the context of the International Federation of Red Cross’s ‘Getting the Balance Right’ report. This is part of the Wikiprogress #Health Series. 
“Communities in rural areas and urban settlements must be empowered to increase their resilience through access to safe water, improved sanitation and effective hygiene promotion.” Getting the Balance Right, International Federation of Red Cross, 2013

This post follows on from Wednesday’s blog on the dangers of diarrhoea by focusing on the disease’s chief causation: poor sanitation. Currently 3.4 million people die each year from water, sanitation and hygiene-related causes (Water.org). An estimated 2.5 billion do not have access to basic sanitation and 1.1 billion of those people practice open defecation. This is not only degrading but a severe health risk as fecal matter-oral transmitted diseases cause at least 1.5 million deaths per year in children under the age of five (Getting the Balance Right). As Gary White and Matt Damon so bluntly put it, by the time you’ve read this paragraph, another child will have died from something that is eminently preventable.  
In the same way that inequality has reared its head in the post-2015 discussions, forcing global leaders to consider how poverty reduction might be carried out more equitably in the future, it is evident that we need to address water and sanitation issues. The “Progress on Drinking Water and Sanitation 2012” report by the WHO and UNICEF highlights that, although the MDG target of halving the number of people globally without access to improved water source will be fulfilled by the MDG 2015 deadline, the target for sanitation is unlikley to be met.  
More often than not aid donors and development agencies have aimed at providing clean and safe water supplies rather than making sanitation a priority. As it stands, sanitation only receives 12 percent of global aid put towards combatting water and sanitation related issues. In the short term this trajectory make sense, since water is usually in more immediate demand, however, if diarrhoea and other hygiene related illnesses are to be dealt with, access to sanitation facilities must be increased. The ‘Getting the balance right’ report emphasizes that ‘neither water nor sanitations is more important: both elements are required to maintain and improve health and dignity.’
Water.org argues that the inability of philanthropic efforts to efficiently deal with the problem of poor sanitation has been a problem in the past. Even the money that has gone towards solving the issue has largely missed the goal of providing relief for those most in need. The organization recognized that if local communities were to make progress, independent of donors, then they must be viewed and view themselves as the owners of the project. Community ownership is the linchpin of Water.org’s philosophy. Without an active engagement from communities from the start of a project to its completion there is a strong likelihood that previously entrenched social norms such as public defecation will continue.
The ‘Getting the Balance Right’ report delivers a similar message, and uses a number of examples of community-based initiatives that have succeeded in improving sanitation. In Eritrea, a country where only three percent of its rural population has access to sanitation, the IFRC and the EU implemented a program focused on mobilizing and educating women in hygiene knowledge that reached a total of 145,000 people in 120 villages. By empowering these local women and providing them with  information, the program motivated them to become promoters of sanitation within their own communities. The Water.org website also lists various bottom to the top initiatives that have shown remarkable success rates. An Emory University review of a Water.org community based ventures in Lempira, Honduras reported that 100 per cent of the project sites were still operational after 10 years with 98 per cent of respondents satisfied with the system.
Since poor sanitation is now firmly in the crosshairs of policy makers and aid groups, it seems that the Water.org and IRFC have laid out a fairly effective framework for combating the problem. Changing intrinsic social norms from the routes of a community appears a far more effective means of catalyzing change than large, trickle down cash injections. The flow of international water aid must of course be rebalanced towards sanitation, but organizations, governments and NGOs need to go further and ensure that it reaches the right groups and individuals. The stark reality of IRCF’s report brings to light the vital role that sanitation plays in human health and dignity:  
“Let us speak clearly; the single largest cause of human illness globally is faecal matter. A society – regardless of how many clinics or water supply points it has – can never be healthy is human waste is not safely disposed of.” Getting the Balance Right



Robbie Lawrence

Childhood Pneumonia and Diarrhoea KILLS!

This article, by Ousmane Aly Diallo, Wikiprogress Africa Advisor, is part of the Wikiprogress Health Series. Wikiprogress Africa aims to  provide a platform for knowledge sharing on measuring progress and well-being in an Africa context. 

We know what works against pneumonia and diarrhoea – the two illnesses that hit the poorest hardest. Scaling up simple interventions could overcome two of the biggest obstacles to increasing child survival, help give every child a fair chance to grow and thrive, Anthony Lake, UNICEF Executive Director.


The Lancet recently published a series of papers on Childhood Pneumonia and Diarrhoea in collaboration with the Aga Khan University of Pakistan, in April 2013.  The series demonstrates that it is possible to eradicate the prevalence of these two diseases among children through a comprehensive strategy involving all the stakeholders and highlights the barriers that have enabled children’s death from it.

Pneumonia and diarrhoea are low in incidence in the developed world but remain serious health concerns in the developing world. Childhood Pneumonia and Diarrhoea are particularly lethal in the developing world; nearly 90% of the children who died from these diseases are from Sub-Saharan Africa and South Asia, according to a recent World Health Organization report.

Assessing  the global burden of childhood pneumonia and diarrhoea in the world,  Walker and Alii’s paper show that these two diseases remain the leading infectious causes of death in children younger than 5 years, and caused an estimated 700 000 and 1·3 million deaths, respectively, in 2011. 

According to the study, more than half of the burden (56% of severe episodes of diarrhoea and 64% of severe episodes of pneumonia) is upon 15 countries and among this category, 10 of them are Sub-Saharan Africa’s ones: Angola, Burkina Faso, Democratic Republic of the Congo, Ethiopia, Kenya, Mali, Niger, Nigeria, Tanzania, and Uganda. Most of these deaths could have been prevented through vaccines and other means of prevention according to this study. Besides, undernourishment constitutes another obstacle to these children’s survival. Any program to tackle childhood pneumonia and diarrhoea should include a facet on improving child nutrition.

Lack of national leadership in the fight against these diseases and a lack of financial resources are important bottlenecks. This, coupled with the inadequate training of health workers, and a lack of health indicators, are key obstacles that need to be addressed to lower the morbidity rate of pneumonia and diarrhoea among children and to improve their survival rates, for these authors.

The second paper on “Interventions to address deaths from childhood pneumonia and diarrhoea…” shows that scaled interventions could save 95% of diarrhoea and 67% of pneumonia deaths in younger children (under 5 years) by 2025. But to reach that goal, the emphasis must be put on community-level healthcare as it is the best way to reach the most exposed populations. 

This series show that childhood pneumonia and diarrhoea are serious health concerns in many developing countries, particularly in Sub-Saharan Africa, but that they could be eradicated through prevention (immunisation campaigns) and effective intervention. In its subject and objectives, this series echoes the recent publication by the World Health Organization and UNICEF, the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea. This plan aims to reduce by 75% (with 2010 levels as reference) the incidence of severe pneumonia and diarrhoea, as well as the death from both these diseases among children under-five. It also aims for a 40% reduction in the global number of children under five who are stunted since undernutrition is one of the key risk factor for children suffering from pneumonia and diarrhoea. There’s a global commitment to ending child death from preventable diseases and these two Lancet publications show that this objective is reachable if all means are galvanised.

Childhood diarrhoea and pneumonia are deadlier in low-income countries of Sub-Saharan Africa and South Asia than in the developed world. Closing the gap is one of the ultimate aims of the Lancet series as shown through different models, it is an objective that is within our reach.

To find out more about Wikiprogress Africa, click here

Ousmane Aly DIALLO
(Wikiprogress Africa Advisor)