Ethiopia has been actively working to reduce child mortality through a comprehensive strategy that includes expanding access to primary healthcare, particularly in rural areas, via the health extension program. This program focuses on preventative services like antenatal care, immunizations, nutrition interventions, and community-based disease management through rapid scaling up of effective interventions.
Taking all this fact into account, The Ethiopian Herald approached Mulugeta Samson, a gender specialist graduated from Addis Ababa University, to have professional information about child rearing and efforts to protect child mortality.
As learnt from him, women can play a critical role in promoting, achieving, and maintaining their health and well-being, often with the support of fathers, partners, and other family members. Thus, all women and babies need access to affordable and high quality care before, during and after pregnancy and childbirth.
He said, “Millennium Development Goal-4 calls for reducing the under-five mortality rate by two-thirds between 1990 and 2015. As global drive for improving child survival rises, monitoring global, continental and country level progress has become critical. Large and increasing differences are observed in childhood mortality among many countries of the world. The rate of decline in childhood mortality, the probability of dying between exact ages of one and five, has accelerated over the past years.”
Aligning food, education, water and sanitation systems is of significantly useful in reducing child mortality, stunting as well as diminishing maternal demise
As to Mulugeta, Ethiopia, a low-income country in the sub-Saharan Africa, but working to be a middle income economy right now, has achieved the MDG to reduce the mortality rate for children under the age of five.
“Post-neonatal and late neonatal deaths are amenable to public health interventions like immunization, breastfeeding, and improved hygiene. The achievement of major reductions in early neonatal deaths has depended on the provision of individualized clinical care and quality of services which is much more challenging.”
To achieve the above goals he said, the country has to work on increasing the knowledge and skills of communities and households as this move is of paramount importance in creating model families who have a crucial spillover effect on the issue under discussion. Healthcare service sites have created greater awareness among the general public on how to prevent communicable diseases. Such a viable step has also brought a change in attitude and behavioral practices in preventive aspects of maternal and child health.
However, as further success in reducing under-five mortality will be very challenging to achieve the desired goals, combined effort has to be exerted to make a difference.
He said, “Education plays a great role in increasing awareness of healthcare. Mainly women’s education results in more effective preventive and healthcare practices.
True, accelerated investments are needed in health system infrastructure, intervention implementation, health worker training, and patient education to improve health outcomes for mothers and newborns.
He further said that all women and babies need access to affordable and high quality care before, during and after pregnancy and childbirth. These new targets will be critical for delivering an effective continuum of care for maternal and newborn health, from access to sexual and reproductive health services to those vital checks in pregnancy, as well as the often neglected postnatal period.
He said that the general trend has exhibited that children with long birth intervals are less likely to face the problem of stunting and underweight. The proper spacing of births allows more time for childcare to make more maternal resources available for the care of the child and mother.
Age, marital and educational status of the mother, birth order, preceding birth interval, and family income has been the dominant and the most significant determinants of childhood mortality. Factors like breastfeeding and healthcare issues like immunization, antenatal care, and delivery care need to be strengthened, he opined.
He said, “Well-known interventions, such as neonatal resuscitation and case management of infections, can be added to existing programs, particularly safe motherhood and integrated management of childhood illness programs, at low peripheral cost. However, as increasing numbers of women and babies reach first-level facilities and hospitals, the quality of care challenges in these facilities need to be addressed. A shift in focus to quality of care has the potential to unlock significant returns for every mother and every newborn, quite lucid.”
The early gaps concerning both cognitive and socio-emotional development are highly correlated with the home environment, such as whether children grow up in a single-or two-parent household, their parents’ education and language skills, the psychological stress faced by parents and the parent–child relationship, he added.
He further suggested that an important role of parents’ socio-economic status in explaining early development gaps between children from different backgrounds needs to be well taken care of.
Mulugeta also underlined the importance of socio-economic conditions for childhood development. These conditions include financial resources, parental mental health and the stability of family relationships have to be given due emphasis.
Many children are growing up in single-mother families and in families where parents are separated/divorced he said adding that separation from biological parents’ matters for childhood development across the entire social ladder.
Yes, he said family stability is highly correlated with parental education, too as more-educated parents on average postpone childbearing, marry before having children and are less likely to separate.
These steps could be especially important for policies aiming to alleviate inequality in early childhood outcomes as parents’ endogenous responses could potentially either magnify or dampen the direct effect of policy interventions, he added.
According to Mulugeta, efforts to reduce child mortality include improving healthcare, providing nutrition and educating communities have come to the forefront towards creating healthy generation.
He further stated that enhancing antenatal care—improving the quality of care before birth—and immunizations—improving immunization coverage, breastfeeding—promoting exclusive breastfeeding for the first six months of life and household food security, which means developing training materials to help local institutions and field staff.
As to him, here community empowerment matters the most. Yes, empowering families and communities to recognize, prevent, and treat common childhood illnesses helps the comprehensive effort bear fruits.
Besides, he said providing treatment for common childhood diseases
Ethiopia has made significant progress in reducing child mortality, but there are still health disparities. To further reduce child mortality, the country is working to improve access to care, reduce inequalities, and implement evidence-based policies.
He said, “Improving access to care, increasing antenatal and obstetric care, implementing standardized clinical protocols, and improving access to pediatric care have to be well focused on in this regard. To this end, it is important to address inequalities in education, income, and material deprivation, address intergenerational trauma, implement evidence-based policies and promote safe sleep practices, such as placing infants on their backs to sleep.”
As to Mulugeta, improving health-seeking behaviors, implementing public education campaigns, leading continental and global efforts to coordinate maternal, newborn, and child health programming have to be taken into account as they are instrumental in supporting every woman, every child to make a difference.
In a nutshell, given the importance of maternal health for families, communities, and nations, addressing the unacceptable rates of maternal mortality and severe maternal morbidity calls for a comprehensive approach that addresses health from well before to well after pregnancy.
A singular focus on the perinatal period would ignore a range of health factors associated with chronic conditions as well as other environmental and social factors that contribute to poor outcomes. The strategies and actions run by the government need to be based on community interest and critical demands. The opportunity for action exists across the spectrum of women, children and families, nationally, among tribes and local communities; healthcare professionals; healthcare systems, hospitals and birthing facilities, among others.
BY MENGESHA AMARE
THE ETHIOPIAN HERALD FRIDAY 28 FEBRUARY 2025
