Better Health Care for Afghan Children

By AMIR SHAH

KABUL, Afghanistan – Close to 90,000 children who would have died before age 5 in Afghanistan during Taliban rule will stay alive this year because of advances in medical care in the country, Afghan President Hamid Karzai said Sunday.

The under-5 child mortality rate in Afghanistan has declined from an estimated 257 deaths per 1,000 live births in 2001 to about 191 per 1,000 in 2006, the Ministry of Public Health said, relying on a new study by Johns Hopkins University.

The U.N. and aid agency Save the Children both hailed the advances in health care in Afghanistan.

"This is certainly very positive news," said the U.N. spokesman in Afghanistan, Adrian Edwards. "To come from such low life expectancy to see this improvement does appear to be an indication that the work on the health sector here is beginning to pay off."

Karzai, surrounded by children at a news conference in Kabul, thanked international aid organizations and Afghan health workers for the work they’ve done to raise health standards. He said 89,000 children will be saved each year because of the improved health care.

Still, Afghanistan continues to face severe problems. Health Minister Mohammad Amin Fatimi said 250,000 children under age 5 die every year, mostly from malnutrition, diarrhea, tuberculosis and malaria.

Child immunizations have risen dramatically in recent years, and newly trained volunteer health workers are helping treat pneumonia among villagers in remote areas, said Tariq Ihsan, a deputy director with Save the Children.

But Ihsan said the youngest children make up the bulk of the country’s high child mortality rate.

"My feeling is that we really need to look at this very carefully, because the children who are dying now could be the newborns," Ihsan said. "Many newborns are dying because they don’t have access to immediate health care. I think that’s a real challenge for Afghanistan. They need to ask, ‘Are we saving enough newborns?’"

Deaths of Afghan children who don’t reach their first birthday have dropped from 165 per 1,000 in 2001 to 129 per 1,000 today, a drop of some 22 percent, Edwards said.

Afghanistan’s child mortality rate, from birth to age 5, has been among the worst in the world. Only Sierra Leone, with 283 child deaths per 1,000 live births, Angola (260) and Niger (259) ranked below Afghanistan at 257, UNICEF said in a 2006 report.

By comparison, the United States has eight under-5 child deaths per 1,000 births. Singapore and Iceland, with three childhood deaths per 1,000, topped the rankings.

The UNICEF report noted that, like Afghanistan, most of the countries with the worst child mortality rates have suffered from armed conflict.

Fatimi, the health minister, said 85 percent of Afghans now have access to basic health care – a marked improvement from the past.

A U.S.-led invasion in 2001 toppled the Taliban militant movement from power.