The global effort to improve children’s chances for survival has reached a milestone: the number of children dying before their fifth birthday has fallen to an all-time low, according to data released by UNICEF on Thursday. Child mortality rates have declined more than a quarter in the past two decades because of more widely distributed vaccinations, anti-malarial mosquito nets, a rise in breast-feeding and philanthropies like the Bill and Melinda Gates Foundation that have donated billions of dollars towards the effort.
Malawi, though one of the world’s poorest country, has experienced one of the most extreme drops in child mortality rates. For every 1,000 Malawian babies born, 125 more survived to their fifth birthday in 2008 than in 1990. Malawi’s success in reducing child mortality is not a given, but the result of their ability to find creative preventative measures and cost-effective treatments. South Africa by contrast, the richest and most developed country on the continent, has experienced a rise in child mortality, many would say because of their flawed political leadership and health-care policy.
One powerful weapon that Malawian has against child mortality is their 10,000 high-school educated village health workers who are trained to diagnose childhood killers, dispense medicines, and give injections, tasks that only doctors and nurses can perform in other countries.
Mr. Mwaraya, a village health worker who earns $90 a month, has a box in his home containing birth control injections and treatments for the most common childhood killers: otrimoxazole, a low-cost antibiotic, against pneumonia; oral rehydration salts for diarrhea; and Coartem, medicine for malaria. “My interest was to assist my fellow Malawians who were falling sick but never had treatment at the village level,” he said.
“Malawi is changing for the better,” said Doris Hebuye, a Malawian woman who listened while her daughter Fanny, a new mother, was counseled by a health-worker on breast-feeding, the danger signs of sickness, and choices for birth control. Mrs. Hebuye had lost two of her seven children for reasons she never fully understood. “In those days, people gave birth without advice. These days, women are assisted in many ways.”
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