6 Reduce child mortality

Where we are?

 Child in the incubator
Free and comprehensive health care coverage and free medicines, in conjunction with the introduction of compulsory health insurance, helped combat infant and maternal death. Photo: UNDP

The final targets set for 2015 for infant mortality and the under-5 mortality rate have already been reached. Nevertheless, social exclusion has also influenced and marked this area as well.

Hence, there are marked inequities in cases of child mortality, which disadvantages poor children, and especially Roma children. This fact again reveals discrepancies between rich and the poor, as well as drawbacks in relation to social equity.

Another challenge is vaccinating children against measles by 2015, which is in some doubt, as in recent years the number of children who have been vaccinated decreased for different reasons. The problem is especially acute in rural areas and, mainly, among the Roma children, due to low levels of knowledge about the benefits of vaccination. The Ministry of Health acknowledges these issues and actively promotes, maternal and child health, and is implementing a series of reforms in this area.

Free and comprehensive health care coverage and free medicines, in conjunction with the introduction of compulsory health insurance, all served as crucial elements in combating infant and maternal death. There are specific national health policies and programmes which focus on mother and child health. The development of a regionalised perinatal assistance system, strengthening paediatric emergency health care and the regional reanimation and intensive therapy departments, as well as an increase in the level of knowledge through continuous medical training all represent some examples of the major efforts which have already had visible impact.

The implementation of Integrated Management of Childhood Illness (IMCI) and the system of individual evaluation of the neonatal mortality cases allows for the collection of some relevant data for developing effective interventions.

Although efforts were undertaken to implement a mechanism for inter-sector collaboration in the medical-social area, the lack of social assurance is one of the major factors driving child mortality cases. Neurodevelopmental surveillance services for children from the high risk groups (especially the extremely premature new-borns) for neurological disorders, early intervention and individualised recovery could be more effi ciently provided on a regional basis to increase access for vulnerable populations, and this would reduce these children’s disability. Further joint efforts together with international development partners are major preconditions to ensure sustainability and increase the prospects for successes.

Targets for MDG4
  1. Reduce by two thirds the mortality rate among children under five
    • Under-five mortality rate
    • Infant mortality rate
    • Proportion of 1 year-old children immunised against measles