Global Study On Child Poverty And Disparities (PDF) - Social Policy ...

Education appears to be a stronger factor than
wealth in influencing variations in outcomes.
Thus, is appears that some children may suffer
from malnutrition not due to lack of food but due
to lack of awareness of good nutrition. Therefore,
concerted efforts are needed to raise people’s
awareness of the importance of children’s and
mother’s health and nutrition.
Breastfeeding practices appear to be relatively
better than overall nutrition practices, as the
youngest infants (many exclusively breastfed)
have better overall nutrition status than older
groups. About 40 per cent of children age 0-5
months are exclusively breastfed and considered
to be adequately fed. Continued breastfeeding at
ages 9-11 months and related positive nutrition
outcomes were significantly higher in rural areas.
This study was not able to assess the contribution
of the Breastfeeding Policy to these outcomes.
Given the nutritional outcomes found in the
MICS, it is disappointing to see that nutritional
policy is not a higher priority in the health sector
policy. The high levels of moderate and severe
malnourishment of children 12 to 59 months,
across all geographic regions and economic
quintiles, indicate the importance of improving
nutrition education.
Health outcomes
The geography of Vanuatu, with a population
scattered throughout many islands, presents a
tremendous challenge for resource allocation,
health facility distribution and service delivery.
Data from 2005 indicate that about 20 per cent
of the population does not have access to health
services (Vanuatu National Health Accounts
team, 2007). Some health indicators show
improvements in recent years, such as improved
prenatal care and attendance at births by trained
health workers.
National laws, policies and
programmes
The Health Sector Policy 2009-2015 aims to
achieve the MDGs and improve access, quality
and capacity to deliver services. Primary health
care is the pre-eminent concern. The Ministry of
Health intends to track a number of indicators
of progress, including the infant mortality ratio,
the number and causes of maternal deaths by
province, the proportion of deliveries attended by
skilled attendants by province, under-five mortality
by cause, and the proportion of people with
access to safe water and proper sanitation in rural
communities. Other program indicators related to
tuberculosis and malaria also still remain in place.
Planning Long, Acting Short articulates four
health goals: (1) strengthening the capacity of the
Ministry of Health; (2) strengthening the delivery
of basic health services to all, in remote, rural
and urban areas; (3) vigorously controlling and
progressively eliminating malaria from Vanuatu
and (4) investing in training and supporting the
health workforce, particularly nurses in rural
facilities.
The National Children’s Policy and its Monitoring
and Evaluation Framework also set a number
of goals: developing indicators for health, water
and sanitation programmes by 2010; improving
reporting on child births and deaths; establishing
a malaria surveillance information system by
2010; and ensuring that 80 per cent of health staff
were able to conduct basic nutrition education in
schools by 2010. There were also calls for a 20
per cent increase in the health budget for youthrelated
activities in the provinces by 2011 and
a revised Primary Health Care Policy by 2010,
as well as improvements to maternal health.
Indicators for these outcomes include 80 per cent
compliance by health care professionals with
antenatal protocols by 2010, and a measurable
increase in contraceptive services linked to
immunisation and maternal health with family
planning.
The Ministry of Health Maternal and Child Health
Programme provides immunisation, antenatal
care and contraception, as well as information and
advice on parenting, child health development,
maternal health and well-being, child safety,
breastfeeding, nutrition and birth spacing. In 2006,
61 per cent of reported births took place in health
clinics and 29 per cent in hospitals, while 7 per
cent were attended by traditional birth attendants
(ADB 2009a).
As noted earlier, health as a proportion of total
national expenditure has maintained an average
share of over 10 per cent since 2001. The main
source of health expenditure is the Ministry
of Health budget. There are insufficient data
available to determine what proportion of this total
spending is directed to children’s health, but in
2005 about 3.2 per cent of Government health
spending (0.6 per cent of GDP) was directed to
reproductive health and maternal care (Vanuatu
National Health Accounts team, 2007).
A major concern is the wide disparity in outcomes
for children in different areas, especially between
urban and rural communities. This mirrors the
limited access to health services in rural areas.
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