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The Status of Kenyan Children

Join the Annual Paediatric Scientific Conference to discuss the rights and deprivations faced by Kenyan children. Explore topics such as maternal health, child mortality, immunization, and food insecurity. Gain insights from experts and collaborate on solutions. Don't miss out on this important event!

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The Status of Kenyan Children

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  1. The Status of Kenyan Children Dr Khadija A. Abdalla Annual Paediatric Scientific Conference White Sands Hotel 9th -12th April 2019

  2. 2010 Kenya Constitution & the Rights of Children

  3. Enablingenvironment Generally favourable legislative and policyenvironment Kenya became a lower-middle income country in 2015: as ODA reduces there is a need to harness private sector potential to facilitate development Devolution bringing service provision closer to communities, but challenges with resources and coordination between different tiers of government Government expenditure relatively high on education, more could be done on water, sanitation, nutrition and child protection Insufficient disaggregated data to monitor children’s rights (for example, on children living in CCIs, children with disabilities, street children)

  4. Children and Adolescents – Situation 75% Children experience (at least)single deprivation

  5. Kenya Overview of children experiencing multiple deprivations in health, education, water and sanitation and nutrition rights together with deprivations in material well-being. • Reaching the most deprived children in Kenya • Composite Index on child deprivation in Kenya

  6. Geographic inequity analysis- where are children left behind? • 45% of children (9.5M) are severely deprived in more than 3 child rights • 70% of children (14.3M) are deprived of at least 2 child rights

  7. Surviving and thriving (1): maternal health • Maternal mortality fell from 759 per 100,000 in 2000 to 510 in 2015 (because of fewer maternal deaths from AIDS and from birth complications) • Maternal mortality highest in north-eastern Kenya, and particularly Mandera County • Government does not collect geographically-disaggregated data on overall maternal mortality (only on maternal mortality in healthcare institutions) Situation Analysis Kenya– UNICEF for every child

  8. Risk of maternal death in the Post-natal period Percent of maternal deaths in developing countries 0-1 day 2-7 days 8-14 days 15-21 days 22-30 days 31-42 days Day of maternal death after delivery

  9. Surviving and thriving (3): child health • Childhood mortality falling at all levels, but much slower among those aged under one month (see graph) • Progress because of • increased use of mosquito nets among children • immunization programmes • improvements in the health system including community-based system • Severe regional disparities: a child born in the former Nyanza Region is almost twice as likely to die before age five as a child born in the former Central Region. Situation Analysis Kenya– UNICEF for every child

  10. NNMR by County (KDHS 2014) Neonatal Mortality Rate Figure 2: Neonatal Mortality rates by county

  11. The most important days for newborns Daily risk of death (per 1000 survivors) Day of life LANCET Neonatal Survival Series When do the newborns die

  12. Surviving and thriving (4): immunization • Full immunization coverage down from 83.8% in 2012 to 76% in 2016; coverage in 2016 much lower in some counties (Mandera 31%, Kajiado 43.2% and TharakhaNithi 47.3%) due to: • underfunding for outreach for underserved populations • stock out of injection devices and vaccines • frequent labour disputes in the health sector •  Challenges linked to devolution of health services and reduced communication between healthcare facilities and communities to address demand side constraints. Situation Analysis Kenya– UNICEF for every child

  13. Surviving and Thriving (5): Immunization • Some counties have been able to develop strong action plans and seen significant increases in immunization rates (e.g. Kisumu 41.9% 2012 to 85.1% 2016; Turkana 38.8% 2012 to 74.8% 2016) • Kenya has introduced new vaccines: IPV, rota, measles and rubella •  significant improvements on polio and measles • Increase in number of healthcare facilities providing immunization from 5,300 to 6,900 between 2011 and 2016 • Reduced proportion of cold chain equipment not working from 17% in 2011 to 8% in 2016. Surviving and thriving (3): immunization Situation Analysis Kenya– UNICEF for every child

  14. Half of the children who have not received 3 doses of Penta are in only 12 counties (40 districts) • Reaching half of the children (or 135,000 children) not receiving 3 doses of penta will increase National coverage to 93% from 83%

  15. Surviving and thriving (6): food and nutrition • Food insecurity is a growing concern, particularly in the ASAL (vulnerability to erratic rains and drought) and informal settlements (poverty and reliance on markets for food) • Nutrition gains seen in 2014 KDHS (stunting, acute malnutrition, underweight, and breastfeeding) at risk because of 2016-2017 drought • Stunting 26%. High mainly in crop-producing regions (higher among boys, and above 40% in Kitui and West Pokot) • Acute malnutrition 4% at KDHS, mainly in pastoral regions • In February 2017, very critical nutrition situation in Turkana North, North Horr in Marsabit county and Mandera county • Complementary feeding still sub-optimal • Government capacity for nutrition improving but requires further strengthening • Research shows every $1 of investment of nutrition in Kenya will bring $22 gain to economy Situation Analysis Kenya– UNICEF for every child

  16. Enhanced Perinatal CareThe 1st Week of Life Neonatal • Essential newborn care: breathing, warming, drying, delayed bathing, clean cord care, assess LBW • Delayed cord clamping • KMC • Early intintiation of breastfeeding, the 10 steps of the BFHI • Water, sanitation, hygiene for hospital, home, health centre: handwashing: soap and water • ARV to newborn of HIV+ mother Postnatal • Active management of the 3rd Stage of Labour: misoprostol, etc. • Birth dose of Vitamin A for the new mother • Transformational education Other programmatic • Strengthened mother-baby bonding through skin-to-skin contact (KMC) • ECD • Birth Registration: child protection.

  17. What do we learn to Accelerate Child Survival and Beyond Focus on: • Equity, HSS using a multisectoral approach • Commonest Killers, Around time of delivery & HIIs to address these killers • Urgency to scale up these interventions • Balance supply and demand interventions (Community engagement and social accountability) • Innovations and Private Sector

  18. Key Evidence for Community Interventions SOURCE: Black RE, Walker N, Laxminarayan R, Temmerman M. Chapter 1: Reproductive, Maternal, Newborn, and Child Health: Key Messages of this Volume. DCP3 RMNCH 2016.

  19. HIIs with potential lives saved * Prioritized by the UN Commission on Life Saving Commodities

  20. Be part of the action for newborns #GlobalNewbornAction

  21. EndThank you

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