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2011-01-28

Algeria links infant mortality to poor prenatal care

By Walid Ramzi for Magharebia in Algiers – 28/01/11

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Over 36,000 children under one year of age die annually in Algeria, the National Statistics Office (ONS) announced at a Tuesday (January 25th) seminar.

Around 16,000 of them die at birth in what the ONS described as a "terrifying" situation that has lasted for 5-6 years. The study presented at the Algiers event stressed the need to draw up a national plan to reduce the infant mortality rate, which is one of the indicators of development and the fourth UN Millennium Development Goal (MDG).

The seminar was held as part of a project to support the implementation of the Algeria-EU Association Agreement and brought together both Algerian and European experts. The attendees discussed the causes behind the high number of child fatalities and made suggestions on how to decrease the rate.

Dr Djamil Lebbane, director of the National Plan of Newborns, called for a review of the law on birth certification, stressing the need to provide good care at all stages of pregnancy and to pay attention to training in this field.

He noted the shortcomings that prevent Algeria from moving from 24.5 deaths per 1,000 live births to 18 deaths per 1,000 live births by 2015 in order to attain the MDG.

"The child mortality rate, which was recorded in the 1970s and estimated at 170 deaths per 1,000 live births, was the result of bad environmental conditions at that time," Lebbane said.

In the past years, however, infant deaths have mainly resulted from "lack of good health care for mothers during pregnancy", he noted.

Remote areas in particular suffer from scant supplies in health centres, low level of care and lack of medical professionals.

Messaouda Chader, who is in charge of the women's health file at the National Economic and Social Council (CNES), stressed the need to "follow up on and monitor pregnancy at the primary health care centres, and for university health institutions to take care of risky pregnancies".

Public authorities need to establish a strategy to "take care of the training of midwives", Algerian National Midwives' Union chief Akila Guerrouche urged.

She pointed to a severe shortage in "this important specialisation that takes care of following up on and monitoring pregnancy and helping with the birth, especially in remote areas that lack specialised doctors in gynaecology, obstetrics and paediatrics."

The attendees from different countries shared experiences and advice on how to tackle the problem.

"The EU is prepared to provide its support to the Maghreb countries that are geographically near it, by presenting its successful experience in combating child mortality and improving health conditions," said EU representative Gye Desplanques.

The French demography expert presented the European countries' strategy and pledged that the Union "will work to help Algeria establish real data so that it may make progress in combating child mortality."

Algeria faces an acute shortage of experts in paediatrics and maternity. A report issued by the Ministry of Health last July showed that Algerian hospitals suffer from an estimated deficit of 900 doctors, including 541 gynaecologists and obstetricians, as well as 389 paediatricians.

Last July, Algeria signed an agreement to bring in 181 Cuban doctors to help reduce the child and maternal mortality rates in the country.

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    abdou 2012-2-28

    Infant mortality is increasing for several reasons, namely the lack of quality health care, the lack of resources and the lack of competent staff. I will take this opportunity to give an example. Not so long ago, a rural maternity ward at the EPSP in Bouinan in the wilaya of Blida staffed nurses who managed male midwives, but had not doctors, no oxygen, no heating and no electrical generator – all with the DSP (the head of the wilaya) knowing about it. And it has been this way since 2008 despite the death of several infants and women. This is the example of a maternity ward 36 kilometres from the ministry, so how is it in Ilizi or Salah?

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    ابراهيم 2011-6-26

    May be some of the underlying causes of the increase in child mortality - in addition to the above – are: 1- incompetence of midwives and some even taking bribery to assist pregnant women in labour. Some death cases were reported either of the pregnant women or the new-born as a result of the laziness of mid-wives in doing their jobs. 2- Low wages of physicians which was reflected by a severe shortage in public institutions of physicians and specialists and their migration abroad or to private clinics. 3- Most cases of child death at birth or immediately after birth are illegitimate children. This requires fighting vice by all means.

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    Nasima 2011-1-30

    This is a very complex issue, but not because the causes are unknown. It is complex because resolving it requires a multifaceted approach. The article is correct that prenatal care is deficient. However, there is a much larger explanation. First of all, our country is poor and it is becoming poorer and poorer. In a word, the cost of basic commodities is increasing faster than our incomes. We cannot afford the proper nutrition. If the price of a potato has increased threefold in the last two years, you can imagine that the cost of meat, milk and vegetables, which contain many of the necessary vitamins and minerals, is not too far behind. Our diets are turning more and more to grains, which are filling and provide energy, but do not provide the necessary proteins, fats, minerals and vitamins that a foetus needs to develop healthily. Moreover, healthcare in general is too expensive. Ideally, the government should pay in full for healthcare costs for anyone who is pregnant or who requires emergency treatment or long-term hospitalisation and the government should pay 70-90% of the healthcare costs for minor illnesses. This is hardly the case here in Algeria, especially since doctors, who are quite underpaid, have come to expect money under the table, elevating the costs beyond what official statistics show. And our hospitals lack the proper equipment and properly trained staff. Lastly, pregnant women lack an education about what proper nutrition and proper healthcare means, often times being led to use harmful or neglectful so-called traditional remedies for problems that require a doctor.

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    Essid 2011-1-29

    I believe that the National Statistics Office (ONS) has not adequately explained the issue. The ONS has not made any attempt to provide us with yearly reports on the median household income, which is the most important indicator in assessing economic development at the level of the household. That said, the UN provides statistics on the ratio between the richest 10% and poorest 10% of the country (ratio 1) and the same for the 20% markers (ratio 2). Both of these numbers are increasing and ratio 1 is increasing faster, which is to say not only is the gap between the rich and the poor getting larger, but also the wealth of the nation is being consolidated into the hands of a few people. Using an estimate of the median household income, I found that this number is roughly $5400 dollars per household. But most households have 5.2 people in Algeria, so the per capita median household income is $1038. Meanwhile, the per capita GDP is $4160. Algerians are only enjoying one quarter of the country’s wealth, compared to Sweden, which has the world’s best social programmes and whose people enjoy one half of the country’s wealth. Moreover, the median household income is only increasing at 0.4% compared to the 1.4% for the per capita GDP. In other words, the country’s new wealth is not going to the people. At the same time, the cost of living (according to the price of milk, bread, eggs, meat, gasoline, electricity, gas, water, sanitation, rent, etc.) increased by 7.8% last year. In conclusion, infant mortality is one the rise because income is increasing at 0.4% and the cost of living is increasing at 7.8%, so pregnant women cannot afford to eat nutritiously or buy prenatal vitamins.

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