United Nations Children's Fund (New York)
Ellen Johnson Sirleaf
22 January 2008
document
According to the Women's Commission for Refugee Women and Children, based in New York, a society's treatment of children is a reflection of its worth. In the case of post-conflict Liberia, the country's fate is inextricably tied to the fate of its most vulnerable population. The survival of children in Liberia is a fundamental underpinning of our development agenda because it shapes how we progress as a nation.
The impact of conflict on the survival of Liberia's children is stark: At 235 deaths per 1,000 live births, Liberia's underfive mortality rate is the fifth highest in the world; its infant mortality is the third highest and maternal mortality the twenty-first highest. Maternal mortality trends are an important benchmark for achieving Millennium Development Goal 4 and other health-related MDG targets for children because maternal health bolsters child survival – and without a sound policy on women's development and empowerment, children in any post-conflict situation will ultimately be neglected reminders of a nation's failures.
It is disconcerting that, despite all the improvements in modern medicine, children under five in Liberia still perish because of malaria (18 per cent of total deaths), diarrhoea and vaccine-preventable diseases, such as measles, neonatal tetanus, diphtheria, whooping cough and acute respiratory infections. Underlying these conditions are chronic malnutrition and vitamin and mineral deficiencies, which are common in children under five. Fifty-one per cent of the population is food insecure. HIV infection in pregnant women is estimated at 5.7 per cent in 2007 compared to 4 per cent in 2004 – another example of the impact of 15 years of conflict and the structural problems in the economy that disadvantage women and girls.
Access to basic health care is improving, but coverage and distribution remain inadequate, especially in the rural areas. The task of achieving universal access is enormous, owing to such devastating effects of armed conflict as the destruction of health infrastructure, low availability of trained health workers and low public sector resources for health. The Government of Liberia is making strenuous efforts to significantly reduce child morbidity and mortality by 2011. A national health policy and plan of action leading to universal access have been developed and are being implemented, while a national strategy and plan to accelerate child survival has been developed. A strategy and plan of action to serve as the 'road map' to reducing maternal mortality are under way. Peace has allowed immunization for young children and pregnant women to increase significantly.
The challenges remain, however.
Safe water, essential for survival, had been available in the large population centres, including Monrovia, Liberia's capital, prior to the conflict, but most of the piped systems were destroyed. Currently, other than Monrovia, where the piped water system is being gradually rehabilitated, urban centres are without access to pipe-borne water. Children cannot survive, much less thrive, without safe, potable drinking water, which stands at a low 32 per cent currently in Liberia.
Health and education are the pillars of any sound child survival strategy. The two are opposite sides of the same coin and must be tackled simultaneously in Liberia to ensure MDG 4. Illiteracy is high in the population, estimated at 68 per cent (male 55 per cent and female 81 per cent); literacy and education, especially of girls, are closely associated with improved child survival rates. The 2006 Girls' Education Policy aims to provide education to all girls. In order to ensure child survival, girl children also need to be protected. The conflict left many young girls pregnant or already mothers. Special efforts are needed to protect adolescent girls from sexual exploitation and abuse, from pregnancy and AIDS, both to ensure they enjoy their own rights to survival and to guarantee the rights of their children.
There needs to be renewed momentum around the issue of child survival, and Liberia is leading that clarion call. We want to ensure that our children move beyond survival and into a phase of development that enables them to thrive and transform into productive citizens.
Ellen Johnson-Sirleaf is President of Liberia. This article was written for The State of the World's Children, published by the United Nations Children's Fund in Monrovia on January 22.
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