Basic care for infants and children includes promoting and supporting early and exclusive breastfeeding (see indicators on “Infant feeding” in Chapter 4) and identifying conditions requiring additional care and counselling on when to take an infant and young child to a health facility. There are several cost-effective preventive and curative services for leading causes of childhood morbidity and mortality. These comprise vitamin A supplementation, measles vaccination, oral rehydration therapy (ORT) and zinc supplementation for severe diarrhoea, and antibiotic treatment for acute respiratory infection (ARI) (Bhutta et al., 2013[1]).
As a safe and effective vaccine is available for measles, its coverage has been used to monitor the progress towards achieving the SDG target 3.2 to end preventable deaths of newborns and children under 5 years of age by 2030. This vaccine is also considered a marker of access of children to health services.
Access to preventive care varies across Asia-Pacific as shown by children receiving two annual high-dose vitamin A supplementations (Figure 5.11, left panel) and vaccination coverage (see indicator “Childhood vaccination” in Chapter 7). Access to vitamin A supplementation is markedly low in the Papua New Guinea, Philippines, Lao PDR and Solomon Islands with less than 40%, whereas Bangladesh, Nepal, Myanmar and DPRK have nearly complete coverage.
Less than one child in four with diarrhoea in the Philippines, Viet Nam, Mongolia, Indonesia and Lao PDR, and less than one child in ten with diarrhoea in Pakistan, Cambodia, Papua New Guinea and Myanmar, received oral rehydration solution and zinc supplement (Figure 5.11, right panel). Furthermore, less than half of children with diarrhoea received continued feeding and ORT in Pakistan, the Philippines, India, Papua New Guinea and Cambodia. The coverage was as high as 71% in Mongolia, DPRK and Thailand (Figure 5.12, left panel).
Access to appropriate medical care for children with ARI can also be improved in many countries and territories in the region. Although at least three‑quarters of children with symptoms are taken to a health facility in most countries, in many less than half of them receive antibiotic treatment (Figure 5.12, right panel). There is a correlation between treatment coverage for diarrhoea and ARI. Antibiotic treatment for ARI is particularly low in Myanmar, the Philippines and Pakistan, where the treatment for diarrhoea is also low. This suggests a need to expand access to care to treat leading causes of child mortality in these countries and territories.
