Rebuilding Essential Health Services September 2003

Iraq Update Rebuilding Essential Health Services September 2003 Challenges: Health conditions in Iraq deteriorated substantially under Saddam Hussein. By 2003, almost a third of the children in the south and central part of the country suffered from malnutrition. Low breastfeeding rates, high rates of anemia among women, low birth weight, diarrhea, and acute respiratory infections all contributed to a high child mortality rate. In 2002, the mortality rate for children under five was 125 per 1000. During and after the conflict, services in the health sector were disrupted and equipment, medicine, and supplies were looted. While there have been no major outbreaks of communicable diseases, the potential for such outbreaks remains a source of concern. USAID’s health goals include: • Providing emergency lifesaving services to vulnerable populations such as treatment of acute malnutrition and vaccinations. • Rebuilding and re-equipping existing health facilities. • Strengthening capacity of Iraqi health workers, including the addition of nursing and public health staff. • Reestablishing health and laboratory services, warehousing and distribution of vaccines, medicines, and medical supplies; and monitoring water quality. • Re-establishing health system monitoring and infectious disease surveillance. • Reducing the mortality rate of children under five years of age. Iraqi women and children wait to see a doctor at a primary health care center in the Al-Kargh district of Baghdad. (USAID Photo by Thomas Hartwell) USAID’s progress includes: Over 1.4 million doses of measles, tuberculosis, hepatitis B, diphtheria, whooping cough, tetanus, and polio vaccinations administered to date through monthly immunization days. 3 million oral re-hydration packets distributed to treat diarrhea. Rehabilitated 49 hospitals and clinics nationwide. 131 more are ongoing or planned. 325 metric tons of high protein biscuits distributed to malnourished children and breastfeeding mothers. Inventoried health facilities nationwide. Rehabilitated 20 hospital delivery rooms and primary health care centers serving 300,000 residents in Basrah. Established a database for tracking and coordinating international medical donations and health activities occurring nationwide. Helped prepare and distribute public service announcements regarding personal hygiene and breastfeeding. Established a surveillance system to monitor for any cholera outbreaks. Over 8000 health workers undergoing training to staff Community Child Care Units to monitor growth and malnutrition and provide supplementary feeding for vulnerable children. Above: Dental care at a primary health care center in the Al-Kargh district of Baghdad, Iraq. (USAID Photo by Thomas Hartwell) Working in close cooperation with Iraqi nationals and the Coalition Provisional Authority to improve the lives of Iraqis, USAID is devoting substantial resources throughout the country to restore critical infrastructure, support the delivery of healthcare and education services, expand economic opportunities, and improve governance. Sector Snapshot Rebuilding Essential Health Services infant and under five mortality rates in Iraq rate 180 160 140 120 100 80 60 40 20 0 1960 1965 1970 1975 1980 1985 1990 1995 1998 year Source – UNICEF infant mortality under five mortality Sector Snapshot Left: An Iraqi woman and child receive drugs from a primary health care center in the Al- Kargh district of Baghdad, Iraq. (USAID Photo by Thomas Hartwell) USAID is working with a number of international and local organizations to reduce the child mortality rate. To help Iraqis achieve this goal, 600 Primary Health Care centers and clinics will be equipped and over 140 primary Clinics will be rehabilitated. Around 21referral centers will be equipped to better provide specialized OB-GYN and emergency services. Maternal and child health care will be available to at least 50 percent of the population in permissive areas. Health information and education will be extended to 100 percent of the population in permissive areas. Essential vaccines have been purchased and distributed for 4.2 million children and tetanus vaccines for 700,000 women ensuring coverage for at least 6 months. Understanding that dysfunctional water and sanitation systems in the country also contribute to a high child mortality rate, USAID’s goal is to restore potable water supply to 60 percent of the rural population, restore water supply to 90 percent of the urban population, rehabilitate wastewater treatment plants, provide sewage treatment to 40 percent of the urban population and restore sanitary means of excreta disposal to 50% of the rural population. USAID’s work in the health sector is guided by fundamental principles: • Ensure Continued Access to Care: provision of medicines and supplies, emergency facility repairs, transportation and other vital needs. • Support the Ministry of Health: USAID supports development and implementation the Ministry of Health’s policies and health strategy. • Develop the capacity of Iraqis: USAID will train and provide resources to Iraqis in order to lay a sustainable foundation for better health care • Collaboration: USAID will collaborate with the Ministry of Health, UNICEF, WHO and other donor and implementing agencies in the country Right: An Iraqi doctor examines a child at a primary health care center in the Al-Kargh district of Baghdad, Iraq. USAID United States Agency for International Development www.usaid.gov/iraq/