Children's right to health

careUrbanisation leaves hundreds of millions of children in cities and towns excluded from vital services, UNICEF warns in its annual report The State of the World’s Children. The 2012 issue focuses on children living in cities. 

An increasing number of children living in urban slums and shantytowns are among the most disadvantaged and vulnerable in the world, deprived of the most basic services and denied the right to thrive. Infrastructure and services, including health services, are not keeping up with urban growth in many regions and children’s basic needs are not being met. While urban areas are home to the majority of modern health facilities, too many children who live in the vicinity are nonetheless deprived of even rudimentary services. Inadequate living conditions are among the most pervasive violations of children’s rights, the report states. The hardships children endure in poor urban areas may include hunger and ill health; substandard housing; poor access to water and sanitation; and insufficient education and protection. Nearly 8 million children died in 2010 before reaching the age of 5 – most from pneumonia, diarrhoea or birth complications.

The report lists a number of health-related problems, which are summarised below:

  • Lower levels of immunization lead to more frequent outbreaks of vaccine-preventable diseases in vulnerable communities such as  slums and informal settlements. 
  • The number of undernourished children is increasing faster in urban than in rural areas. Even apparently well fed children – those who receive sufficient calories to fuel their daily activities – can suffer the 'hidden hunger' of micronutrient malnutrition: deficiencies of such essentials as vitamin A, iron or zinc. Without these micronutrients, children are at increased risk of death, blindness, stunting and lower IQ. Poor nutrition contributes to more than a third of under-five deaths globally.
  • Every year, polluted indoor air is responsible for almost 2 million deaths among children under 5 years of age. The use of hazardous cooking fuels in badly ventilated spaces – common in low-income settings – is among the factors contributing to the problem. City life also exposes children to high levels of outdoor air pollution.
  • The outdoor world also represents another threat to children – one heightened by a lack of safe play spaces, sidewalks and crossings: the World Health Organization (WHO) estimates that road traffic injuries account for 1.3 million deaths annually worldwide.
  • Recent data suggest that new infections with HIV are decreasing. Despite this progress, about 1,000 babies a day were infected through mother-to-child transmission in 2010. A further 2,600 people aged 15–24 were infected per day that year, mainly as a result of unprotected sex or unsafe injection practices. HIV prevalence remains generally higher in urban areas.
  • Even though urban dwellers in general enjoy better access to drinking water and sanitation than people living in rural areas, access to (affordable) safe drinking water can be low in slums. Sanitation also remains a major issue – the number of people practising open defecation rose by 20 per cent between 1990 and 2008. Where public sanitation facilities exist, they are frequently overcrowded, poorly maintained and contaminated; special provisions for children is rare. Congested and unsanitary conditions make urban slums particularly high-risk areas for communicable diseases. Without sufficient access to safe drinking water or an adequate water supply for basic hygiene, children’s health suffers.

Access State of the World's Children 2012: Children in an Urban World

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