A new report says the lives of millions of young children could be saved each year if basic medical care and medicine are made available to the poor. Douglas Bakshian has more from Manila.
The report by the U.S. organization Save the Children says about 10 million children die every year from easily preventable and treatable diseases. About six million of those could be saved with basic services.
Those services include immunizations, antibiotics, skilled care at childbirth and treatment for diarrhea and pneumonia.
The report says that more than 200 million children under age five lack basic health care. Of the 55 developing nations evaluated, the Philippines, Peru, South Africa, Indonesia and Turkmenistan do the best job of providing basic care to children under five.
Countries doing the worst are the Laos, Yemen, Chad, Somalia and Ethiopia.
The Philippines comes out on top in the survey, with 31 percent of children under five missing basic care. Ethiopia is at the bottom, with 84 percent lacking the basics.
Doctor Stephanie Sison of Save The Children in Manila, says effective community health workers are the key to the success in the Philippines.
"We have been able to mobilize many community health volunteers," she said. "These are women and men who may not be highly educated but they were trained by the Department of Health, and by NGO's and the local government. They live in the community so they're able to educate mothers directly. Mothers know to come to them when their kids are sick and they're able to identify which children need to be referred to health centers."
Sison says one of the biggest risks for the poor is not being able to get preventive services such as immunization and proper nutrition. In addition, many people do not recognize when a symptom, such as a fever or a cough, indicates severe disease, so they may not get treatment until an illness is advanced.
Also, because they can not afford the cost, many families put off treatment for a child until they have no choice.
"There is reluctance to seek professional care in a clinic because they are looking at how much it would cost just to get to the clinic," she said. "And then once they get there people will be asking them for money to be able to treat their children. So it's usually when you can really tell that the child is very, severely ill and near death. That's when they usually get enough motivation to bring the child to a health center."
In the Philippines, she says, families have to pay 44 percent of general health costs. So the very poor suffer and need free medicines.
Sison says it is up governments all over the world to provide basic health care for children, especially for poor children.
The report says the inequity between rich and poor is graphically illustrated in Peru, where the poorest children are 7.4 times more likely to die than the richest. However, based on national averages Peru has relatively high standards of health care for children.
The 55 nations surveyed in the study account for nearly 60 percent of the world's population of children under five, and 83 percent of all child deaths. India has the highest number of children without adequate care - 67 million, or 53 percent of those under five. Nigeria is second, with 16 million children suffering, or 66 percent.
One section of the report also identifies the best and worst places to be a mother and child in 146 countries. Sweden takes top place while Niger is in last place.
