Those who suffer the most from the prevailing situation are children and women. Diarrhoeal disease-related dehydration, respiratory infections and malaria, account for more than one half of all child deaths. Neonatal tetanus and other birth-related problems also contribute significantly to infant mortality, while measles and its complications result in many deaths during outbreaks. Recent localised surveys show immunisation coverage to be less than 30 per cent. Children's vulnerability to infectious diseases is aggravated by their poor nutritional status.
Maternal mortality is estimated to be the third highest in the world.
The underlying causes include limited availability of trained midwives and referral services for emergency obstetric care. Malnutrition is a chronic problem in all areas, and appears in acute form in areas of drought, flood or localised conflict. Poor infant feeding practices and infectious diseases are the main causes of malnutrition. There are good reasons to believe that iron deficiency anaemia is a serious problem and that clinical and sub-clinical vitamin A deficiency may contribute to both child and maternal morbidity and mortality. It is also suspected that iodine deficiency is a public health problem.