The Multiple Indicator Cluster Survey (MICS), carried out by the Government of Iraq with the full participation of the United Nations Children's Fund (UNICEF), looked at a range of health, nutrition and education issues - from immunization and safe water to school enrolment rates. The survey, which covered a total of 6,375 households throughout southern and central Iraq last year, was followed by two further nutritional surveys in April 1997 and in October/November 1997, covering the same governorates, with the participation of UNICEF and support from the World Food Programme.
The most alarming results are those on malnutrition, with 32 per cent of children under the age of five, some 960,000 children, chronically malnourished - a rise of 72 per cent since 1991. Almost one quarter (around 23 per cent) are underweight - twice as high as the levels found in neighbouring Jordan or Turkey.
"What we are seeing is a dramatic deterioration in the nutritional well-being of Iraqi children since 1991," says Philippe Heffinck, UNICEF Representative in Baghdad. "And what concerns us now is that there is no sign of any improvement since Security Council Resolution 986/1111 came into force."
The results come on the eve of the publication of the UN Secretary-General's 180-day report on the impact of Security Council Resolution 986/1111 (commonly known as oil-for-food) which came into effect in December 1996.
All three surveys found that around one quarter of children under the age of five were underweight, with no improvement since the first survey was carried out in 1996. There was little or no improvement in the figures for underweight infants in 1997, with 14.6 per cent of infants underweight in October, compared to 14.7 per cent in April.
Some areas have been particularly badly hit, with the MICS results from the Governorate of Missan, in the east of the country, showing chronic malnutrition in almost half the children under the age of five.
There is also concern at the low primary school enrolment rate across southern and central Iraq which, according to the MICS, stands at 73 per cent of children aged 6 to 11 years. This suggests that around one quarter of primary school age children are not in school at all.
"It is clear that children are bearing the brunt of the current economic hardship," says Philippe Heffinck. "They must be protected from the impact of sanctions. Otherwise, they will continue to suffer, and that we cannot accept. " The MICS also reveals serious problems in rural areas, where only 50 per cent of people have access to a water supply from a network, public tap or well, compared to 96 per cent of people living in towns and cities. Only 34 per cent have a sanitary type of latrine, compared to 97 per cent of the urban population. Immunization rates are some 10 to 15 per cent lower in rural areas and the survey found similar gaps in the proportion of rural children who have received Vitamin A supplements and on the numbers entering primary school.
Unexpectedly perhaps, the rural-urban division evaporates when it comes to malnutrition, with children no more malnourished in the countryside than in the towns and cities. Ready access to locally produced food and higher incidence of breastfeeding provide at least some protection for rural children who, according to the survey, lag behind in so many other areas.
The Multiple Indicator Cluster Survey does reveal some positive, as well as negative, trends. Around half of all children surveyed had received at least one dose of Vitamin A, and immunization coverage remains adequate, with at least 80 per cent of children aged one to two years immunized against measles. The survey reveals no significant gender disparities between boys and girls in any of the areas examined.
UNICEF is working throughout Iraq to tackle child malnutrition by organizing training workshops for nutrition workers and promoting the benefits of breast-feeding. UNICEF also supports growth monitoring in 1,000 Community Child Care Units and therapeutic feeding in 60 Nutrition Rehabilitation Centers.
