She explained that in most cases, the causes of child mortality are known and preventable. "These are diseases such as diarrhoea, pneumonia, respiratory disorder, anemia, contact with and exposure to HIV. In all these deaths, we really know where the problems are and what has to be done," she said. El-Halabi added that maternal mortality trends have not abated over the years. "A significant number of pregnant women attend the ante-natal care with 98 percent having skilled supervised delivery but we still have high maternal deaths. Their attendance shows that we are doing well as compared to other countries in the region," she said.

El-Halabi pointed out that majority of the deaths that are caused by hemorrhage, eclampsia, septic abortions, embolism, obstetric sepsis, HIV/AIDS, cardiac, anesthesia and diabetes are preventable. "High HIV/AIDS, whose deaths stand at 14.5 percent is still a threat with more focus needed on primary prevention. This shows that more and more HIV positive women still have repeated pregnancies," she said. El-Halabi stated that there is need to strengthen the audit system at institutional level for maternal mortality rates and newborn mortality rates. "We have a challenge of shortage or uneven distribution of trained staff and functional equipment. We also have a challenge of high coverage but poor quality of some services such as ante-natal care, post-natal care and other sexual and reproductive health services," she said. More focus is needed to address socio-cultural, behavioural and other factors contributing to maternal and newborn mortality.

"There is evidence that scaling up High Impact Interventions can significantly reduce mortality globally by 63 percent in children under the age of five if a limited number of priority and affordable interventions are implemented on a larger scale," El-Halabi stated.

She said that the Ministry of Health (MoH), under the department of Public Health, has embarked on a strategy (the Accelerated Child Survival and Development Plan 2009-2015) to deliver high impact interventions at large scale in order to reduce the deaths of children and mothers. She explained that districts have been trained on the strategic plan. She added that the districts are working on plans to re-prioritise and incorporate the High Impact Interventions. "Furthermore, we have also developed a road map that accelerates the reduction of maternal mortality.

This is yet to be disseminated and planned." She revealed that the child health high priority interventions include an increase and strengthening of communication training for health workers, strengthening complementary feeding practices, increasing coverage of Vitamin A, emphasising exclusive breast feeding, strengthening outreach services for immunisations in urban areas and farms, newborn temperature management and cord care and early care seeking for illnesses, especially pneumonia.