북한 모자보건 현황 및 향후 과제

Abstract

The Government of North Korea with WHO proposed the improvement of healthcare for mothers and children as the second-highest priority for North Korea in 2009. The maternal mortality ratio in North Korea was 76 per 100,000 live birth in 2012, almost seven times higher than that of South Korea. The leading cause of maternal death was postpartum hemorrhage, which accounted for 33 percent of all mothers’ deaths. Postpartum hemorrhage is indeed a life-threatening crisis that requires a well-established emergency obstetric care (EmOC) system including safe blood. The rate of children under the age of five with chronic malnutrition stood at 27.9 percent in 2012. Infant malnutrition was more prevalent after the first six months of life, with the rate reaching a peak of 36.8 percent at 24 months of age. The proportion of chronic malnutrition was lowest in Pyongyang, at 19.6 percent, and second-lowest in South Phyongan, at 25.8 percent. On the other hand, the proportion was the highest in the three provinces of Ryanggang, Jagang and South Hamgyong at 39.6 percent, 33.4 percent, and 32.9 percent, respectively. Lack of food security has led to a high prevalence of malnutrition. The mortality rate of children under the age of five was 25 per 1,000 live birth in 2014. Of the North Korean children who die under the age of five, 51 percent died within first four weeks of their birth in 2010. Of these, 40 percent was born low birth weight (less than 2,500 grams at birth), indicating the severity of malnutrition in mothers. Therefore this paper suggests strategies approach to improve the quality of the population for the next generation unified the Korean peninsula for future initiatives. First, we need to develop of strategies and actions for reducing geographical disparity in access to maternal and child health services in North Korea. Second, we have to introduce a 'Mother and Child 1,000-Day Project' to reduce undernutrition among mothers and children in the first 1,000 days of a child’s life, from conception to two years old. Third, it is desirable to adopt a policy on access to primary health care to build local governance.