Photo: Supplied/ NZ Human Rights Commission
A development specialist says there is an urgent need for action to reduce mortality rates for children under five in Kiribati.
In 2015, the country recorded 56 deaths per 1000 live births, more than twice the regional average of 27 deaths per 1000 live births, and second only to Papua New Guinea.
This compares to the Cook Islands' 8 deaths, according to the 2016 UNICEF State of the Worlds Children's report.
Rachel Nunn recently co-authored an article with the Kiribati health ministry team regarding the country's high infant mortality rate.
She said it is unacceptable, particularly given the number of international aid organisations active in the country.
Seh described the situation as: "extremely stark, extremely concerning".
Child mortality rates in Kiribati 'unacceptable' - consultant
"The target under the Sustainable Development Goals...is 25 [deaths], so Kiribati is currently double that.
Kiribati recorded 56 deaths per 1000 live births in 2015. It's a figure more than twice the regional average of 27 deaths per 1000 live births, and second only to Papua New Guinea. Photo: Supplied
"I think here in Australia, I think we might be around one or two. I think New Zealand might be around two.
"When I started speaking with the Minister for Health and Medical Services in Kiribati, I was really shocked to learn just how far off track Kiribati is to meeting the Sustainable Development Goal target for reducing child and infant mortality."
Nunn said it is hard to say what the driving forces are behind the numbers.
"It doesn't appear to be lack of investment," she noted.
"Part of the reason we wanted to draw attention to this issue is because many donors, New Zealand included, and UN agencies, other multilateral agencies, UNICEF, World Health Organization, UN Population Fund and others have been present in Kiribati for decades.
Rachel Nunn Photo: supplied
"I think, in my opinion, one of the key factors is that the most pressing health care needs in Kiribati - which are maternal and child health services - haven't been addressed as much as other health issues have received resources."
She said one of the things the health system lacks compared to other Pacific countries is community outreach.
"Health seems to start and stop at facilities Kiribati. So once you get to a health facility or you get to a hospital, you may be able to access health services, but there's no community outreach. There's no meeting people where they are."
Nunn said a child community nursing outreach program is due to launch next year, with support including from Plunket in New Zealand.
"But one key problem is the recruitment of nurses, and this isn't a problem just in Kiribati.
"Challenges with the health workforce exist across the region. Recruiting the required number of nurses, but also ensuring that they're trained to an appropriate standard, is essential, because it's nurses that are at the front line of maternal and child health."