The U.N. Children's Fund says the situation of children in North Korea remains generally bleak, but the presence of humanitarian agencies is helping to make improvements.
A survey conducted in 2002 shows 42 percent of North Korea's children below seven years of age are chronically malnourished. But UNICEF reports malnutrition rates since have been reduced. It says progress also has been made in bringing immunization coverage up from 35 percent in the mid-90s to more than 75 percent now.
UNICEF's representative in North Korea, Pierrette Vu Thi, says UNICEF and the World Food Program, along with North Korean officials, will conduct a new nutritional survey at the end of the year to assess the status of children.
While improvements have been made, Ms. Vu Thi says, the situation of children is still precarious.
"Schools have little heat," she said. "Hospitals have limited equipment. Children get very sick from diarrhea and respiratory infections. There is a lack of electrical power which is having effects on everything from factory employment to the supply of clean water and we are also concerned that the current breaks in the food pipeline could compromise some of the results that we have obtained for children over the past few years."
The UNICEF representative notes during the past six months, international food aid to North Korea has been irregular. Japan cut off its food assistance altogether, and South Korea and the United States have periodically reduced shipments.
The resulting shortfall has forced the World Food Program to cut food rations for three million people, almost half of its beneficiaries.
Ms. Vu Thi says children are the biggest victims of the reductions.
"It is these sort of ups and downs that are very detrimental to the work that is being done for children and to the relief work and that is a cause of concern for us in the sense that it could have a negative impact on the results we have managed to achieve for children in other sectors," said Ms. Vu Thi.
But she says she is encouraged by signs of goodwill shown by the North Korean government. One such sign, she says, is that the government allowed aid agencies to go to Ryongchon, the site of a devastating train explosion in April, within 48 hours of the accident.