The number of homicides and possible homicides of young children in Hawaii has declined in recent years, but the death of 3-year-old Marley Makanani on Sunday has renewed concern about the future of programs intended to protect children from abuse.

State Rep. John Mizuno, chairman of the House Human Services committee, said state budget cuts to programs to prevent child abuse  — including substance abuse counseling, parenting education and in-home support services — could reverse the decline in child homicides.

“It is a very big concern,” Mizuno said. “These programs are designed to prevent child abuse, and I can say with absolute certainty that there’s a real concern about a rise in child abuse cases with these cuts.”

The Honolulu Medical Examiner’s Office ruled Makanani’s death a homicide after she sustained brain damage from a near drowning, head trauma and abdominal injuries.

The girl’s uncle, Ezekiel Wakinekona, 37, of Hawaii island, has been charged with manslaughter in Makanani’s death and two counts of abuse for injuries to Makanani’s sisters, ages 2 and 6.

All three girls had lived with Wakinekona for about two months.

Wakinekona was being held on $12,100 bail at the Hawaii Community Correctional Center and is scheduled to appear in court today.

The number of homicides and possible homicides among children under age 2 — measured in five-year increments from 1991 to 2010 — fell by half, from 18 to nine, according to the state Department of Health’s Injury Prevention and Control Program.

There were no homicides or possible homicides of children under 2 in 2010, the last year data was available.

For older children, the number of homicides and possible homicides for those ages 2 to 5 was mixed, but still encouraging.

There were eight homicides from 1991 to 1995, dropping to two from 1996 to 2000, according to the Department of Health’s Injury Prevention and Control Program.

But there were four homicides and two possible homicides in the period from 2001 to 2005.

The numbers then dropped again to two homicides and one possible homicide from 2006 to 2010.

“It’s a sign that we’re moving in the right direction, but we should never stop working until we get the number to zero,” said state Rep. Kymberly Marcos Pine

(R, Ewa Beach-Iroquois Point), a member of the House Human Services committee. “We need to let residents know that state leaders will do everything we can to protect our children.”

Annabel Murray used to represent foster children and now practices family law with a focus on child custody evaluations and mediation through the Children’s Law Center.

She said she believes that many of Hawaii’s child homicides are the result of abuse, such as shaken baby syndrome, “which is incredibly hard to prosecute. In general, that’s how the little ones are dying.”

According to court affidavits, Wakinekona found Makanani partially submerged in the bathtub Friday. The child’s breathing was restricted.

Makanani was in a coma from the near-drowning and physical abuse. While she was being treated in an emergency room, a doctor noticed several bruises on both legs and a laceration on the left hip, consistent with signs of child abuse.

Makanani’s older sister was examined at Kona Community Hospital and found to have numerous bruises in different stages on her entire rear end, legs and left ear.

She also had a lump on the back of her head and complained of pain to her left rib cage, saying at one point “Uncle Eze did this to her,” court documents said.

Her younger sister had a cut lip and facial marks.

Tiffany Ching, whose cousin is the father of the three girls, saw Makanani on Oahu after she had been airlifted to Kapiolani Medical Center for Women & Children.

Makanani had bruises all over the front of her body and burns on her chest, face, arms and the underside of her toes, Ching said.

She also had scrapes on her face, and it appeared some of her hair might have been pulled out.

Ching has not seen the girls’ parents since the family gathered at the hospital.

The girls’ mother — Tasha Nihau-Lindsey — left “a lot of holes” in her story, Ching said on Wednesday. “She said she left them with her cousin, then she got the call that Marley got hurt. We have a lot of unanswered questions: What, why and how?”