Child mortality declining, but not on pace to meet Millennium Development Goal

The number of children who die before their fifth birthday dropped by 700,000 between 2010 and 2011, which is not enough to put the world on track meet the United Nation’s goal to cut deaths by two-thirds before 2015, according to a UN progress report published Monday.

Still, global health leaders remained optimistic.

“We have the leadership, partners, infrastructure and vast majority of the resources to continue making progress,” said Ray Chambers, the UN Secretary-General’s Special Envoy for Financing the Health Millennium Development Goals, in a news release. “The key is to maintain our commitment regardless of financial, political or other obstacles in our path.”

Progress toward the Millennium Development Goal to reduce child mortality has accelerated since the UN established the target in 2000, according to the report. From 1990 to 2000, child mortality declined by 1.8 percent each year. Over the next decade, that increased to 3.2 percent. Overall, since 1990, child mortality rates have dropped 41 percent.

“There have been a lot of surprising successes,” said David Oot, associate vice president of health and nutrition for Save the Children. “There is a possibility that a number of countries that one would not have expected to meet the MDG 4 and 5 goals may meet them.”

In all regions of the world, fewer children are dying. But wealthier regions are progressing faster. Eastern Asia and Northern Africa have already met the UN’s goal. Latin America and the Caribbean, Southeastern Asia and Western Asia have halved their child death rates.

The regions with the poorest countries — Southern Asia and sub-Saharan Africa — are lagging behind. Of the 6.9 million children who died in 2011, 83 percent lived in Southern Asia and sub-Saharan Africa. In 24 countries in these two regions, more than 10 percent of children die before they turn five.

The most progress has been made among children between the ages of one and five, Oot said, because interventions for many deadly diseases, like measles and polio, are logistically simpler to address.

While overall, child mortality rates have dropped 2.5 percent per year since 1990, infant death rates have declined by just 1.8 percent. Now, 43 percent of children who die do so within the first month of life.

“Many of the relatively easier to implement interventions can be planned because they are preventative in nature,” Oot said. “For example, immunization. If you want to ensure that kids are immunized, you can plan to deliver those immunization services.”

The majority of infants, though, die because they aren’t breathing when they are born, they get an infection or they are born too small. To solve these problems, health workers can’t just swoop into a village two times in a year, Oot said. Countries must develop stronger health systems.

“The most critical time is right when a newborn is delivered,” Oot said. “You need to have someone present who is trained and skilled.”

For similar reasons, treating diseases like pneumonia and diarrhea, which account for a big share of under-five deaths, has proven challenging, Oot said.

“In many countries, people don’t have easy access to a health worker who is trained and supplied to treat the causes of illness,” he said. “Antibiotics are not routinely and reliably available in sufficient quantities. Parents may not recognize the signs of severe illness or may delay seeking care until it’s too late.”

With relatively simple interventions, Oot said it is possible to make significant progress toward the UN’s goal before the December 2015 deadline. Many newborn lives could be saved, for example, by simply teaching mothers to give their babies “kangaroo care,” keeping them warm with skin-to-skin contact, and emphasizing the importance of early and continuous breastfeeding.

“We have effective, low-cost interventions that we just haven’t scaled,” he said.
Regardless of what happens, though, Oot said the Millennium Development Goals have been “hugely important” in motivating political leadership to take action on child mortality.

“Even if we fail to meet the 2015 deadline, we will have made remarkable progress in reducing under-five mortality,” he said.