Strategies that can help reduce the number of children who die
before their fifth birthday were highlighted at the release of
UNICEF report, "The State of the World's Children 2008: Child
Survival", in Geneva yesterday.
Though recent data show under-five mortality rate has fallen,
the report goes beyond the numbers to suggest actions and
initiatives for further progress.
World Health Organization's (WHO) China representative Hans
Anders Troedsson summarizes the report in four key points: "It is
progress. We've seen progress. And we see a reduction in children's
death across the world. But it is not enough. We still have too
many children dying every year - 9.7 million. It's a staggering
figure.
Displaced Afghan children stand in the cold in front of an
abandoned building, which is their home in Kabul. Cold weather and
heavy snow has exposed children to avoidable diseases and killed
more than 100 people and over 35,000 heads of cattle across
Afghanistan this month alone. Reuters
"We could prevent the majority of deaths, but we just let them
happen. It is unacceptable. We have the knowledge and power to
prevent and save at least two-thirds of these 9.7 million children.
It's time to turn this knowledge into real action. We need to put
resources to prevent the deaths of both mothers and children."
How can we do that? "Community-level integration of essential
services for mothers, newborns and young children, and sustainable
improvements in national health systems can save the lives of many
of the more than 26,000 children under five who die each day," says
UNICEF Executive Director Ann M. Veneman.
"The report describes the impact of simple, affordable
life-saving measures, such as exclusive breastfeeding,
immunization, insecticide-treated bed nets and vitamin A
supplementation, all of which have helped reduce child deaths in
recent years," Veneman says.
An analysis of the report shows that far more needs to be done
to increase access to treatments and means of prevention to reduce
the devastating impact of pneumonia, diarrhea, malaria, severe
acute malnutrition and HIV. The challenge is to ensure children
have access to a continuum of healthcare, backed by strong national
health systems.
More money has to be spent on health systems "if we are to meet
the child health targets set by the UN", says WHO Director-General
Margaret Chan. "Innovative programs in many countries show that an
integrated approach where each child is reached with a package of
interventions at one time can bring immediate benefits."
New information in the UNICEF report has been drawn from
household survey data, as well as material from key partners,
including WHO and the World Bank. It provides examples of
successful initiatives, such as the Accelerated Child Survival and
Development Initiative, which provides integrated primary care to
impoverished households in sub-Saharan Africa, and the Measles
Initiative - a global campaign that has helped reduce measles
deaths by about 68 percent worldwide, and by more than 90 per cent
in Africa, since 2000.
The approach to child survival that the report advocates would
see the best disease-specific initiatives combined with spending on
strong national health systems to create a continuum of care for
mothers, newborns and young children that extends from home to the
local clinic to the district hospital and beyond.
The report emphasizes the need to involve local communities that
generate the necessary demand for quality healthcare. Their
engagement is vital if marginalized and remote populations are to
be reached.
Nowhere is the need for life-saving strategies more apparent
than in sub-Saharan Africa where, on an average, two in every 12
children die before their fifth birthday. In 2006, almost half of
all under-five deaths occurred in sub-Saharan Africa, even though
less than a quarter of the world's children live there.
The report provides information on a strategic framework
developed by UNICEF, WHO and the World Bank - at the invitation of
the African Union - to help African and other countries reduce the
number of mother and child deaths. The framework calls for:
Good data to inform of policies and programs;
A shift to combine disease-specific and nutrition interventions
in integrated packages to ensure a continuum of care;
The mainstreaming of maternal, newborn and child health and
nutrition into national strategic planning processes to scale up
and strengthen health systems;
Improved quality and increased, predictable financing for
strengthening health systems;
Political commitments to approaches that provide a continuum of
care; and
The harmonization of global health programs and
partnerships.
"Child survival is not only a human rights imperative, it's also
a development imperative," says World Bank's Human Development
Network Vice-President Joy Phumaphi. "Spending on children's and
their mothers' health is a sound economic decision and one of the
surest ways for a country to set its course towards a better
future."
(China Daily January 25, 2008)
