Fewer under-fives are dying. Let’s celebrate: then let’s bring that figure to zero

Kinfu stands in front of Maicheka school with his daughter...
Kinfu, who lives in a small rural village in the Tigray region of Ethiopia, with his youngest daughter, age 4 (Amerti Lemma/Save the Children)

Today the unsnappily-named UN Inter-agency Group for Child Mortality Estimation has put out some very snappy news indeed:  the rate at which under-five children are dying is falling faster than in any time over the past two decades.

Or to put it more succinctly: children in poor countries now have a better chance than ever of reaching their fifth birthday.

This is excellent news, which we should celebrate. The worldwide under five mortality rate has almost halved since 1990, dropping from 90 deaths per 1,000 live births to 46 in 2013.

We should also congratulate those governments whose improved policies have brought about this change.

Stronger health systems have made the difference

Countries like Ethiopia and Malawi have invested in stronger health systems, meaning that more doctors, midwives, nurses and community health workers are paid and trained, and equipped clinics are within reach of the poorest inhabitants, in both the geographic and the financial sense (ie close enough, and without cash payments deterring users).

There are some interesting and important details underneath that happy headline:  rates of reduction in eastern and southern Africa – not regions that you’d typically associate with stellar development performance – are very high.

Also worthy of note is that, outside of Sub-Saharan Africa, the gap in the rate of death between the poorest and the richest households is finally reducing.

We now need to see this happen in sub-Saharan Africa, where so many child deaths happen and where it’s the most disadvantaged who miss out on progress.

 

But – bad news on newborns

But there’s also some very bad news from the Inter-agency Group: rates of newborn deaths are falling more slowly than those for other under-five children.

Day-old Zoe, born at the Kopsiro Health Centre in Bungoma - one of the counties with the highest numbers of maternal and newborn deaths in Kenya. (Tugela Ridley/Save the Children)
Day-old Zoe, born at the Kopsiro Health Centre in Bungoma – one of the counties with the highest numbers of maternal and newborn deaths in Kenya. (Tugela Ridley/Save the Children)

This is an unacceptable situation that we highlighted earlier this year. Save the Children calculated that 2 million newborn babies could be saved every year if skilled, well equipped birth attendants (such as a midwife) were available to assist every woman during her delivery.

An astounding 40 million women round the world still give birth every year without trained help.

So both the progress made, and that left to achieve, should be a clarion call to heads of state who next year will negotiate a new set of global development goals, which will then need to be adopted by national governments.

We now know that ending all preventable child deaths is possible: with the right policies and funding, we really can get there.

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Comments

  • It is the responsibility of richer countries, as well as the poor ones, to make sure that every woman in poorer countries have safe pre-natal care and a safe environment for the delivery of their babies. There should be state education for all children too, and safe drinking water and sanitation for all people.

    I could write a lot more about the inequality many face, including other species, but it would detract from the focus on children`s well being.

  • I fear for the grim fate of all newborns on this planet and wonder what kind of ravaged, polluted, and resourceless world they will face when and if they reach adulthood. I also fear they will justifiably curse our greedy selfish generation.

  • David Paul Bartlett

    I am optimistic that with our help an ever increasing number of lives will be saved. The important thing is to remain resolute and not take things for granted. Then, and only then shall we succeed.