click to enlarge photo UNICEF, India
29 October 2007
Nearly 10 million children under the age of five die every year - more than 1000 every hour. Almost all of these children could survive and
thrive with access to simple, affordable interventions.
The loss of a child is a tragedy - families suffer and human potential is wasted. WHO is improving child health by helping countries to
deliver integrated, effective care in a continuum, starting with a healthy pregnancy for the mother, through birth and care up to five years
of age. Investing in health systems is key to delivering this essential care.
A child's risk of dying is highest in the first month of life, when safe childbirth and effective neonatal care are essential. Preterm
birth, birth asphyxia and infections cause most newborn deaths. Once children have reached one month of age, and up until the age of five
years, the main causes of loss of life are pneumonia, diarrhoea, malaria, measles and HIV. Malnutrition contributes to more than half of all
Newborn life is fragile. Almost four million children die every year within a month of their birth. Health risks to newborns are minimized
- quality care during pregnancy,
- safe delivery by a skilled birth attendant, and
- strong neonatal care: immediate attention to breathing and warmth, hygienic cord and skin care, and exclusive breastfeeding.
Pneumonia is the largest single cause of death in children under five years of age. Out of 154 million cases each year, nearly
three-quarters occur in just 15 countries. Addressing the major risk factors for the illness - malnutrition and indoor air pollution - is
essential to prevention, along with vaccination. Antibiotics and oxygen are vital treatment tools.
Diarrhoeal diseases are a leading cause of sickness and death among children in developing countries. Exclusive breastfeeding helps prevent
diarrhoea among young children. Treatment for sick children with Oral Rehydration Salts (ORS) and zinc supplements is safe, cost-effective
and saves lives. The lives of more than 50 million children have been saved in the last 25 years as a result of ORS.
Every 30 seconds a child dies from malaria in Africa. It is the leading cause of death in that region among under-fives. Insecticide-treated
nets prevent transmission and increase child survival. Early treatment with anti-malarial medication saves lives.
Over 90% of children with HIV are infected through mother-to-child transmission, which is preventable with the use of antiretrovirals, as
well as safer delivery and feeding practices. An estimated 2.3 million children under 15 years of age are living with HIV, and every day
more than 1400 are newly infected. Without intervention, more than half of all HIV-infected children die before their second birthday.
Antiretroviral therapy for HIV-infected children greatly improves survival rates and quality of life.
About 20 million children under five worldwide are severely malnourished, which leaves them more vulnerable to illness and early death.
Around three-quarters of these children can be treated with "ready-to-use therapeutic foods". These highly fortified and energy-rich foods
provide ample nutrients for malnourished children aged over six months to be treated at home. They need no refrigeration, and can be used
even where hygiene conditions are not ideal.
Child survival rates differ significantly around the world - three-quarters of child deaths occur in Africa and South-East Asia. Within
countries, child mortality is higher in rural areas, and among poorer and less educated families.
Child health is improving, but serious challenges remain to achieve global goals to reduce deaths. Still, about two-thirds of child deaths
are preventable through access to practical, low-cost interventions, and effective primary care up to five years of age. Stronger health
systems are crucial for improving access to care and prevention.
Greater investment is key to achieving the target of Millennium Development Goal 4: to reduce the under-five mortality rate by two-thirds by
2015. Public and private partners must come together to fill the gap - estimated at around US$ 50 billion - in order to meet this ambitious,
but achievable, goal. The launch of the International Health Partnership, the related Global Campaign for the Health MDGs, and several large
bilateral donor pledges in recent months are important steps in the right direction.