MDG4 Digest 1

There has been decent headway towards achieving Millennium Development Goal 4, reducing child mortality, but complete success is still far off, even with the deadline for the MDGs coming in five years.

As compared to 1990, there has been a 28% decrease in the number of deaths of children under 5-years of age in 2008, which means that from 100 deaths per 1000 live births, it has dropped to 72. Overall, in 2008, there were 10,000 fewer children each day who died under the age of 5 than in 1990.

Relative to progress on the other MDGs, the target of reducing child mortalities by three-fourths from the 12.5 million under-5 deaths in 1990 has been going well. However, there are significant barriers to overcome and a real possibility that many developing countries will not be ale to meet the 2015 goal.

The highest rates of child mortality are found in developing countries such as in sub-Saharan Africa and Southern Asia. In 2008, 34 countries in Africa registered over 100 deaths per 1000 live births (40 deaths and higher per 1000 live births is considered by the UN to be “high”). Even though rates have dropped by 22% since 1990, combined with high fertility rates, progress so far is not sufficient to reach the MDG target.  In South Asia, one in 14 children dies before they hit five-years old.

Sadly, the main causes of under-five deaths are diseases that are usually preventable and treatable. There are vaccines and medications that combat sicknesses such as diarrhea and malaria, which are among the main causes of death among children under five years of age. Others stem from poverty—malnutrition, marginalization, conflict, lack of safe water and sanitation.

Research shows that the deaths of six million children every year could be avoided by low-tech, evidence-based, cost-effective measures such as vaccines, antibiotics, micronutrient supplementation, insecticide-treated bed nets and improved family care and breastfeeding practices. Yet, they remain major problems because of poverty, the lack of funding, equal access, and knowledge.

Click here for the United Nations’ MDG Report 2010.

There are four diseases that commonly affect children—pneumonia, diarrhea, malaria, and AIDS. Together they account for 43% of child-related deaths around the world. As mentioned above, many of these could have been saved by treatments and precautionary steps that, while readily available in Western countries, are difficult and expensive to obtain in the global South. In sub-Saharan Africa, malaria kills a child around every 40 seconds. Malaria is particularly damaging to pregnant women and their unborn children. It can result in maternal anemia and low birth weight which is the single greatest risk factor for death during the first months of life

Click here for Unicef’s Mortality Index.

Of the 8.8 million children who died before the age of five in 2008, more than 40% were under four weeks old. Neonatal causes include problems due to pre–term birth (28%) severe infections, mainly pneumonia/sepsis (26%) and problems related to complications during childbirth (23%). A baby in a high–mortality country is 11 times more likely to die of infection than others in a low–mortality country.

Even though there are pneumococcal conjugate vaccines for pneumonia, rotavirus vaccine for diarrhea, and bed bets for malaria, funding remains problematic. For example, the Global Alliance for Vaccination and Immunization (GAVI) needs $7 billion between now and the end-date of the MDGs, 2015, to fund all the immunisation programmes it considers necessary. Unfortunately, it will have a hard road ahead of it in securing these funds, especially exacerbated by the financial crisis. Too often, it is the case of giving funding for one life-saving treatment and sacrificing another.

Click here for Guardian.co.uk.’s article on vaccine funding. 

Poverty is a considerable barrier to reducing child mortality. Families who live in poverty are often unable to obtain even the most basic healthcare for their children. Even then, quality of healthcare is often poor, insufficient, and access to medical facilities difficult. It is also the poor who usually suffer most from food scarcity and lack of access to a safe water source or adequate sanitation. These factors increase the likeliness of malnutrition, illness or death.

Malnutrition contributes to more than 1/3 of child deaths. When it is not fatal, malnutrition often leads to stunted physical growth and mental impairment. Breastfeeding is often promoted as one of the best ways to ensure babies are given all the nutrients they need. In addition, a WHO study found that breastfeeding had a very positive effect on infant mortality from diarrhea and acute respiratory infections. The results showed that about 55% of infant deaths from diarrhea and acute respiratory infections could be prevented by exclusive breastfeeding among infants aged 0-3 months and partial breastfeeding throughout the remainder of infancy. Among infants aged 4-11 months, 32% of such deaths could be prevented by partial breastfeeding.

Click here for UNFPA’s report on MDG4.

Despite the challenges outlined in this article, there has been much progress made in reducing child mortality.

Bolivia has the highest maternal and neonatal mortality rates in the Latin American Region. In order to improve access to skilled attendants at birth, the Latin American Center for Perinatology and Human Development (CLAP) and USAID, jointly with other United Nations agencies, have supported a training initiative to train mid-wives to care for and safely deliver infants.

Click here for article.

Save the Children trains up local health workers to address the needs of children in their region. They serve 64 million children worldwide. Ade Yunarsih who works in Indonesia has served in her community for 15 years.

Click here for video.

With the help of donor aid and UN organizations, the Eritrean government commenced an aggressive vaccination campaign in 2005, increasing the number of children vaccinated from 9.6% in 1991 to 76% in 2002.Over 500 additional health workers were also trained to both prevent and cure diseases. Children were vaccinated against tetanus, diphtheria, whooping cough, measles, polio, and hepatitis B. Malaria also fell by 85% as the benefits from increased use of mosquito nets took effect. Measures to safguard child and infant health also included expanded training on the management of childhood illnesses, the development of community manuals, and the construction of maternity waiting homes for semi-nomadic people.

Click here for article.

Azalea Lee, August 2010