Reducing Unnecessary Child Deaths

Although cost-effective measures such as vaccines, antibiotics, micronutrient supplementation, and insecticide-treated mosquito nets are available, more than 10 million children under 5 years still die each year, most from diseases that can be treated or prevented with known approaches.

Child mortality rates vary considerably among regions and countries, but the most disturbing findings are those countries whose annual rate of progress has been negative; in other words, they are heading in reverse, with rising child mortality rates. In several countries in sub-Saharan Africa and the Commonwealth of Independent States, children are less likely to make it to their fifth birthday than they were in 1990.

Research has found that spending more resources on low-cost treatments that prevent disease and death, and on basic health practices such as breastfeeding that build children's defenses against illness can have a significant effect. The U. S. Agency for International Development (USAID) funds programs that care for newborns, train midwives, teach preventative health care, and develop vaccines against respiratory infections. Simply training community health workers, for example, to diagnose and treat pneumonia in children could end one third of the deaths from that disease, USAID-supported research found.

Inadequate birthing conditions – meaning little or no health care for mothers, and the lack of skilled attendants during deliveries – cause the largest proportion of preventable deaths. Infectious and parasitic diseases, such as diarrhea and acute respiratory infections, followed by malaria and measles are the next biggest killers. Acute respiratory infections and diarrhea are at the root of roughly one-third of child deaths.

Malnutrition contributes to more than half of all child deaths. Unsafe water and poor sanitation are also contributing factors.

Child mortality remains shockingly high in many developing countries, particularly those in sub-Saharan Africa, according to the UNICEF report Progress for Children. Six of the ten countries that have performed worst in reducing child deaths are located in this region. These are Botswana (where mortality has increased by 5.3 percent annually from 1990 to 2002), Zimbabwe, Swaziland, Kenya, Cameroon and the Ivory Coast (which recorded a 1.1 percent increase).

This means that while only seven out of every 1,000 children who survived birth in developed countries died before age 5 in 2002, 174 of every 1,000 children in sub-Saharan Africa did not reach their fifth birthday.

Of the 10 countries with the highest mortality rates in 2002, nine were located in Africa, with Sierra Leone registering the greatest number of child deaths globally.

For every 1,000 children born in this West African nation, 284 will die prematurely. Next on the list is Niger (with 265 deaths), Angola, Liberia, Somalia, Mali, Guinea-Bissau, Burkina Faso and the Democratic Republic of Congo (205 deaths).