Geoffrey Kalebbo Denye
16 November 2009
Nairobi — A simple set of interventions like oral rehydration for cases of diarrhoea, bednets to prevent malaria and exclusive breastfeeding can save 16,000 children under five years daily, a report by humanitarian and development agency World Vision reveals.
Commitment to this action alone would save up to six million children under the age of five globally, and half of them would be in Africa.
Diarrhoea, pneumonia and childbirth complications are among preventable causes claiming the lives of most of the 4.5 million children who die annually in Africa alone.
Ninety-nine per cent of nine million preventable child deaths globally are in the developing world, the report says.
It is rare to hear of a child dying from any of these conditions in a rich country.
In just two minutes, 30 children under the age of five will die. Most of them will succumb to preventable causes, such as diarrhoea, pneumonia, childbirth complications and malaria.
These killers will continue to claim children's lives unabated if governments do not show high-level political leadership on child health and continuously fail to prioritise child wellbeing, the report warns.
"This is more than just a problem facing the developing world. It's a 'silent' emergency. And it is, I believe, the greatest child rights violation of our time," World Vision's international president and CEO, Kevin Jenkins, writes in the report. The report will be launched in Nairobi and New York on November 16.
The Indian Ocean tsunami shocked the world when it cost the lives of 216,000 people in December 2004, but more than 40 million children aged five and below have died from readily preventable diseases since then.
Together, the UN Millennium Development Goals on health are farthest off-track, of all the eight development goals.
Time is running out for MDG number four, which seeks to cut child mortality by two thirds by 2015.
Five years from the target date of the MDGs, in a period of economic downturn and political flux, no task demands more immediate and concerted action, and a greater sense of fierce urgency -- from governments, donors and civil society -- than ending the silent emergency that each year claims the lives of almost nine million children under the age of five.
Sufficient government funding is a necessary condition of providing effective healthcare for children and their families.
Currently, only three of the 30 high-burden countries are spending at least 15 per cent or more of their public expenditure on health.
While not all the 30 high-burden countries are in Africa, this allocation is well below the commitment made by African governments in the Abuja Declaration (2001) to lift health funding to at least 15 per cent of national budgets.
Even within high-burden countries, life chances are not distributed equally.
In Tanzania, for example, the child mortality rate in Ngorogoro district is 40 per 1,000 births whereas in Ruangwa it stands at 250.
Urban Moshi district has over 12 health workers per 1,000 people, compared with 0.3 in the rural district of Bukombe.
Health Care continues to be deeply unaffordable and in some extreme manifestations reported in Kenya, women have been locked up in maternity wards until they pay their delivery bills.
"The first tier of healthcare for children is the household level, and beyond that the immediate community.
"Yet relatively little attention is paid by most governments to low-cost and easy-to-deliver measures that can be taken at this level that can have a decisive impact on child health, from handwashing and breastfeeding to early identification of pneumonia," the report reads.
To improve children's health globally, World Vision calls for national health strategies that go beyond the current focus on formal health systems and single disease initiatives, to interventions in the areas of safe water and sanitation, nutrition and family care.
A couple of stories of progress in the report provide a ray of hope in an otherwise gloomy situation.
"Despite being one of the poorest countries in the world, Malawi has almost halved its under-five mortality from 210 per 1,000 in 1990 to 111 per 1,000 in 2007."
Malawi was able to do this through proven, low-cost measures, including increasing the number of children delivered by a skilled attendant to 60 per cent, increasing immunisation cover to 99 per cent, and increasing Vitamin A supplements from zero to 86 per cent.
Community management of pneumonia and wide scale food security programmes, therapeutic feeding and promotion of exclusive breastfeeding also played a significant role.
Similarly, a 90 per cent reduction in deaths from measles in Southern Africa has been achieved through near-comprehensive vaccination since 2001.
Provision of insecticide-treated bednets to every household in Ethiopia has, since 2005, resulted in a 61 per cent reduction in malaria cases.
These successes show that most child deaths are avertable.
Comparable successes will be achieved only where governments, organisations, communities and individuals work together to ensure that there is commitment to following through on decisions made and proper allocation and use of resources earmarked for children's health.
Geoffrey Kalebbo Denye is the East Africa communications team leader of World Vision International.
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