Geneva — A new report says the number of global deaths among children under age five is almost half what it was 22 years ago. A joint report by the United Nations Children's Fund, the World Health Organization,and World Bank finds about 6.6 million children died before reaching their fifth birthday in 2012 compared to 12 million children who died in 1990.
The report calls the progress being made in cutting child deaths remarkable. However, it says this is still not good enough. It says most child deaths are preventable, and that by applying a number of simple, affordable measures, more children's lives can be saved.
Elizabeth Mason, director of the World Health Organization's department of maternal, newborn, child and adolescent health, says the first 28 days of life are critical for a child's survival. That, she says, is inextricably linked to the care the mother receives during pregnancy and, most importantly, the care she receives during labor, childbirth and the early hours of the baby's life.
"We have new low-cost solutions that can reduce deaths of pre-term babies by up to three-quarters. And these include anti-natal corticosteroid injections to the mother when she goes into pre-term labor, kangaroo mother-care where the baby is literally put into a pouch, but next to skin-to-skin care, next to the mother's chest so that the baby can keep warm and can have early access to breast milk," said Mason.
The leading causes of death among children under five years old include pneumonia, prematurity, birth asphyxia, diarrhea and malaria. Globally, WHO says about 45 percent of under-five deaths are linked to under-nutrition.
The report says about half of under-five deaths occur in only five countries-China, the Democratic Republic of the Congo, India, Nigeria, and Pakistan. It notes sub-Saharan Africa is the region with the highest child mortality rates in the world, with 98 deaths per 1,000 live births.
It says a child born in sub-Saharan Africa faces more than 16 times the risk of dying before his or her fifth birthday than a child born in a wealthy country. At the same time, the report says the pace of decline in the number of annual deaths has quadrupled since 1990.
Mark Young, a senior adviser on health at the U.N. Children's Fund, says overall economic development is helpful in reducing child mortality, but poor countries that have a good strategy can make significant gains.
He cites the case of Niger, one of the poorest countries in West Africa. Two decades ago, he says, Niger had the highest rate of under-five mortality in the world. This, he says has been cut by nearly two-thirds.
"They have done this through a series of targeted, focused, government-led initiatives that UNICEF has supported," he said. "They instituted a free health care policy for women and children, abolished user fees, so increased financial access. They expanded geographic access by establishing a series of rural health posts... staffed by community trained health workers to deliver essential maternal-newborn child health services at the peripheral level. They implemented a series of integrated mass campaigns to deliver a package of high impact preventive interventions."
The package includes childhood immunization, vitamin A, and insecticide treated nets for malaria. Young says Niger also has set up an emergency nutrition program to address child malnutrition.
The report notes other countries are also implementing life-saving interventions. It says Ethiopia, Kenya, Niger, Tanzania, Bangladesh and states in India are following strategies to reduce child deaths from pneumonia and diarrhea, which together kill two million children each year.
These interventions providing antibiotics and oral rehydration salts, introducing new vaccines against these diseases and ensuring access to sanitation and safe drinking water.