PHA-Exchange> Half of East Asia and the Pacific region set to miss Millennium Development Goal on child survival

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On MDGs:

Half of East Asia and the Pacific region set to miss Millennium Development
Goal on child survival

Maternal health and mortality key to saving children

Bangkok, October 8 2004 – More than half of the countries in East Asia and
the Pacific will fail to
meet the Millennium Development Goal on under-five child mortality if
current trends continue, says
a new report released today by the United Nations Children’s Fund (UNICEF).

The global report, Progress for Children, notes that this region has seen an
average reduction in
under-five mortality of less than 2 per cent per annum over the last decade,
compared to 5 per cent
throughout the 1960s and 1970s. This alarming slowdown means that only 13 of
27 countries in the
region for which figures are available will meet the international
commitment.

  “We have to do more to reach women – and reach them before they are
pregnant,” said Dr Steve
Atwood, UNICEF’s Regional Advisor for Health and Nutrition. “Maternal health
before and during
pregnancy and maternal understanding of the importance of breastfeeding and
nutrition are key to
child survival and development – particularly since such a high proportion
of children in the region
are dying in the first month of life.”

Although the region’s overall under-five mortality rate has dropped by more
than 75 per cent since
1960, 43 in 1,000 children still die before their fifth birthday. Inadequate
birthing conditions –
meaning little or no healthcare for mothers and an absence of skilled
attendants during deliveries –
account for the largest proportion of preventable deaths (45 per cent)
including deaths due to low
birth-weight, birth trauma and asphyxiation.

In addition to inadequate birthing conditions, other significant killers of
children under five in
East Asia and the Pacific are diarrhoea (17 per cent), acute respiratory
infections (16 per cent),
accidents (8 per cent) vaccine preventable diseases and TB (7 per cent) and
vector-borne diseases
such as malaria (5 per cent). Malnutrition is a contributory factor in more
than half of these
deaths. In some parts of the region, malnutrition rates are almost
comparable with those in
sub-Saharan Africa.
Cambodia, where one in seven children die before they reach five years old,
is the only country in
the region where child mortality has actually risen since 1990. High
fertility and maternal
mortality rates, poor sanitation, unregulated privatization of healthcare
and an absence of
government services have all contributed to this reversal of progress.
Similarly, DPRK, Myanmar, the
Pacific Island Countries and Papua New Guinea have all seen little or no
reduction in under-five
mortality since 1990.

At the opposite end of the scale, Malaysia’s under-five mortality rate has
dropped by 8 per cent,
the second-best rate of progress in the world. Brunei Darussalam, the
Republic of Korea and
Singapore have also performed well.

“The success of these countries has been due not only to their relative
economic prosperity but also
enlightened leadership and the political will to invest in providing basic
healthcare for all
citizens,”

Even in countries that are on track to meet the child survival target,
national figures can hide
disparities among people and regions. Figures at the local level, which do
not significantly affect
national statistics, can still represent huge numbers who have no access to
services or are
underserved.

To meet the Millennium Development Goal on child survival, countries must
achieve a two-thirds
reduction in their 1990 under-five child mortality figures by 2015. This
requires an average annual
improvement of roughly 4.4 per cent.

Globally, at the current rate of progress, the average under-five death rate
will have dropped by a
mere quarter. Only 90 countries out of the 191 that have committed
themselves to meeting the global
target are on track.

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