By David Oot:
Since 1990, and despite significant increases in the global population, the annual number of maternal and child deaths has dropped by nearly 50 percent. UNICEF estimates that 100 million children under age five have been saved over the past two decades alone. Several very poor countries, such as Nepal, Bangladesh, and Ethiopia are on track to meet the Millennium Development Goal of reducing under-five deaths by two-thirds by the end of 2015 – an achievement many once thought impossible. In sub-Saharan Africa, where efforts to reduce child death rates have lagged, a recent UNICEF report documented the good news that the annual rate of decline in mortality has accelerated since the early 1990s.
Yet globally, over 6 million children and nearly 300,000 mothers still die each year – most from preventable causes and more than 98 percent in the developing world. Access to quality care before, during and after delivery; immunizations; prevention and treatment of malaria; life-saving treatment of diarrhea and pneumonia; and improved breastfeeding practices could help save most of these lives. But too many, and especially the poorest and most marginalized, are still not benefiting from these lifesaving interventions.
It is for that reason that the Government of India hosted a ‘Call to Action Summit‘ on August 27 and 28 involving delegations from 24 countries, donors, and global health experts to review progress made, and actions needed, to accelerate progress toward the achievement of the global goal of “ending preventable child and maternal deaths.” On the eve of the main summit, August 26, Save the Children convened an international consultation of civil society organizations from across the world, to discuss similar issues, but from a civil society perspective, and develop a set of recommendations and key asks for governments’ to consider in future.
While some progress has been made in addressing the equity gap, we must do more. Save the Children’s recent report on urban health, for example, found that a child in the poorest quintile was twice as likely to die before his or her fifth birthday as a child in the wealthiest quintile. Wide disparities exist as well in access and use of high-impact services and practices that can save lives. In short, we need to focus more attention on understanding and removing barriers to access and increasing effective use of these interventions by those who need them most.
Imagine, for example, a mother who delivers her newborn in the absence of skilled attendant, a newborn that is not breathing but there is no one present who knows what to do, or a mother who knows she should breastfeed but others are telling her to discard the colostrum (the first milk from the breast filled with nutrients and antibodies for preventing illness). Imagine a family with a child in respiratory distress or suffering from dehydrating diarrhea, but does not know what to do or where to get quality, affordable care. None of us wants to be in this situation – but that is the reality for far too many.
In addition to closing the health care equity gap, we also need to focus more attention on ending preventable child deaths during the first month of life when 44 percent of children under age five die. In South Asia, this percentage is close to 60 percent, yet for many, access and use of quality maternal and newborn services and practices care that could save these lives remains low. Our world continues to rapidly urbanize, and an increasing portion of maternal and child deaths occur among the nearly 900 million who live in urban slums. Yet, we lack innovative, scalable approaches to reaching these populations with basic health services, including clean water and basic sanitation. Poor infant and young child nutrition are the underlying causes of nearly half of all under-five deaths, yet there are few examples of large-scale programs that have documented improvements in feeding practices and nutritional outcomes. We also know that ensuring access to contraception is key to improving maternal and newborn health and survival, but globally more than 200 million women or girls who want to delay or space a pregnancy are not using a safe and effective means of contraception. Increased investments in strengthened health systems will be key to achieving and sustaining progress in delivering these, and other interventions we know can dramatically improve health and survival.
These challenges may seem daunting, but we know they can be met. Our hope is that the experience and learning shared in the Call to Action Summit will help inform a renewed commitment to taking the actions needed to further reduce maternal deaths and end preventable newborn and under-five deaths as envisioned in the 2030 Sustainable Development Goals.
To show your support for ending preventable deaths of newborns and children under 5 years of age by 2030, sign this petition.