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Analysis points to health system failures at critical time around birth as a significant contributing factor to these needless deaths

Child survival rates have increased dramatically since 1990, during which time the absolute number of under-five deaths has been slashed in half from 12.7 million to 6.3 million, according to a report released recently by UNICEF.  

The 2014 Committing to Child Survival: A Promise Renewed progress report, indicates that the first 28 days of a newborn’s life are the most vulnerable with almost 2.8 million babies dying each year during this period. One million children don’t even live to see their second day of life.

Many of these deaths could be easily prevented with simple, cost-effective interventions before, during and immediately after birth.

Analysis points to failures in the health system during the critical time around delivery as a significant contributing factor to these unnecessary deaths. It also shows that there is considerable variation – from country to country and between rich and poor – in the take-up and quality of health services available to pregnant women and their babies.

Key findings in this study include:

• Around half of all women do not receive the recommended minimum of four antenatal care visits during their pregnancy.
• Complications during labour and delivery are responsible for around one quarter of all neonatal deaths worldwide. In 2012, 1 in 3 babies (approximately 44 million) entered the world without adequate medical support.
• Evidence shows that initiating breastfeeding within one hour of birth reduces the risk of neonatal death by 44 per cent, yet less than half of all newborns worldwide receive the benefits of immediate breastfeeding.
• Quality of care is grossly lacking even for mothers and babies who have contact with the health system. A UNICEF analysis of 10 high mortality countries indicates that less than 10 percent of babies delivered by a skilled birth attendant went on to receive the seven required post-natal interventions, including early initiation of breastfeeding. Similarly, less than 10 per cent of mothers who saw a health worker during pregnancy received a core set of eight prenatal interventions.
• Those countries with some of the highest number of neonatal deaths also have a low coverage of postnatal care for mothers. Ethiopia (84,000 deaths; 7 per cent coverage); Bangladesh (77,000; 27 per cent); Nigeria (262,000; 38 per cent); Kenya (40,000; 42 per cent).
• Babies born to mothers under the age of 20 and over the age of 40 have higher mortality rates.

Additionally, the report shows that the education level and age of the mother has a significant bearing on the chances of her baby’s survival. Neonatal mortality rates among mothers with no education are nearly twice as high for those with secondary schooling and above.

“The data clearly demonstrate that an infant’s chances of survival increase dramatically when their mother has sustained access to quality health care during pregnancy and delivery,” said Geeta Rao Gupta, UNICEF Deputy Executive Director. “We need to make sure that these services, where they exist, are fully utilised and that every contact between a mother and her health worker really counts. Special efforts must also be made to ensure that the most vulnerable are reached.”

Inequality, particularly in health care access, remains high in the least developed countries: women from the richest households are almost three times as likely as those from the poorest to deliver their baby with a skilled birth attendant. Despite this, the report suggests that the equity gap in under-5 child mortality is steadily reducing. In every region, except sub-Saharan Africa, the proportion of under-five mortality among the poorest sections of society is declining faster than in the richest. More significantly, worldwide, the poor are registering greater absolute gains in child survival than their wealthier compatriots. 

“It is deeply heartening that the equity gap in child survival is continuing to narrow,” said Rao Gupta. “We need to harness this momentum and use it to drive forward programmes that focus resources on the poorest and marginalised households; a strategy which has the potential to save the largest number of children’s lives.”

Notes for editors:

For more information, please contact the UNICEF UK press office on 020 7375 6030 or media@unicef.org.uk

About A Promise Renewed

A Promise Renewed is a global movement that seeks to advance Every Woman Every Child – a strategy launched by United Nations Secretary-General Ban Ki-moon to mobilize and intensify global action to improve the health of women and children around – through action and advocacy to accelerate reductions in preventable maternal, newborn and child deaths.

The movement emerged from the Child Survival Call to Action convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF, to examine ways to spur progress on child survival. It is based on the ethos that child survival is a shared responsibility and everyone – governments, civil society, the private sector and individuals – has a vital contribution to make.

Since June 2012, 178 governments and many civil society organizations, private sector organizations and individuals have signed a pledge to redouble their efforts, and are turning these commitments into action and advocacy. More details on A Promise Renewed are available at www.apromiserenewed.org

About Committing to Child Survival: A Promise Renewed 2014 Progress Report

This year’s annual report focuses on newborn survival. This report not only presents levels and trends in under-five and neonatal mortality since 1990, but also provides analysis on key interventions for mother and newborn.

About UNICEF

UNICEF is the world’s leading organisation for children, working in over 190 countries to help every child realise their full potential. We work with partners to transform the lives of children everywhere. UNICEF provides health care, water, nutrition, education and protection for children. The most vulnerable and disadvantaged children are our priority. As champion of the UN Convention on the Rights of the Child, we work to protect and promote the rights of every child. UNICEF UK raises funds for UNICEF’s emergency and development work and advocates for lasting change for children everywhere. We are a UK registered charity, supported entirely by voluntary donations. We do not receive any money from the UN. For more information, please visit www.unicef.org.uk