A death of child or youth every 4.4 seconds; many could have been prevented with equitable access to high-quality healthcare
The tragic state of child healthcare globally has been highlighted by two United Nations studies released January 10, 2023, reporting the death of a child or a youth every 4.4 seconds in 2021. An estimated five million children died before they turned five years old and over two million aged 5-24 lost their lives, found Levels & Trends in Child Mortality.
These numbers were released by the UN Inter-agency Group for Child Mortality Estimation (UN IGME). Almost two million babies were also stillborn in the same year, found a second UN report. Many of these deaths could have been prevented with equitable access and high-quality maternal, newborn, child and adolescent healthcare.
Children continue to face wildly differentiating chances of survival based on where they are born, with sub-Saharan Africa and southern Asia shouldering the heaviest burden, the reports showed.
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Every day, far too many parents face the trauma of losing their children, sometimes even before their first breath, Vidhya Ganesh, UNICEF director for data analytics, planning and monitoring said in a press release.
“Such widespread, preventable tragedy should never be accepted as inevitable. Progress is possible with stronger political will and targeted investment in equitable access to primary healthcare for every woman and child,” Ganesh said.
There are some positive outcomes in the report, with a lower risk of death across all ages globally since 2000. However, these gains have reduced significantly since 2010 and 54 countries will fall short of meeting the Sustainable Development Goals target for under-five mortality, the reports pointed out.
The global under-five mortality rate fell by 50 per cent since the start of the century, while mortality rates in older children and youth dropped by 36 per cent. The stillbirth rate has decreased by 35 per cent.
These positive outcomes can be attributed to more investments in strengthening primary health systems to benefit women, children and young people.
However, swift action for health services is needed, or almost 59 million children and youth may die before 2030 and nearly 16 million babies will be lost to stillbirth.
Though sub-Saharan Africa had just 29 per cent of global live births, the region accounted for 56 per cent of all under-five deaths in 2021 and southern Asia for 26 per cent of the total, the reports said.
Globally, the under-five mortality rate (U5MR) fell to 38 deaths per 1,000 live births in 2021, while under-five deaths dropped to 5 million. Children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world.
“It is grossly unjust that a child’s chances of survival can be shaped just by their place of birth and that there are such vast inequities in their access to lifesaving health services,” Anshu Banerjee, director for maternal, newborn, child and adolescent health and ageing at the World Health Organization, stated in the release.
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In contrast to the global rate, children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world with a 2021 U5MR of 74 deaths per 1,000 live births — 15 times higher than the risk for children in Europe and Northern America and 19 times higher than in the region of Australia and New Zealand.
Mothers in sub-Saharan Africa and South Asia also endure the painful loss of babies to stillbirth at an exceptional rate, with 77 per cent of all stillbirths in 2021 occurring in sub-Saharan Africa and South Asia.
Children born in poorer countries are also more likely to die before reaching age 5. Children born in low-income countries, where the 2021 U5MR was 67 deaths per 1,000 live births, were 14 times more likely to die before reaching age 5 than children born in high-income countries, where the 2021 U5MR was just 5 deaths per 1,000 live births.
At the country level, U5MRs in 2021 ranged from two deaths per 1,000 live births to 115 deaths per 1,000 live births, 67 times higher than in the lowest mortality country.
Nearly half of all stillbirths happened in sub-Saharan Africa. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times more likely than in Europe and North America.
Access to and availability of quality healthcare continues to be a matter of life or death for children globally. Most child deaths occur in the first five years, of which half are within the very first month of life.
For these youngest babies, premature birth and complications during labour are the leading causes of death. Similarly, more than 40 per cent of stillbirths occur during labour — most of which are preventable when women have access to quality care throughout pregnancy and birth.
For children that survive past their first 28 days, infectious diseases like pneumonia, diarrhoea and malaria pose the biggest threat.
While COVID-19 has not directly increased childhood mortality — with children facing a lower likelihood of dying from the disease than adults — the pandemic may have increased threats to to their survival.
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Concerns around disruptions to vaccination campaigns, nutrition services and access to primary healthcare, which could jeopardise their health and well-being for many years to come, were highlighted in the report.
In addition, the pandemic has fuelled the largest continued backslide in vaccinations in three decades, putting the most vulnerable newborns and children at greater risk of dying from preventable diseases, it said.
Gaps in data, which could critically undermine the impact of policies and programmes designed to improve childhood survival and well-being were also noted by the analysis.
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