In 2021, an estimated five million boys and girls died before their fifth birthday, along with about 2.1 million peers between the ages of five and 24, according to the latest estimates from the United Nations Inter-Agency Group for Estimating Infant Mortality (UN IGME).
A second report found that 1.9 million babies were stillborn during the same period. Many of these deaths could have been prevented through equal access and the provision of better quality maternal, newborn, adolescent and child health care.
progress is possible
UN IGME was established in 2004 to share data on child mortality and report on global progress towards child survival goals, among other goals.
The group is supported by the United Nations Children’s Fund (UNICEF) and includes the World Health Organization (WHO), the World Bank Group and the Population Division of the United Nations Department of Economic and Social Affairs (UN DESA).
“Far too many parents face the trauma of losing their children every day, sometimes before they even breathe their first breath,” said Vidhya Ganesh, director of UNICEF’s Data Analysis, Planning and Monitoring Division.
“Such a widespread, preventable tragedy should never be accepted as inevitable. Progress is possible with stronger political will and targeted investment in equal access to basic health care for all women and children.”
life or death
Access to and availability of quality health care remains a matter of life and death for children worldwide, the group said.
Most child deaths occur before the age of five, and half occur within the first month of life. For these babies, premature birth and complications during labor are the leading causes of death.
Likewise, more than 40 percent of stillbirths occur during labor, although most are preventable if women have access to quality care during pregnancy and childbirth.
For children who survive their first 28 days of life, infectious diseases such as pneumonia, diarrhea and malaria are the greatest threat.
advances and pitfalls
The reports also show how women, children and youth have benefited from greater investment in strengthening primary health systems.
The global under-five mortality rate has fallen by half since 2000, while the mortality rate for older children and adolescents has fallen by 36 percent and the stillbirth rate by 35 percent.
However, gains have fallen significantly since 2010 and 54 countries will not achieve this Sustainable Development Goals (SDG) target for under-five mortality.
It calls for ending preventable deaths in newborns and children under five by 2030, with all countries aiming to reduce neonatal mortality to at least 12 per 1,000 live births and under-five mortality to up to 25 per 1,000 live births .
Millions more at risk
The reports warn that unless swift action is taken to improve health services, nearly 59 million children and adolescents will die before the end of the decade, and nearly 16 million stillbirths are likely.
“It is grossly unfair that the place of birth alone can affect a child’s chances of survivaland that there are so many inequalities in access to life-saving health services,” said Dr. Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Aging WHO.
Even today, children still have “very different chances of survival” depending on where they were born. Sub-Saharan Africa and South Asia bear the heaviest burden.
A mother holds her 18-month-old daughter in Sao Tome e Principe.
A worthwhile investment
Although sub-Saharan Africa accounted for only 29 percent of global live births, in 2021 the region accounted for 56 percent of all deaths under the age of five and 26 percent in South Asia.
Children born in sub-Saharan Africa also have the highest risk of childhood death in the world – 15 times higher than in Europe and North America.
Meanwhile, mothers in sub-Saharan Africa and South Asia experience the painful loss of stillbirth on an extraordinary scale.
In 2021, 77 percent of all stillbirths occurred in these regions, and almost half of all stillbirths occurred in sub-Saharan Africa. The risk of a woman having a stillborn baby there is seven times more likely than in Europe and North America.
“Behind these numbers are millions of children and families who are being denied their basic rights to health,” said Juan Pablo Uribe, World Bank global director for health, nutrition and population and director of the Global Financing Facility.
“We need political will and leadership for sustainable primary health care financing, which is one of the best investments countries and development partners can make,” he added.
Future Impact of COVID-19
During COVID-19 The pandemic has not directly increased child mortality, it may have increased future risks to their longer-term survival, according to the reports.
According to the reports, disruptions to vaccination campaigns, nutrition services and access to primary health care could jeopardize children’s health and well-being for many years to come.
In addition, the pandemic has also triggered the largest sustained vaccination backlog in three decades, putting the most vulnerable newborns and children at greater risk of dying from preventable diseases.
Reduce injustice, end deaths
The two reports are the first in a series of important datasets, with the UN maternal mortality figures due to be released later in the year.
While they highlight the remarkable global advances since 2000 in reducing the under-five mortality rate, more work is needed, said John Wilmoth, director of UN DESA’s population division.
“Only by improving access to quality healthcare, especially around the time of birth, will we be able to reduce these inequalities and end preventable newborn and child deaths around the world,” he said.
