UNICEF report: Infant mortality rates still high

By Barry Mason
31 January 2008

Nearly 10 million children under five died worldwide in 2006, according to a new report. That is a daily rate of 26,000 deaths.

The United Nations Children’s Fund (UNICEF) has used the latest data available (2006) on the under-five mortality rate for every country in the world. The rate is expressed as the number of children dying before their fifth birthday per 1,000 live births.

Of the 10 million, 4 million die within the first month of life, half of these within the first 24 hours. Many of these deaths are related to the lack of adequate medical and nursing intervention at the time of birth. The report notes that half a million women a year die in childbirth.

The mortality rate is a result of various factors, such as nutrition, availability of safe water, child and maternal services available, the availability of medication and immunisation. The report provides a detailed picture of the conditions facing newborn children around the world.

The five countries with the highest rates of infant mortality were Sierra Leone, with 270 deaths per 1,000 live births; Angola with 260; Afghanistan with 257; Niger with 253; and Liberia with 235. In contrast, Sweden and Iceland were among the countries with the lowest mortality rates—3 deaths per 1,000 live births.

The report notes, “For every newborn baby who dies, another 20 suffer birth injury, complications arising from preterm birth or other neonatal conditions.... [A]t present in the developing world, one quarter of pregnant women do not receive even a single visit from skilled health personnel.... [O]nly 59% of births take place with the assistance of a skilled attendant; and just half take place in a health facility.”

Whilst there has been some reduction in child mortality rates, progress in some regions of the world has been negligible. One of the millennium development goals set by the UN in 2000 was to reduce the under-five child mortality rate by two thirds by the year 2015.

Amongst regions making “insufficient progress” towards this goal are sub-Saharan Africa and Eastern and Southern Africa, whilst the region of West and Central Africa has made no progress.

The report notes, “Sub-Saharan Africa remains the most troubling geographic area.... 1 in every 6 children dies before age five.” Almost half of all deaths of children under five occurred in sub-Saharan Africa. Yet only 22 percent of children were born there.

“Of most concern,” the report continues, “are the 27 countries that have registered scant progress since 1990 or have an under-five mortality rate that is stagnant or higher that it was in 1990... The region as a whole only managed to reduce child mortality at an average annual rate of 1 percent from 1990-2006, and double-digit reductions will be needed during each of the remaining years (to 2015) if it is to meet MDG4 (the millennium goal of reducing child mortality by two thirds).”

British Prime Minister Gordon Brown admitted the likely failure to reach the millennium goals. Speaking at the world economic summit being held in Davos, Switzerland, he said: “We have promised that infant mortality will be cut by three quarters by 2015. On present trends we will not make that happen until at least 2050.”

The UN General-Secretary Ban Ki-moon added: “We need fresh ideas and fresh approaches. It is unacceptable that one child dies of hunger every five seconds.”

A separate report issued by the International Rescue Committee (IRC), a non-governmental relief agency, on the situation in the Democratic Republic of Congo, shows around 45,000 people a month are dying, of which half are young children.

The IRC report noted: “The majority of deaths have been due to infectious diseases, malnutrition and neo-natal and pregnancy-related conditions. Increased rates of disease are likely related to the social and economic disturbances caused by conflict, including disruption of health services, poor food security, deterioration of infrastructure and population displacement. Children...are particularly susceptible to these easily preventable and treatable conditions.”

Ann Veneman, UNICEF executive director, in a foreword to the UNICEF report, noted: “Widespread adoption of basic health interventions including early and exclusive breastfeeding, immunisation, vitamin A supplementation and the use of insecticide-treated mosquito nets to prevent malaria, are essential to scaling up progress, in sub-Saharan Africa and elsewhere.”

The report notes: “Pneumonia kills more children than any other disease—more than AIDS, malaria and measles combined. It is a major cause of deaths in every region.” The report goes on to note how other factors such as malnutrition and environmental conditions heighten the susceptibility of children to pneumonia.

It further notes that there are more than 2 million children under the age of 15 living with the HIV virus and that in 2006 more than half a million were born HIV-infected. Antiretroviral drug therapy can dramatically reduce the chance of HIV-infected mothers passing the virus to their children. But the report notes, “Despite the obvious benefits of drug therapy and it relatively low cost, only 11% of women in low and middle income countries who were HIV-positive were receiving services to prevent transmissions of the virus to their newborns in 2005... The vast majority of these women live in sub-Saharan Africa.”

The interventions necessary to reduce this appalling total of infant deaths are comparatively simple and cheap. The fact that the death rate is so high is the result of the failure of Western governments to provide the means to address this problem.

The indifference is not confined to developing countries. The under-five mortality rate in Britain is dramatically higher than in other Western nations such as Sweden. While the figure for Sweden is 3 per 1,000 live births, it is 6 in Britain. The figure for mothers dying in childbirth in Sweden is 1 in 17,400, whilst that in Britain is 1 in 8,200.

A recent report by the Healthcare Commission in Britain, an independent health watchdog, stated 31 National Health Trusts (around 20 percent of the trusts) provided maternity care that was below approved standards.

Anna Walker, commission chief executive, was reported in the Guardian January 25 saying that the investigation had been triggered by “serious concerns” about maternity services.

Walker spoke of “real concerns about performance” at some London hospitals. Antenatal and postnatal care was consistently poor at these hospitals, she said.

With the threat of worldwide recession, economic turmoil and an increased turn to militarism, whatever minimal pledges may have been made by the world’s leading powers in the past to address the plight of those at the bottom of the development indices, they are likely to fall off the agenda in the coming period.