|© UNICEF/ HQ98-0503/ Pirozzi|
|A child who suffers from severe malnutrition, rests his hand in his mother's palm at a supplementary feeding centre. Sierra Leone.|
In some developing countries, the toll is so harsh that more than one in five children die before they reach their fifth birthday. Many of those who do survive are unable to grow and develop to their full potential. Most deaths result from five causes, or a combination of them: acute respiratory infections (ARI), diarrhoea, measles, malaria and malnutrition. Poverty and the failure to ensure universal access to basic social services are to blame.
Complications related to pregnancy and childbirth kill more than half a million women each year - more than one every minute -and injure and disable many more.
Together with governments, humanitarian agencies, civil and community leaders, families and children themselves, UNICEF is addressing these threats.
Impressive progress has been made in improving the survival rates and health of children, even in some of the poorest countries. The global child mortality rate declined by almost one quarter between 1990 and 2006.
Despite this encouraging progress, immense obstacles continue to stand in the way of ensuring that every child gets the best start in life. The HIV/AIDS pandemic has reached catastrophic proportions in several parts of the world, unraveling decades of hard-won gains in child survival and development, especially in sub-Saharan Africa.
Armed conflicts that kill and injure children are proliferating and chronic poverty remains the greatest obstacle to fulfilling the rights of children. Infant and child mortality rates are also the highest in countries ravaged by civil strife, weak governance and chronic underinvestment in public health systems and physical infrastructure. Similarly, fragile states, characterized by weak institutions with high levels of corruption, political instability and a shaky rule of law, are often incapable of providing basic services to their citizens.
Gender inequity and discrimination persist. Millions of women and children have been excluded from progress in recent decades because they are poor. The inequalities in child survival between poor and better-off children are stark, not only between countries but within them. For countries with available data, children in the poorest 20% of households are far more likely to die before their fifth birthday than children living in the richest quintile.