Why are millions of children and women dying?

Under-five mortality by cause: Child Health Epidemiology Reference Group (CHERG).

The countries and regions in which children under five are dying in large numbers are well known, and the main proximate causes of premature deaths and ill health are also well established.

Almost 40 per cent of all under-five deaths occur during the neonatal period, the first month of life, from a variety of complications. Of these  neonatal deaths, around 26 per cent – accounting for 10 per cent of all under-five deaths – are caused by severe infections. A significant proportion of these infections is caused by pneumonia and sepsis (a serious blood-borne bacterial infection that is also treated with antibiotics).

Around 2 million children under five die from pneumonia each year – around 1 in 5 deaths globally. In addition, up to 1 million more infants die from severe infections including pneumonia, during the neonatal period. Despite progress since the 1980s, diarrhoeal diseases account for 17 per cent of under-five deaths. Malaria, measles and AIDS, taken together, are responsible for 15 per cent of child deaths.

Many conditions and diseases interact to increase child mortality beyond their individual impacts. Child undernutrition contributes to more than a third of global childhood deaths. Unsafe water, poor hygiene practices and inadequate sanitation are not only the causes of the continued high incidence of diarrhoeal diseases, they are a significant contributing factor in under-five mortality caused by pneumonia, neonatal disorders and undernutrition.

The lack of access to vital services and technologies is compounded by a lack of information. Households and communities often do not know why immunization is vital, how to recognize a disease’s symptoms, or when to seek help. Maternal education is a very important factor here: an educated mother is more likely to know, for example, the benefits of exclusive breastfeeding, how to treat malnutrition and diarrhoea and the importance of family planning. For more information, visit our Basic Education and Gender Equality pages.

Many children may simply have lost their mothers to pregnancy and childbirth complications. The lifetime risk of a pregnant woman dying from pregnancy or childbirth in a least developed country is 1 in 13, compared to 1 in 3,900 in Northern Europe. Again, these deaths are largely preventable, but many women in impoverished countries lack quality emergency obstetric services or the means to access them.

Children are also increasingly at risk because of the AIDS pandemic. They are dying of the disease in ever-growing numbers. In 2006, 2.3 million children under the age of 15 were living with the HIV/AIDS. The number of children who have lost one or both parents to AIDS has reached 15.2 million as of 2005, of whom 80 per cent live in sub-Saharan Africa. These children usually lack basic care and are less likely to be immunized, more likely to be malnourished and less likely to go to school. They are also, therefore, more susceptible to common childhood killers such as malaria. For more information, visit our HIV/AIDS pages.

Lack of access to safe drinking water and poor hygiene and sanitation contribute to the deaths of more than 1.5 billion children each year from diarrheal diseases. Millions of children suffer intestinal infections caused by parasites. An estimated 2.6 billion people do not use improved sanitation facilities which also contributes to diseases such as cholera or diarrhoea. For more information, visit our Water, environment and sanitation pages.

Children are also dying as a direct result of armed conflicts – more than 2 million over the past decade. The devastating effects of such armed conflicts continue, however, to kill many more children, who die of malnutrition and disease. Population displacement, often resulting in living conditions with poor hygiene, disruption of health services and interruption in food supply, are all factors contributing to disease epidemics and diarrhoea. Natural disasters or other emergencies resulting from environmental mismanagement can have similar effects. For more information, visit our Child Protection pages.



Articles and related evidence

"Where and why are 10 million children dying every year?". The first paper of the new Lancet series on Child Survival and other key related evidence can be found under Articles and related evidence.
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