Issue of The Lancet on child and maternal health highlights equity and accountability
LONDON, United Kingdom, 20 September 2012 - A week after UNICEF and partners released data showing that rapid progress has been made in reducing the number of children dying before the age of 5, and with the 2015 deadline to achieve the Millennium Development Goals fast approaching, the call is louder than ever to reach the estimated 19,000 children who still die every day from mostly preventable causes.
Improving child survival and reducing maternal mortality rely on donors worldwide. Yet, despite an increasing number of donors, latest figures presented in a study by the Countdown to 2015 group show that, in 2010, official development aid ranging from aid for maternal to newborn and child health activities stalled for the first time.
According to a Countdown to 2015 country case study featured in the issue, the Niger, one of the world's poorest countries, has made impressive advances in reducing child mortality. The country has been able to reduce its child mortality rates by nearly 50 per cent – from 226 deaths per 1,000 live births in 1998 to 128 deaths per 1,000 live births in 2009. Severe wasting has also declined, with the authors estimating that about 59,000 children's lives were saved in 2009.
These successes have been seen as a sign that the government's approach is working – from providing universal access to health care, free of charge for pregnant women and children, to such low-cost interventions as providing bed nets for the prevention of malaria, vitamin A supplementation and treatment of diarrhoea with oral rehydration salts.
Focus on equity is key
Two studies from UNICEF highlight the importance of equity in maternal and child health improvement strategies.
The first study was led by UNICEF Chief of Health Mickey Chopra. The paper focuses on strategies used to overcome supply-and-demand bottlenecks and provides recommendations for improving the coverage of health care, including expanding roles for lay health workers and providing access to services.
The second Series paper was prepared by UNICEF Health Specialist Carlos Carrera. The article shows that focusing on providing health services to the poorest and most marginalized is more effective and more cost-efficient than more conventional approaches.
Integrated push on child survival
Mr. Lake's Comment reminds the international community: "Reaching deprived populations with evidence-based interventions to prevent childhood deaths is now the central challenge for the international child survival movement …The analysis presented in these articles provides a strong case for proceeding with optimism. Great things can be achieved when the best possible science, sound strategies, adequate investment, and political will combine. A Promise Renewed provides the framework for such an integrated push on child survival."
As in UNICEF's recently published Committing To Child Survival: A Promise Renewed, this issue of The Lancet makes it clear that focusing on the poorest and hardest-to-reach children is not only the best way to increase overall maternal and child health coverage, but also key to accelerating progress.