Reduce child mortality and improve maternal health
(MDG 4, 5)

Saving young children and their mothers

© UNICEF/HQ05-0921/Noorani
UNICEF’s commitment to children’s survival has been central to its mission since the organization’s establishment 60 years ago. Progress since the early years has been remarkable, but an estimated 10.5 million children under five are dying every year of mainly preventable or treatable diseases.

Reinvigorated efforts against the most entrenched causes of under-five death have begun to show promising results. Expanded efforts by UNICEF, the World Health Organization and many partners have cut worldwide measles deaths by around 48 per cent from 1999 to 2004.

But over 27 million children below age one and 40 million pregnant women worldwide are still overlooked by routine immunization services, as shown in UNICEF’s Progress for Children: A Report Card on Immunization.

Results of integrated approaches to child health, such as the Accelerated Child Survival and Development (ACSD) strategy and community IMCI (Integrated Management of Childhood Illnesses), are demonstrating new potential.

ACSD has been implemented by governments and a host of international and local partners since 2002 in 97 districts in 11 West and Central African countries. In intensive implementation districts, under-five mortality has dropped 16–25 per cent compared to control districts, and it is estimated the entire programme is preventing about 18,000 child deaths per year. In Eastern and Southern Africa, community IMCI has fostered better home care practices in 15 countries.

A summons to action

With the lives of so many young children at stake, the clarion call could not ring louder. The early promise of ACSD has prompted some governments to move towards expanding the programme countrywide. In July 2005, the African Union requested that UNICEF and other partners extend the programme and called for its member states to integrate it into their national health policies, poverty reduction strategies and health sector reforms.

At the worldwide level, the Global Immunization Vision and Strategy, designed by the World Health Organization and UNICEF, was adopted by governments at the World Health Assembly in May. The goal is for each country to reach 80 per cent immunization coverage by 2010, with a focus on new ways to reach marginalized children.

In September, UNICEF hosted the launch of the Partnership for Maternal, Newborn & Child Health, formed to accelerate progress towards Millennium Development Goals 4 and 5. The Partnership helped organize the ‘Countdown to 2015: Tracking progress in child survival’ conference in London. There, experts looked at the challenges of scaling up programmes and called for action on the part of policymakers.

Well-being of mothers is crucial

While momentum is building to save children under five, helping their mothers remains more daunting. Complications during pregnancy and childbirth kill more than half a million women annually – a number tragically consistent for many years. It is clear that urgent action and additional resources are needed.

UNICEF supported maternal health in 2005 through an array of activities, as well as advocacy around such issues as avoiding child marriage, eliminating female genital mutilation/cutting, and preventing malaria and promoting tetanus toxoid vaccination and iron/folate supplements during pregnancy.