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Young child survival and development

POINT OF VIEW / Ann M. Veneman: Child survival in Africa – seven signs of hope

© UNICEF Japan/2008
UNICEF Executive Ann M. Veneman with Tanzanian President Jakaya Kikwete during the launch of The State of Africa's Children 2008: Child Survival' at the Fourth Tokyo International Conference on African Development.

YOKOHAMA, Japan, 28 May 2008 – The following op-ed by UNICEF Executive Director Ann M. Veneman was published today by the Asahi Shimbun newspaper in Japan. Ms. Veneman is attending the African development summit in Yokohama.


The Fourth Tokyo International Conference on African Development (TICAD IV), opening today in Yokohama, will bring together African governments and their development partners.

It is not often you read about signs of hope in Africa. It is the most difficult place in the world for a child to survive until the age of 5. But where sound strategies, adequate resources and a consistent political commitment exist, lives can be saved.

© UNICEF Japan/2008
African leaders and other dignitaries, including UNICEF Executive Director Ann M. Veneman (third from left), hold copies of the new report, 'The State of Africa's Children 2008', at the African development summit in Japan.

UNICEF’s latest publication on the situation of children in the continent, “The State of Africa’s Children,” which I will present at a press conference in Yokohama today, reports that each of the five African countries that are predominately north of the Sahara (Algeria, Egypt, Libya, Morocco and Tunisia), have reduced their child mortality rates by at least 45 percent since 1990.

It also outlines seven recent achievements in child survival and primary health-care in sub-Saharan Africa that demonstrate that improvements are not just possible there, they are actually taking place: 

  1. Eritrea, Ethiopia, Malawi and Mozambique, four of the world’s least developed nations, have reduced their under-5 mortality rates by 40 percent or more since 1990.
  2. Measles deaths in sub-Saharan Africa have fallen by a remarkable 91 percent between 2000 and 2006, through concerted efforts by governments and international partners to boost immunization.
  3. Sixteen African countries have tripled coverage of insecticide-treated mosquito nets – an excellent protection against malaria – since 2000.
  4. Rates of exclusive breastfeeding – the best source of nutrition for newborns – have increased from 22 percent in 1996 to 30 percent in 2006 throughout sub-Saharan Africa.
  5. Use of micronutrient supplements like Vitamin A, often introduced as part of immunization programs, has risen.
  6. Access to treatment for HIV-positive mothers and children is also rising, although from a low base. Coverage of antiretroviral treatment to prevent mother-to-child transmission of HIV tripled in eastern and southern Africa between 2004 and 2006.
  7. A growing consensus is emerging on the framework and strategies required to accelerate progress on child and maternal survival in Africa.

These achievements were attained in an environment that is far from positive. Almost half of the world’s under-five deaths – around 4.8 million – occurred in sub-Saharan Africa in 2006. Children there currently face a one-in-six risk of dying before their fifth birthday, and nowhere has there been less overall success in improving child mortality rates since 1990.

The essential services and practices required to avert child deaths in Africa are well established. They include improved antenatal care and skilled attendance at birth; immunization against vaccine-preventable childhood diseases; adequate nutrition; protection against and treatment of malaria; treatment for mothers and children living with HIV and prevention of mother-to-child transmission of HIV; improved drinking-water sources, decent sanitation facilities and better hygiene practices. Largely preventable childhood illnesses – particularly pneumonia and diarrhea – account for almost 40 percent of sub-Saharan Africa’s child deaths.

© UNICEF/HQ06-0036/Bannon
In Somalia, a medical worker measures the circumference of a girl’s arm as part of a UNICEF survey to determine the nutritional status of children, a key factor in their survival.

Packaging these interventions together and delivering them to mothers and children as part of a continuum of care can increase their effectiveness. In sub-Saharan Africa, achieving this continuum of care for 90 percent of mothers and newborn children would avert two-thirds of newborn deaths, saving 800,000 lives a year.

This is why the seventh achievement is so significant. Increasingly, major stakeholders including governments, donors, nongovernmental organizations, the private sector and civil society, are coalescing around common platforms to scale up access to primary health care.

At the request of the African Union, a strategic framework to support African countries in their efforts to reduce the toll of maternal and child deaths has been developed by the World Health Organization, the World Bank and UNICEF. The framework outlines a three-phase approach to lowering child mortality – a minimum package, an expanded package and a maximum package of essential services for mothers, newborns and children.

If this framework is followed, the necessary investments in child and maternal survival and health in Africa will be both affordable and attainable.

It is possible to meet the challenge of helping children in sub-Saharan Africa survive beyond their fifth birthdays. But it will require all involved to redouble their efforts, scale up essential interventions and integrate improved maternal, newborn and child health programs at the community level.

Large-scale investment in health systems – from the community and household levels to outreach services and facility-based care – will be necessary. These investments need to be focused on delivering results, particularly for the poorest families.

And the survival of Africa’s children and mothers must become a global imperative and a central measure of human progress.



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