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Equity: a fair chance for every child

A fair start

UNICEF Image: A mother adds micronutrients to her son’s meal.
© UNICEF/BNG-2014-Noorani-0199/Noorani
Bangladesh: A mother sprinkles a micronutrient packet onto her child’s meal. Micronutrient packets are a low cost treatment for children in areas with high levels of anaemia and other forms of malnutrition.

When the most deprived children are not given a fair chance to realize their rights, they fall further behind and equity gaps grow wider. As children age, these initial inequities result in worse health and learning outcomes, lower nutritional status, earlier fertility for adolescent girls, and lower employment rates and earnings as adults.

Children in the poorest households are less likely to attend school, less likely to learn, more likely to be married as children and less likely to have complete knowledge about HIV. Children with disabilities grow up poorer and are often excluded from the workforce, perpetuating cycles of poverty.

Eventually, unbalanced outcomes produce inequalities in economic and social conditions. Those disparities weigh down overall economic growth and prosperity, making it harder for families and countries to invest more in the next generation of disadvantaged children.

A fair chance in life begins with a strong, healthy start.

Today, too many children are not receiving the basic nutrition they need to survive and thrive. Undernutrition is one of the greatest killers of children under 5, responsible for nearly half of the deaths for that age group. For those who survive, the consequences of stunting – an irreversible condition that inhibits the physical and intellectual growth of children – cast a long shadow across their lives, harming health, school performance and potential future income.

In 2014, about one out of every four children under the age of 5 had stunted growth. The damage caused cannot be repaired; improvements in nutrition after age 2 usually do not help recover the lost potential.

Stunting prevalence among children
Rural children are twice as likely to have stunted growth as urban children.

Proper nutrition is especially important during the earliest years of life, when the brain rapidly produces cells and complex connections at a pace that is never again repeated. The first 1,000 days, or the period from pregnancy through the first 18 months of life, has a lasting impact on future outcomes.

Guaranteeing a fair start for every child therefore begins with making sure that mothers have access to quality health care and education. Poor maternal nutrition impairs foetal development and contributes to low birthweight, subsequent stunting and other forms of undernutrition.

Unequal at Birth

Where a child is born has a significant bearing on his or her chance to survive and on future outcomes.

  • Ninety-nine per cent of maternal and newborn deaths occur in the developing world, where in some regions 50 per cent of women still give birth without the assistance of a skilled health worker.
  • Rural children are 1.7 times more likely to die before reaching age 5 than children born in cities.
  • Children whose mothers have no education are, on average, about two-and-a-half times more likely to die before their fifth birthday than those whose mothers have received secondary or higher level instruction. Half the reduction in under-5 mortality from 1970 to 2009 can be traced to increases in the average number of years of schooling for young women.

Inequities in maternal health

For many girls, gender discrimination begins the day they are born. In countries where sons are preferred, daughters from poor families are sometimes deprived of health care or proper nutrition, increasing the chances that those girls will die as children. At the national level, this practice manifests in a disproportionate number of men to women.

Girls who do survive this precarious start may be at a disadvantage later because they were not registered with government or civil authorities at birth. Unregistered children do not legally exist, and therefore may not be able to access basic health and social services or obtain identity documents, and face increased risk of being trafficked or illegally adopted.

Birth registration is vital for governments and service providers to identify the most vulnerable children and target investments, policies and programmes specifically to their needs. Four out of every ten infants born in 2012 were not registered with civil authorities.




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