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Half of East Asia and the Pacific region set to miss Millennium Development Goal on child survival

Maternal health and mortality key to saving children

Bangkok, October 8 2004 – More than half of the countries in East Asia and the Pacific will fail to meet the Millennium Development Goal on under-five child mortality if current trends continue, says a new report released today by the United Nations Children’s Fund (UNICEF).

The global report, Progress for Children, notes that this region has seen an average reduction in under-five mortality of less than 2 per cent per annum over the last decade, compared to 5 per cent throughout the 1960s and 1970s. This alarming slowdown means that only 13 of 27 countries in the region for which figures are available will meet the international commitment.

 “We have to do more to reach women – and reach them before they are pregnant,” said Dr Steve Atwood, UNICEF’s Regional Advisor for Health and Nutrition. “Maternal health before and during pregnancy and maternal understanding of the importance of breastfeeding and nutrition are key to child survival and development – particularly since such a high proportion of children in the region are dying in the first month of life.”

Although the region’s overall under-five mortality rate has dropped by more than 75 per cent since 1960, 43 in 1,000 children still die before their fifth birthday. Inadequate birthing conditions – meaning little or no healthcare for mothers and an absence of skilled attendants during deliveries – account for the largest proportion of preventable deaths (45 per cent) including deaths due to low birth-weight, birth trauma and asphyxiation.

In addition to inadequate birthing conditions, other significant killers of children under five in East Asia and the Pacific are diarrhoea (17 per cent), acute respiratory infections (16 per cent), accidents (8 per cent) vaccine preventable diseases and TB (7 per cent) and vector-borne diseases such as malaria (5 per cent). Malnutrition is a contributory factor in more than half of these deaths. In some parts of the region, malnutrition rates are almost comparable with those in sub-Saharan Africa.

“A child’s right to survival is the first measure of equality, possibility and freedom,” said UNICEF’s Executive Director Carol Bellamy at the launch of the report in New York. “It is incredible that in an age of technological and medical marvels, child survival is so tenuous in so many places, especially for the poor and marginalized. We can do better than this.”

Cambodia, where one in seven children die before they reach five years old, is the only country in the region where child mortality has actually risen since 1990. High fertility and maternal mortality rates, poor sanitation, unregulated privatization of healthcare and an absence of government services have all contributed to this reversal of progress. Similarly, DPRK, Myanmar, the Pacific Island Countries and Papua New Guinea have all seen little or no reduction in under-five mortality since 1990.

At the opposite end of the scale, Malaysia’s under-five mortality rate has dropped by 8 per cent, the second-best rate of progress in the world. Brunei Darussalam, the Republic of Korea and Singapore have also performed well.

“The success of these countries has been due not only to their relative economic prosperity but also enlightened leadership and the political will to invest in providing basic healthcare for all citizens,” said Dr Atwood.

“In Malaysia, for example, significant reductions were made in maternal mortality rates and neo-/peri-natal survival through providing widespread access to skilled birth attendants before the economic boom,” added Dr. Atwood, who noted that such health improvements may have contributed to economic development in the country.

Even in countries that are on track to meet the child survival target, national figures can hide disparities among people and regions. Figures at the local level, which do not significantly affect national statistics, can still represent huge numbers who have no access to services or are underserved.

In many cases, this is because marginalized groups are being left behind. As countries make the transition to market economies, traditional sources of healthcare, such as state firms and hospitals disappear, leaving many people without access to medical services despite increased national prosperity.

Where fees have been introduced for treatment, immunization rates have fallen and health indicators have worsened. This is especially true in parts of China, whose dwindling progress is largely responsible for the slowdown in the region as a whole.

To meet the Millennium Development Goal on child survival, countries must achieve a two-thirds reduction in their 1990 under-five child mortality figures by 2015. This requires an average annual improvement of roughly 4.4 per cent.

Globally, at the current rate of progress, the average under-five death rate will have dropped by a mere quarter. Only 90 countries out of the 191 that have committed themselves to meeting the global target are on track.

For more information, please contact

Robert Few, Communications Consultant: 662 356 9499 ext. 9518, Mobile: 661 746 3048

Madeline Eisner, Regional Communications Advisor: 662 356 9406, Mobile: 661 701 4626




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