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Diverse countries are making rapid progress in child survival but disparities remain – UNICEF report

A child is weighed at the Binh Thanh Trung Health Centre in Dong Thap, Viet Nam.
© UNICEF Viet Nam\2011\Dominic Blewett

UNICEF calls upon Viet Nam to seize the opportunity to build on the achievements of the past two decades

Ha Noi, 13 September 2012 – Countries across the world are making rapid progress in reducing child deaths, demonstrating that it is possible to radically reduce child mortality over the span of two decades, a UNICEF report says today.

The 2012 Progress Report on Committing to Child Survival: A Promise Renewed examines trends in child mortality estimates since 1990, and shows that major reductions have been made in under-five mortality rates in all regions and diverse countries. This has translated into a sharp drop in the estimated number of under-five deaths worldwide. Data released today by UNICEF and the UN Inter-agency Group for Child Mortality Estimation show that the number of children under the age of five dying globally fell from nearly 12 million in 1990 to an estimated 6.9 million in 2011.

Viet Nam has achieved impressive reductions in the under-five mortality rate over the past decades. Indeed, the under-five mortality rate has dropped significantly from 66 children (per 1,000 live births) who die before their fifth birthday in 2000 to 16 deaths (per 1,000 live births) in 2011. Yet, despite commendable progress, here in Viet Nam, 87 children under five still die every day from preventable causes.

The report underscores that neither a country’s regional affiliation nor economic status need be a barrier to reducing child deaths. Low-income countries such as Bangladesh, Liberia and Rwanda, middle-income countries such as Brazil, Mongolia and Turkey, and high-income countries such as Oman and Portugal, have all made dramatic gains, lowering their under-five mortality rates by more than two-thirds between 1990 and 2011.

“The government of Viet Nam has renewed its commitment to save children’s live. Prioritising and investing in child survival and their early years means fewer deaths, better lives and long-term benefits for society as a whole. But that lesson is not always clear, and children from poor rural areas are statistically much more likely to die before their fifth birthday than those in urban areas, while disadvantaged or marginalised populations often bear the burden of child deaths. This is especially true in Viet Nam. Here, an ethnic minority child under five is nearly four times more likely to die before their fifth birthday than a non-ethnic minority child,” said Lotta Sylwander, UNICEF Representative in Viet Nam.

“We know what the biggest killers of young children are here in Viet Nam: over half of under-five deaths occur in the first 28 days of life due to premature birth and factors related to poor antenatal care and birth facilities. Pneumonia and diarrhoea are the next biggest causes of death and the most common reasons why a mother brings her child to a health clinic. Inexpensive solutions are within reach, such as vaccines against measles, polio and mother-to-child transmission of HIV; oral-rehydration salts and zinc to treat diarrhoea; antibiotics for pneumonia; and oxytocin preventing women from bleeding to death after childbirth. The challenge is to make these available to every child.”

The report combines mortality estimates with insights into the top killers of children under five and the high-impact strategies that are needed to accelerate progress. Under-five deaths are increasingly concentrated in sub-Saharan Africa and South Asia, which together accounted for more than 80 per cent of all under-five deaths in 2011. On average, one in every nine children in sub-Saharan Africa dies before reaching the age of five.

More than half the pneumonia and diarrhoea deaths – which together account for almost 30 per cent of under-five deaths worldwide – occur in just four countries: the Democratic Republic of the Congo, India, Nigeria and Pakistan. Infectious diseases are characteristically diseases of inequity, disproportionately affecting poor and vulnerable populations who lack access to basic treatment and prevention interventions. These deaths are largely preventable.

Under the banner of A Promise Renewed, a movement for child survival is growing to re-energize, refocus and build on two decades of significant progress. The opportunity for further sharp reductions in preventable child deaths has never been greater.

Greater efforts are particularly required in populous countries with high mortality. In addition to medical and nutritional factors, improvements in other areas – notably education, access to clean water and adequate sanitation, adequate food, child protection and women’s empowerment – will also improve prospects for child survival and development.

“With its renewed promise to save children’s lives, we take this opportunity to call on the government to seize the opportunity to build on the achievements of the past two decades”, Lotta Sylwander added.

UNICEF works in 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit:

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