Iraq + 3 more

Egypt makes the most progress and Iraq the least in reducing child deaths, report finds

Millions of Children Still Dying Each Year Despite Availability of Proven, Low-Cost Interventions that Could Save Their Lives

WESTPORT, Conn. (May 8, 2007) - Egypt has made the most progress since 1990 - and Iraq the least - in saving the lives of children under 5, according to the eighth annual State of the World's Mothers Report issued today by Save the Children, a U.S.-based global independent humanitarian organization.

The report includes the first-ever Child Survival Progress Rankings of 60 developing countries, which together account for 94 percent of all child deaths worldwide. The rankings indicate which countries are succeeding and which are failing to save the lives of children under the age of 5.

According to the report, Iraq's child mortality rate has increased by a staggering 150 percent since 1990. Some 122,000 Iraqi children died in 2005 before reaching their fifth birthday. More than half of these deaths were among newborn babies in the first month of life.

On the positive side, Egypt has achieved an impressive 68 percent decline in child deaths in the past 15 years. Investments in health services for mothers and children have helped improve care for pregnant women, made childbirth safer and increased the use of family planning services. As a result, thousands of children's lives have been saved.

Twenty of the 60 countries in the Child Survival Progress Rankings have either made no progress in reducing deaths among children under age 5, or their mortality rates have increased since 1990. Iraq, Botswana, Zimbabwe and Swaziland emerge as the countries that are regressing the most. In each of these countries, under-5 mortality rates have increased in the past 15 years. In Iraq and Botswana, rates have more than doubled.

"More than 10 million children under age 5 still die each year. That's almost 28,000 a day - almost all in developing countries," said Save the Children President and CEO Charles MacCormack, in issuing the report. "The interventions that can save these lives, such as vaccines, oral rehydration therapy and insecticide-treated mosquito nets are not expensive. Yet, sadly, many mothers and children lack access to these lifesaving measures," he said.

"Every mother is concerned for the welfare of her child," said Save the Children spokesperson Jamie Lee Curtis. "Few mothers in this country realize how frequently children under 5 die in the developing world," said the actress, herself a mother of two and author of several children's books.

"Nine out of 10 mothers, for example, in sub-Saharan Africa are likely to lose a child during their lifetime. It doesn't have to be this way. We can prevent this tragedy by ensuring that we do as much to protect mothers and children in poor countries as we do in rich countries," stressed Curtis.

The report also includes Save the Children's eighth annual Mothers' Index, which identifies the best and worst countries to be a mother and child-based on a comprehensive look at child and maternal well-being in 140 countries. More countries are included in this year's Index than in any previous year. Sweden, Iceland and Norway top the rankings this year. The United States places 26th, tied with Hungary, while Niger ranks last.

Major findings in the report on child survival:

- The three biggest killers of children under 5 worldwide are newborn disorders, pneumonia and diarrhea. By using existing interventions, the report notes, we can save more than 6 million of the 10.1 million children who die every year from easily preventable or treatable causes.

- Child and maternal death rates are highest in the poorest, most disadvantaged places. According to the report, nearly all under-5 and maternal deaths (99 percent) occur in developing countries in settings of poverty, where children are most vulnerable to diseases and malnutrition. The highest rates are in Africa and South Asia.

- The majority of child deaths occur in just 10 countries, many with large populations (such as China and India) and others with very high child mortality rates (such as Afghanistan, Angola and Democratic Republic of the Congo).

- AIDS remains one of the underlying causes affecting child mortality trends, particularly in sub-Saharan Africa. Other key factors behind spiking child mortality rates, as in the case of Iraq and Afghanistan, are the effects of armed conflict and social instability.

- Among developing countries, Malawi, Bangladesh, Nepal, Tanzania and Madagascar are making great strides in child survival despite limited financial resources. These countries have invested in better health care for mothers, better nutrition for children, and lifesaving health care services to prevent and treat deadly diseases, proving that political will and social commitment matter more than national wealth when it comes to saving the lives of children. Malawi, the report noted, has a per capita gross national income (GNI) of only $650, but it achieved a remarkable 43 percent decline in under-5 mortality between 1990-2005 by directing more resources toward basic health care, offering better salaries and training for health workers, and widely distributing insecticide-treated bed nets to prevent malaria. The report also credits Nepal - despite having a GNI of only $1,530 and being mired in conflict - for having reduced its under-5 death rate by almost half in the past 15 years. The report highlights increasing immunization coverage and vitamin A supplementation among young children as key to this success.

- Among the 44 more-developed countries reviewed in the report, the United States ranked 26th. Children's deaths in the industrialized world are most likely the result of injury suffered in traffic accidents, intentional harm, drowning, falling, fire and poisoning. According to the report, American Indian, Alaska Native and African American children have the highest death rates in the United States. In the United States, Connecticut has the lowest under-5 death rate and Wyoming the highest.

To succeed in saving the lives of children under 5, Save the Children recommends that countries:

- Ensure the well-being of mothers. Three key interventions that help both mothers and children to survive and thrive are nutrition, skilled care during childbirth and access to voluntary contraception.

- Invest in basic, low-cost solutions to save children's lives. The most dangerous threats to children's survival can be fought with relatively simple and inexpensive solutions. Breastfeeding provides nutrition and improves immunity to often life-threatening illnesses common to infants. Immunizations protect children from measles and other diseases. Oral rehydration therapy can save a child from dying of dehydrating diarrhea. Antibiotics treat pneumonia. Insecticide-treated mosquito nets help prevent malaria.

- Make health care available to the poorest and most vulnerable mothers and children. Childbirth can be made much safer if mothers and newborns receive care from trained health workers before, during and after delivery. In remote, hard-to-reach communities, diarrhea and many cases of pneumonia can be treated by training community-based health workers close to where children live.

- Increase funding and improve strategies to provide basic, effective, lifesaving services to those who need it most. Basic health systems and services in developing countries are grossly underfunded. To increase access to services, poor countries need new strategies such as community case management linked to local health facilities, and community education and mobilization to encourage family members to adopt lifesaving home-based practices.

The report calls on governments to increase their political and financial support for proven solutions that save the lives of mothers, children and newborns. MacCormack noted that the United States government should demonstrate leadership toward these goals by passing legislation that would authorize increased resources and require a comprehensive U.S strategy for improving maternal, newborn and child health.

"It only costs a few dollars to protect young children from conditions that disable or kill millions each year," said MacCormack. "With modest increases in funding, we can help countries reach the poorest with child survival and maternal health services. The United States can provide the leadership that will give mothers and children new hope and opportunity to lead healthy and productive lives," he said.