Attachments
Executive Summary
Governments around the world are failing to honour a pledge to reduce extreme inequalities in child survival, malnutrition, education, protection and other development indicators. In 2015, world leaders signed up to the United Nations Sustainable Development Goals (SDGs) – a set of 2030 targets for eradicating extreme poverty in all its forms. As part of this agreement, governments committed to ensure that the pace of change would be fastest for those left furthest behind. Evidence set out in this report shows that progress to date has been limited, and that SDG monitoring and review is still focusing on average change rather than those who are furthest behind. This neglect of unfair inequalities threatens to derail the entire SDG project.
The leave no one behind pledge: a commitment to progress with equity
The Leave No One Behind pledge lies at the heart of the SDG framework – a commitment ‘to reach the furthest behind first’ and ensure that targets are met for all segments of society. Monitoring and delivering on this promise is not just a matter of equity and fulfilment of fundamental children’s rights. It is also a condition for achieving the 2030 goals. Failure to narrow the gaps between the most marginalised children and the rest of society is acting as a brake on progress.
To illustrate this globally, this report presents inequality trends for five key child poverty indicators – child mortality, malnutrition, child marriage, birth registration and primary education. For each of these, we calculated progress trends for the world’s poorest 20% of households and compared them to global average trends. The world’s poorest households are located in a mix of middle- and low-income countries. The majority – almost a third – are in India, comprising 486 million people. This is followed by Nigeria (127 million), Democratic Republic of Congo (71 million), Indonesia (68 million) and China (63 million).
Across all of the indicators we analysed, we found that inequality is a major barrier to progress, with the world’s poorest households lagging considerably behind global average rates of change. On current trends, we can only expect a marginal or no reduction in these gaps by 2030.
Child survival provides a stark illustration of the challenge. On current trends there will still be more than 4 million deaths of children under the age of five in the year 2030, compared with 5.6 million in 2016. Children in the world’s poorest 20% of households are nearly 40% more likely to die before their fifth birthday than the global average.
Eliminating this wealth gap would save 4.1 million lives between now and 2030. However, social disparities in child survival are narrowing far too slowly. On current trends, the global gap is set to fall by only three percentage points.
In addition to global trends, we looked at what is happening in individual countries, analysing trends for marginalised segments of society including the poorest households, rural areas and girls. Our analysis shows that in 19 of the 45 countries that are off-track for achieving the minimum SDG targets on child mortality for all segments of society, the gap between the poorest children and the national average is not set to close by the end of the century, if at all. 228 million children live in these countries, and they include India and Nigeria, the two countries with the highest numbers of child deaths in the world.
As this report argues, there is an urgent need for governments and aid donors to ensure that progress is not only fast, but also that it is equitable. To achieve this, governments need to understand the extent of the problem. Yet, to date, SDG monitoring is failing to systematically track progress for the furthest-behind groups.
Governments, supported by the international community, must shift their attention from averages to focus on the progress that the children who are furthest behind are making, and the extent to which they are catching up, or converging, with their more advantaged peers.
Inequalities in child survival reflect deeper disparities in access to healthcare and the neglect of major killers. Parents of the poorest children are often unable to meet the costs of health provision. Pneumonia, for example, is the leading cause of child deaths from infectious disease, killing 879,000 children in 2016, overwhelmingly concentrated in South Asia and sub-Saharan Africa. If diagnosed early, the disease can be treated with antibiotics that cost a mere $0.40.
Pursuing equitable pathways towards universal health coverage is essential, ensuring that everyone, and critically the poorest and most marginalised, can access the good-quality health services they need without financial hardship.
Malnutrition is one of the most important indicators for national progress, providing insight into how much support children receive in their early years. Here, too, social disparities loom large: being born into the world’s poorest 20% of households increases the chance of being stunted by 60% among children under five. Worryingly, the gap between the poorest and the global average is static. Of countries that have sufficient disaggregated data to compare trends, none are on track for achieving the SDG target of ending malnutrition by 2030 for all segments of society. In over two-thirds of these countries, social disparities are either widening or static.
For malnutrition, as for child survival, governments need to address underlying social disparities as a matter of urgency. For the poorest 20% of households the rate of decline needed to achieve the SDG target has to increase ten-fold.
The picture is similarly bleak for the other indicators of child development examined in this report.
Child marriage: Progress for girls in the poorest households needs to accelerate by a factor of 13 to reach the target of ending child marriage by 2030. Girls in this group are 76% more likely to marry before 18 than the global average, and this gap is set to close by a mere three percentage points by 2030. Eliminating this wealth gap would prevent 20 million child marriages over the next 12 years. Of 68 countries with data, none are set to achieve the SDG target for all segments of society by 2030.
Birth registration: If current trends continue, there will still be 101 million children by 2030 across the world under age five who do not officially exist as they were not registered at birth. This undermines their access to essential services and rights, and increases their vulnerability to child marriage and labour. Progress for the poorest households needs to more than double to reach the SDG target of universal registration by 2030. Eliminating the wealth gap between the poorest and the global average would see 28 million more children registered by 2030.
Education: Progress for children in the poorest households needs to more than triple to ensure all children complete primary school by 2030. Eliminating the wealth gap between the poorest and the global average would allow 31 million more children to complete primary school over the next 12 years. However, this gap is set to fall by only 5 percentage points by 2030 if current trends continue. Of the 62 countries that are off track for achieving universal primary school completion for all segments of society, 55 will not see the gap between the poorest and the national average close this century.