Committing To Child Survival: Progress Report 2013

  • Within sub-Saharan Africa, there is beginning to be a divergence in child survival trends between Eastern and Southern Africa, and West and Central Africa. This has important implications for strategies, priorities, resources and leadership in the global drive to end preventable child deaths
  • Eastern and Southern Africa has managed to reduce its under-five mortality rate by 53% since 1990 — and in the past seven years has been among the best performing regions in the world, reducing under-five mortality at an annual rate of 5.3% in 2005-2012. But it still has high rates of mortality, with one in every 13 children dying before the age of 5
  • In contrast, West and Central Africa has seen a drop of just 39% in its under-five mortality rate since 1990, the lowest among all regions. Moreover, its annual rate of reduction, while accelerating, is still the slowest in the world. The region also has the highest rate of mortality, with almost one in every eight children dying before the age of 5
  • West and Central Africa is also the only region not to have at least halved its rate of under-five mortality since 1990, and the only region to have seen virtually no reduction in the absolute number of children dying over the past 22 years. Its burden of child deaths now stands at about 2 million annually, almost identical to the level in 1990
  • The good news is that much faster progress is possible. Country experience shows that sharp reductions in preventable child deaths are possible at all levels of national income and in all regions

Some of the world’s poorest countries in terms of national income have made the strongest gains in child survival. Seven high-mortality countries (Bangladesh, Ethiopia, Liberia, Malawi, Nepal, Timor- Leste and United Republic of Tanzania) have already reduced their under-five mortality rates by twothirds or more since 1990; six of these countries are low-income, proving that low national income is not a barrier to making faster and deeper gains in child survival. A further 18 high-mortality countries have also managed to at least halve their under-five mortality rates over the same period.

  • Many middle-income countries have also made tremendous progress in reducing under-five deaths, and most high-income countries have also seen sharp declines since 1990 — proving that even in highincome countries, rapid declines in child mortality are possible.
  • New analysis suggests that disparities in under-five mortality between the richest and the poorest households have declined in most regions of the world. And under-five mortality rates have fallen among the poorest households in all regions.
  • These examples show that it is possible to sharply reduce preventable child deaths, even from initially high rates and among the poorest households, when concerted action, sound strategies, adequate resources, and political will are consistently applied in support of child and maternal health.

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