JOIN USSince1990, and despite significant increases in the global population, the annual number of maternal and child deaths has dropped by nearly 50 per cent. The Unicef estimates that 100 million children under age five have been saved over the past two decades alone.
Several very poor countries, such as Nepal, Bangladesh, and Ethiopia are on track to meet the Millennium Development Goal of reducing under-five deaths by two-thirds by the end of 2015 – an achievement many once thought impossible.
Yet globally, over six million children and nearly 3,00,000 mothers still die each year – most from preventable causes and more than 98 per cent in the developing world. Access to quality care before, during and after delivery, immunisations, prevention and treatment of malaria, life-saving treatment of diarrhoea and pneumonia; and improved breastfeeding practices could help save most of these lives. But too many, and especially the poorest and the most marginalised, are still not benefiting from these lifesaving interventions.
It is for this reason that the Government of India will host a “Call to Action Summit” on August 27 and 28 involving delegations from 24 countries, donors, and global health experts to review progress made, and actions needed, to accelerate progress toward the achievement of the global goal of “ending preventable child and maternal deaths.”
While some progress has been made in addressing the equity gap, we must do more. Save the Children’s recent report on urban health, for example, found that a child in the poorest quintile was twice as likely to die before his or her fifth birthday as a child in the wealthiest quintile.
Wide disparities exist as well in access and use of high-impact services and practices that can save lives. In short, we need to focus more attention on understanding and removing barriers to access and increasing effective use of these interventions by those who need them most.
Affordable care
Imagine, for example, a mother who delivers her newborn in the absence of skilled attendant, a newborn that is not breathing but there is no one present who knows what to do, or a mother who knows she should breastfeed but others are telling her to discard the colostrum (the first milk from the breast filled with nutrients and antibodies for preventing illness).
Imagine a family with a child in respiratory distress or suffering from dehydrating diarrhoea, but does not know what to do or where to get quality, affordable care. None of us wants to be in this situation – but that is the reality for far too many.
In addition to closing the healthcare equity gap, we also need to focus more attention on ending preventable child deaths during the first month of life when 44 per cent of children under age five die. In South Asia, this percentage is close to 60 per cent, yet for many, access and use of quality maternal and newborn services and practices care that could save these lives remains low.
Our world continues to rapidly urbanise, and an increasing portion of maternal and child deaths occur among the nearly 900 million who live in urban slums. Yet, we lack innovative, scalable approaches to reaching these populations with basic health services, including clean water and basic sanitation.
Poor infant and young child nutrition is an underlying cause of nearly half of all under-five deaths, yet there are few examples of large-scale programmes that have documented improvements in feeding practices and nutritional outcomes.
We also know that ensuring access to contraception is key to improving maternal and newborn health and survival, but globally more than 200 million women or girls who want to delay or space a pregnancy are not using a safe and effective means of contraception. Increased investments in strengthened health systems will be key to achieving and sustaining progress in delivering these, and other, interventions we know can dramatically improve health and survival.
These challenges may seem daunting, but we know they can be met. Our hope is that the experience and learning that will be shared in the Call to Action Summit will help inform a renewed commitment to taking the actions needed to further reduce maternal deaths and end preventable newborn and under-five deaths as envisioned in the 2030 Sustainable Development Goals.
(The writer is Senior Health and Nutrition Advisor, Save the Children)