Monday, September 16, 2013

More children than ever before are surviving past their fifth birthday

Saving children’s lives will benefit entire societies 

By Angela Kearney, UNICEF Representative Indonesia


The opportunity to end preventable child deaths has never been greater than it is today.

Thanks to proven solutions and global and national efforts, the lives of 90 million children were saved globally in the past 22 years; children who would otherwise have died if mortality rates had remained at the same levels as in 1990.

Half as many children died in 2012 than in 1990, with the annual number of under-five deaths falling from 12.6 million in 1990 to 6.6 million in 2012.

In Indonesia, we have also witnessed remarkable progress. While in 1990, as many as 385,000 under-five children died, today, the number has fallen to 152,000. As we take a moment to savour this good news, we must also take stock and remember that we are failing the more than 400 children in Indonesia who still die needlessly every day. And we also need to be aware that although the overall reduction in child deaths is impressive, recent data show that this decline has been slowing down over the past 5 to 10 years. If the current trajectory continues, the achievement of Millennium Development Goal 4 of reducing child mortality by two thirds between 1990 and 2015 remains at risk.



It is even more distressing that so many of the children who die do so within the first few days of life. Globally almost half (or 44 per cent) of under-five children who died worldwide in 2012 did so within the first month of life. A staggering one million babies even died on the day they were born. In Indonesia, an estimated 72,000 babies died in 2012 before completing their first month of life, to great angst for their parents and a great loss for society.

But it doesn’t have to be like this.  We know that we have affordable and effective solutions to prevent child deaths.

Neonatal complications, pneumonia and diarrhoea are still the main causes of deaths among young children in Indonesia despite the presence of effective prevention, diagnosis and treatment against these diseases. Newborn complications result in a substantial proportion of child deaths and these too can be largely controlled through the provision of evidence based interventions by high quality, round the clock health services that are accessible to all.

Typically, it’s the poorest and most marginalized children who fall victim to these easily preventable and treatable diseases. We need to make sure that available prevention and treatment services are available to those vulnerable and poorest children who need them the most

Here is an example of the impact of a simple solution to address a major cause of child death. Since the 1970s, oral rehydration salts (ORS) therapy has been the mainstay of treatment for the life-threatening dehydration that can result from diarrhoea. ORS is inexpensive and is available in various formulations and flavours to encourage use by children. However, in 2012, less than 30 per cent of children who needed ORS received it in the 15 countries which accounted for three-quarters of all diarrhea related child deaths.

Other readily available solutions that can save children’s lives include insecticide-treated mosquito nets for malaria prevention; vaccines against a number of diseases like measles and diphtheria; appropriate breastfeeding practices including exclusive breastfeeding during the first six months of life and its continuation until the age of two;  nutritional supplements and therapeutic food as appropriate; safe water; sanitation facilities; and access to essential medicines and medical supplies.

We also need to make sure that we address all aspects that affect a child’s life. It is not only about health solutions. Efforts towards poverty reduction, ensuring increased access to quality education, policies and systems to ensure child protection including birth registration and ending child marriage, as well as gender equality are all important elements that will contribute to the survival of children. In Indonesia, there are increasing efforts to link the various poverty reduction schemes such as PKH Prestasi and PNPM Generasi to achieve health and nutrition outcomes. These programmes need to be scaled up in order to maximize their impact.



Children who thrive are more likely to live longer, stay in school, be productive members of their society, and realise their dreams, creating benefits that reverberate through future generations.

And that is what motivates UNICEF to work with partners in the ‘A Promise Renewed’ movement towards eliminating preventable child deaths.

The movement, which is based on shared responsibility for child survival, has indeed grown steadily since its start just over a year ago. We are witnessing commitment in its true sense with pledges turning into action on the ground for children.

So far, 176 governments, including Indonesia, have signed the A Promise Renewed pledge and are following the principles and recommendations therein and thousands of civil society groups and private individuals have mobilized actions and resources to dramatically reduce mortality rates even further.

With less than 1,000 days to go before the Millennium Development Goals deadline in 2015, now is the time to step up our efforts to make sure that more children survive past their fifth birthday, and get the chance to realise their full potential in life.

Read the full A Promise Renewed - Progress Report 2013 here.

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