Last year marked the 25th anniversary of the UN Convention on the Rights of the Child. The status report on the Convention published by the UN in September noted an incredibly important fact - that under-5 mortality has nearly halved, from 90 deaths per 1,000 live births in 1990 to 48 per 1,000 in 2012.
That is 17,000 fewer children dying every day.
The pace in reducing early child deaths has quickened â from a 1.2% per annum in 1990-95 to 3.9% in 2005-12. Of course this is a tremendous success story, but to put it into perspective, the global average of 48 per 1000 compares to 5 per 1000 in the UK and 3 in Sweden, and the MDG goal of a two-thirds reduction will not be met by the 2015 target year.
Last week Save the Children issued a report, The Lottery of Birth, which shines a spotlight on a key part of this story which is that even within national averages, the progress has not been equitable - mortality rates are typically falling least among the poorest and most marginalised children and mortality inequalities within countries are growing. The implication of this is that to make further reductions requires policies to reach the poorest families, where the problem is greatest.
Amid a useful array of statistics and case studies, I take away two central messages from the report:
- National averages mask large disparities in child mortality and some of these inequalities have grown (especially different progress by social and economic groups). In Indonesia, for example, children in the poorest 40% of households were 2.5 times more likely to die than a child in the richest 10%, and this gap had doubled since 2002. These gaps are found by income, location, and ethnicity.
- But it isn't universally the case that the gaps are widening - and equitable progress can be faster. Some countries have managed both to reduce mortality and to narrow the gaps between rich and poor - Rwanda, for example, which has also increased he
In a sense this second story of countries which manage to reduce mortality, and to do so equitably, is the key argument â countries which have found an equitable pathway to reducing mortality have achieved on average a 6% faster progress in reduced mortality over ten years. Indeed as high child mortality is increasingly concentrated among the poorest families, a more equitable approach is essential to building the pace in reducing mortality. In terms of policy messages;
First, the report emphasises the need for the Sustainable Development Goals to focus attention on inequalities (e.g. better data and targets with equity stepping stones to meet them). Recent debates on the SDGs have picked up at least part of that that concern, and suggested that targets should be disaggregated to track progress for different social groups and age groups. The key issue here is to ensure that the aim of adequate disaggregation is not lost in the intergovernmental (and inter-statistical) conversations over the coming months.
Second, there is the question of what types of policies and programmes are essential to support reductions. The report identifies the importance of stronger heyoung women's aspirations and also would help to reduce child and maternal mortality (which can result from early child-bearing). It is also worth noting that since greater reductions have been achieved in child mortality reductions than infant mortality, deaths are more concentrated among the youngest children (neonatal deaths increased from 37% to 44% of under-5 deaths between 1990 and 2013), highlighting the importance of focusing attention on the very earliest point of life. There is also a growing head of steam around the importance of universal heAmartya Sen recently called 'the affordable dream'). Tackling poor hea key cause of becoming poorer. And as we know from the UK's earlier experience, improved sanitation and nutrition is central to reducing mortality.
So the central message I take away from reading this report is that more equitable progress is both possible and necessary to further reducing child mortality. Policies that support this include public he
Finally, the title of the report 'the lottery of birth' - can be read in two ways. First, that from the perspective of social justice and a social contract, children's life-chances behind the veil of ignorance' are a lottery: no one chooses where or in to which households they will be born. But viewed differently, a lottery which can be predicted by social background is no kind of lottery at all: it is one of the very clearest forms of social injustice.
The Lottery of Birth: Giving All Children the Chance to Survive, published by Save the Children on 9 Feb 2015
Last year marked the 25th anniversary of the UN Convention on the Rights of the Child. The status report on the Convention published by the UN in September noted an incredibly important fact - that under-5 mortality has nearly halved, from 90 deaths per 1,000 live births in 1990 to 48 per 1,000 in 2012.
That is 17,000 fewer children dying every day.
The pace in reducing early child deaths has quickened â from a 1.2% per annum in 1990-95 to 3.9% in 2005-12. Of course this is a tremendous success story, but to put it into perspective, the global average of 48 per 1000 compares to 5 per 1000 in the UK and 3 in Sweden, and the MDG goal of a two-thirds reduction will not be met by the 2015 target year.
Last week Save the Children issued a report, The Lottery of Birth, which shines a spotlight on a key part of this story which is that even within national averages, the progress has not been equitable - mortality rates are typically falling least among the poorest and most marginalised children and mortality inequalities within countries are growing. The implication of this is that to make further reductions requires policies to reach the poorest families, where the problem is greatest.
Amid a useful array of statistics and case studies, I take away two central messages from the report:
- National averages mask large disparities in child mortality and some of these inequalities have grown (especially different progress by social and economic groups). In Indonesia, for example, children in the poorest 40% of households were 2.5 times more likely to die than a child in the richest 10%, and this gap had doubled since 2002. These gaps are found by income, location, and ethnicity.
- But it isn't universally the case that the gaps are widening - and equitable progress can be faster. Some countries have managed both to reduce mortality and to narrow the gaps between rich and poor - Rwanda, for example, which has also increased he
In a sense this second story of countries which manage to reduce mortality, and to do so equitably, is the key argument â countries which have found an equitable pathway to reducing mortality have achieved on average a 6% faster progress in reduced mortality over ten years. Indeed as high child mortality is increasingly concentrated among the poorest families, a more equitable approach is essential to building the pace in reducing mortality. In terms of policy messages;
First, the report emphasises the need for the Sustainable Development Goals to focus attention on inequalities (e.g. better data and targets with equity stepping stones to meet them). Recent debates on the SDGs have picked up at least part of that that concern, and suggested that targets should be disaggregated to track progress for different social groups and age groups. The key issue here is to ensure that the aim of adequate disaggregation is not lost in the intergovernmental (and inter-statistical) conversations over the coming months.
Second, there is the question of what types of policies and programmes are essential to support reductions. The report identifies the importance of stronger heyoung women's aspirations and also would help to reduce child and maternal mortality (which can result from early child-bearing). It is also worth noting that since greater reductions have been achieved in child mortality reductions than infant mortality, deaths are more concentrated among the youngest children (neonatal deaths increased from 37% to 44% of under-5 deaths between 1990 and 2013), highlighting the importance of focusing attention on the very earliest point of life. There is also a growing head of steam around the importance of universal heAmartya Sen recently called 'the affordable dream'). Tackling poor hea key cause of becoming poorer. And as we know from the UK's earlier experience, improved sanitation and nutrition is central to reducing mortality.
So the central message I take away from reading this report is that more equitable progress is both possible and necessary to further reducing child mortality. Policies that support this include public he
Finally, the title of the report 'the lottery of birth' - can be read in two ways. First, that from the perspective of social justice and a social contract, children's life-chances behind the veil of ignorance' are a lottery: no one chooses where or in to which households they will be born. But viewed differently, a lottery which can be predicted by social background is no kind of lottery at all: it is one of the very clearest forms of social injustice.
The Lottery of Birth: Giving All Children the Chance to Survive, published by Save the Children on 9 Feb 2015