Metropolitan Model United Nations Conference XLII

United Nations Development Programme Child Mortality

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In 2000, all 189 member states of the United Nations and more than two dozen international agencies agreed to the Millennium Development Goals (MDGs) and committed themselves to reaching the eight goals by 2015. The 4th of these goals is to reduce Child Mortality by two-thirds. Child Mortality is defined as the death of a child before the age of five years old. There has been significant progress towards this goal in many countries. The United Nations Development Programme (UNDP) reports that despite population growth, child mortality dropped almost 50% from 1990 to 2012. In 1990, 12.4 million children died before their 5th birthday; the child mortality rate was 87 deaths per 1,000 live births. In 2012, that number had dropped to 6.6 million children, for a child mortality rate of 51 deaths per 1,000 live births. This drop means that 17,000 fewer children die each day than in 1990. But 6.6 million deaths are still too many, especially when 2/3rds of these child deaths are preventable. The vast majority of these deaths occur in the worlds poorest countries. Afghanistans child mortality rate is the worlds worst at 119.41 deaths per 1,000 live births. The next 23 worst countries are all in Sub-Saharan Africa (SSA).1 Nicholas Kristof, columnist for the New York Times and an advocate for women and children around the world, asks some difficult questions: When additional kids survive in poor countries, does that really matter? Isnt the result just a population explosion that eventually leads to famine or war, and more deaths later on? Kristof answers these questions in this way: Thats a frequent interpretation, but its wrong. When child mortality drops and families know that their children will survive, they are more likely to have fewer babies and to invest more in the ones they do have. In other words, declining child deaths leads to declining births. Bangladesh, for example, is now down to an average of 2.2 births per woman, below the world average of 2.5 births per woman and close to the U.S. average of 2.2 In contrast, Nigers fertility rate is the highest in the world at 7.03 births per woman, and SSA has the highest regional fertility rate. Afghanistans fertility rate is 5.54 births per woman.3 The relationship between child mortality and fertility rates has been demonstrated for the last several hundreds years of history, across every region of the world. Healthier babies and children lead to slower population growth. The progress against child mortality been impressive in the years since 2012, but the statistics continue to paint a grim picture for babies and children. One in nine children in SSA die before their fifth birthday. Children in SSA are about 16.5 times more likely to

die before age five than children in developed regions. In low-income countries across the globe, one child out of every 10 dies; in wealthier nations, this number is only one out of 143. In South Asia, one in 16 children die before age 5. Almost one-half of all child deaths occur in the first twenty-eight days of life. Despite improvements in reducing infant mortality, defined as death before the first birthday, three million infants continue to die each year. 4 We know how to reduce child mortality. The World Bank outlines the steps that must be taken:5 Strengthen national health systems Expand immunization programs Enhance growth monitoring of children Ensure the survival and improved health of mothers Support better nutrition for child and mother Invest in improved reproductive health Make infrastructure investments According to Women and Children First, an NGO based in the United Kingdom, the most common causes of death in children under age five are: 6 Birth asphyxia, failure to breath Pneumonia Pre-term-birth complications Diarrheal diseases Malaria Measles Malnutrition Most babies and children could survive these threats if they, their families, and their communities had access to simple, affordable interventions. Lets examine several programs that have produced measurable effects: Care and Education for Mothers: China has made a concerted effort to reduce the gap between infant and child mortality rates in rural areas and those rates in Chinas cities. Chinas government has made decadelong efforts to promote hospital deliveries and improve health care for newborns in rural areas. More hospitals have been built, so that women can actually reach a hospital when they go into labor. Educating women about the benefits of delivering their babies in hospitals has helped overcome the long tradition of home-births. Prenatal care has also increased. Now, in many rural provinces, every pregnant woman admitted to the hospital has been given five physical examinations before delivery, and receives regular checkups for both her and her infant for the following three months. Hospital births are now the

norm, helping to slash infant mortality rates, particularly by reducing deaths form pneumonia. 7 Pre-natal health care and a safe birth are essential for the long-term health of both mother and child. Children who have lost their mothers are up to 10 times more likely to die prematurely than children who have a mother. Thus, it is clear that a healthy pregnancy and healthy birth for the mother leads to a healthy child. Education also increases rates of breast-feeding for mothers, leading to better nutrition for infants and all the health benefits that come with breast-feeding. In Uruguay, a program begun by Women and Children First has now expanded to become the governments policy for the entire country. Teams of health specialists and social workers work with the most vulnerable families, providing food for pregnant women and their babies, education on nutrition and childcare, and regular pediatric visits. Great effort goes into ensuring that mothers and families understand that they have a right to use government and non-profit clinics. Now, 82% of children get medical check-ups as opposed to just 50% before the program began. The program has decreased rates of premature births, low birth weight, malnutrition and low height a measure of growth rates in children. 8 A 2009 study by U.S. researchers discovered a profound link between education for girls and women and child mortality. Those countries that have improved the number of years of schooling for reproductive-age women demonstrate the most progress towards reaching the MDG goal for reducing child mortality. "More education helps mothers make better choices in a range of areas -- personal hygiene, nutrition, parenting approaches," said Dr. Christopher Murray, IHME Director and one of the paper's co-authors. "It also helps them take better care of their own health when pregnant, and, after the child is born, they are able to navigate the expanding array of health services being offered to their families."9 The positive effects of education were measurable even when all other factors were controlled in this study. Accessible Medical Care for Newborns: Another major factor in child mortality is lack of medical treatment. The first 28 days of life - the neonatal period- is the most vulnerable in a newborns life. In 2012, close to three million babies died during the first month of life, mostly from preventable causes; half these deaths occurred on the first day of life. Nearly 1 million newborns die in the first minute after birth simply because they cannot take their first breath. This "golden minute" is the most dangerous time in a persons life. Birth asphyxia kills more children than malaria and nearly five times more than HIV/AIDS. While complications from preterm birth are responsible for 34% of neonatal deaths, the majority of them preventable. Developing nations need more capable medical practitioners than they now have. In addition, simple resuscitators can save the lives of newborns, and access to life-saving

medical intervention and treatment for unborn children can prevent the deaths of these youngest patients. Vaccinations and Prevention: Malaria kills one child every minute in SSA. Insecticide-treated Mosquito nets to cover the beds of children prevent transmission of malaria and increase child survival. Measles is a leading cause of childhood mortality, but this disease can be prevented with just two doses of a safe, effective, and inexpensive vaccine. Poverty, poor health systems, and a lack of information in developing countries continues to limit access to preventative vaccinations for too many children. Vaccines have worked to lower child mortality rates in many developing nations. For example in Ghana, currently 80 children out of 1,000 do not survive to age five. Rotavirus and pneumococcal disease are the leading causes of diarrhea and pneumonia in young Ghanaian children. Together they account for close to 25 percent of under-five mortality and are behind only malaria as the leading causes of child deaths here. New vaccines in Ghana have significantly lowered the mortality rate. Now both the vaccines for rotavirus and pneumococcal disease are being given to young children before they reach four months of age. Ghana expects to immunize more than 400,000 children against both diseases. Since 2000, measles vaccines have averted over 10 million childhood deaths worldwide. World Bank investments helped to fund the immunizations of 600 million children from 2003 to 2013. Root Causes of Child Mortality: It is important to keep in mind the many other factors that affect child mortality. For example, about 45% of under-five deaths are attributable to under-nutrition. The development of affordable, non-perishable nutritional supplements has helped reduce childhood deaths in areas of famine. Long-term, sustainable solutions for food insecurity must be developed. When a child born in poor country is more than twice as likely to die as a child born in a wealthy nation, it is clear that poverty continues to impact child mortality. The underdeveloped infrastructure of many developing nations kills countless children. The chances of surviving the first five years of life should not depend on the luck of where a child was born; sadly, it often does. Simply building roads has a huge positive impact because roads make health facilities more accessible to rural families and allows health care providers to reach more children. HIV/AIDS continues to affect child mortality. In SSA, more women than men have HIV/AIDS and are at risk of passing on the disease to this children. The medicines that can prevent transmission exist; the challenge is to get these medicines to mothers and children,

to educate children and their parents, and to protect girls and women from contracting HIV. Health education for girls must be aimed at pushing back the age of first pregnancy, as complications of childbirth and infant mortality rates are highest in young girls and teens. There can be no doubt that the MDG goal of reducing child mortality even further is attainable, even in SSA and South Asia. The leading countries in making dramatic and sustainable progress towards meeting the MDG goal about Child Mortality are Niger, Liberia, Rwanda, Indonesia, China, Madagascar, India, Egypt, Tanzania, and Mozambique. Countries that have developed programs to successfully reduce child mortality are encouraged to share their ideas and experiences with others. It is the task of this committee to develop concrete resolutions for addressing the causes of child mortality and the solutions that can reduce childhood deaths. Questions to Consider: What are the current rates for infant and child mortality and fertility in your country? What are the main factors that contribute to child mortality in your country? What is already being done to combat child mortality in your country? How can your country apply its resources to solve the problems at hand? How can your country contribute to global solutions? In what ways can the international community assist your country to reduce child mortality? Notes: 1. CIA World Fact Book 2. Kristof, Nicholas, The End of Extreme Poverty? The New York Times Upfront Upfrontmagazine.com, December 9, 2013 3. CIA World Fact Book 4. http://www.womenandchildrenfirst.org.uk/what-we-do/key-issues/ infant-mortalitynewborn-health/infant-mortality-statistics 5. http://www.worldbank.org/mdgs/child_mortality.html 6. http://www.womenandchildrenfirst.org.uk/what-we-do/key-issues/ infant-mortality-newborn-health/infant-mortality-statistics 7. http://news.xinhuanet.com/english/china/2012-08/27/c_131810284.htm 8. http://www.undp.org/content/undp/en/home/ourwork/womenempowerment/ successstories/in-uruguay--program-helps-parents-keep-children-healthy/ 9. http://news.xinhuanet.com/english2010/health/2010-09/18/c_13518179.htm

Other Sources: http://www.undp.org/content/undp/en/home/mdgoverview/mdg_goals/mdg4/ http://www.worldbank.org/mdgs/child_mortality.html http://www.undp.org/content/undp/en/home/ourwork/womenempowerment/suc cessstories/in-uruguay--program-helps-parents-keep-children-healthy/ http://www.savethechildren.org http://www.scielosp.org/scielo.php?pid=S004296862000001000005&script=sci_arttext&tlng=e