WOMEN’S, CHILDREN’S AND ADOLESCENTS’ HEALTH: status update and strategic priorities
1.2

Children’s health
and well-being

Many issues and shortcomings in health care that lead to death or illness for women around the time of childbirth also affect the health of newborns and young children. Other factors that affect the health and life chances of women – including poverty, inequity, malnutrition and adverse social norms – also profoundly affect their children.

STATUS UPDATE

Survive

The link between maternal health and child health is seen most starkly in the neonatal mortality rate (NMR), which is still both too high and declining too slowly. In 2015, 2.7 million newborns died within 28 days of birth, representing 45% of all deaths among children under five and an NMR of 19 deaths per 1000 live births (down from 36 deaths per 1000 live births in 1990).46 The SDGs and EWEC Global Strategy target an NMR of no more than 12 deaths per 1000 live births in any country.47
More progress was made in reducing the under-five mortality rate (U5MR) than the neonatal mortality rate in the MDG era, with declines of 53% and 47% respectively between 1990 and 2015. However, this fell short of the MDG 4 target of a 66.6% reduction. There still is a high death toll: 5.9 million children died in 2015, largely from preventable causes.48 The smallest relative declines occurred in the WHO Eastern Mediterranean Region (48%) and the WHO African Region (54%). The SDG target is a U5MR of no more than 25 deaths per 1000 live births in any country.49 Currently, 79 countries worldwide do not meet the SDG target for under-five mortality.
More than half of the decline in the U5MR since 2000 has been achieved by addressing the major causes of deaths in childhood (Figure 5). A 75% reduction in measles deaths among children under five was achieved, and
significant progress made against other major killers such as pneumonia, diarrhoea and malaria, including by substantially scaling up vaccine coverage, addressing environmental factors such as water, sanitation and hygiene, and using insecticide-treated nets.50 Malnutrition underlies around half of all child mortality.51

 

 

Thrive

Beyond mortality and morbidity, current monitoring systems are generally poor at capturing data about the health and development of children. This makes it difficult to assess whether children are thriving through childhood and into adolescence. However, indirect data clearly indicate several risk factors, such as poverty, undernutrition, lack of access to education and exposure to violence.52 The Early Childhood Development (ECD) Lancet series (2016) indicates that 250 million children in low- and middle-income countries are at risk of suboptimal development due to poverty and stunting (Figure 6).53 The effects of undernutrition and stunting can include diminished cognitive and physical development, poor educational performance and reduced resistance to disease.
Significant improvements were made to childhood nutrition during the MDG era. A 44% reduction was achieved between 1990 and 2015 in the proportion of children under age five who were underweight. Globally, stunting declined by 41% in the same period, although the condition still affected an estimated one in four children in 2015.54
A poor start in life also affects future generations. It is estimated to cause adults to lose about one quarter of average adult income per year, causing a loss for some countries of twice their current GDP expenditures on health and education.55

250

MILLION CHILDREN
IN LOW- AND MIDDLE-INCOME COUNTRIES

are at risk of suboptimal development due to poverty and stunting