Few Countries on Track to Curb Maternal, Child Mortality Rates
Global initiative stymied by shortage of money, human resources, analysis concludes
FRIDAY, April 11, 2008 (HealthDay News) -- Three-quarters of the 68 countries most in need of improving mother and child mortality rates have made little, if any, progress in meeting internationally set goals over the past three years, according to a series of new reports.
The Countdown to 2015 for Maternal, Newborn and Child Survival, an international group that monitors these goals, still holds hope that progress can be made quickly in these underachieving nations, according to reports this week in a special edition of The Lancet.
The medical journal looks at the group's efforts in 68 "priority" or "countdown" countries, where 97 percent of the maternal and child-under-5 deaths occur worldwide. The group has set goals to reduce child mortality rate by two-thirds and maternal deaths by three-quarters by 2015.
In a commentary, Lancet Editor Dr. Richard Horton calls the Countdown project's overall progress "strikingly inadequate" and concludes, "children and mothers are dying, because those who have the power to prevent their deaths choose not to act. This indifference -- by politicians, policy makers, donors, research funders and civil society -- is a betrayal of our collective hope for a stronger and more just society."
Of the priority countries, only 16 are on track to reach the goal of reducing the mortality rate in children. Three -- China, Haiti and Turkmenistan -- had made demonstrable progress to improve maternal, newborn and child survival since the countdown began in 2005. The others were either already on track when the countdown was launched or were added onto the list only recently.
Most of the countries that have made no progress, or even taken steps backward, are in sub-Saharan Africa.
Another report in The Lancet states that most of the countries being watched have made some progress since 1990 to reduce the coverage gap for four key interventions -- family planning, maternal and newborn care, immunization and treatment of sick children. Yet the study, by the Countdown 2008 Equity Analysis Group, said the pace needs to be more than doubled if they hope to meet goals for 2015.
While actual maternal mortality was still high or very high in 56 of 68 countries, one report suggests some key parts of the solution are in place. These include consensus on priority interventions (such as immunization and antenatal care), various health-care policies and funding increases.
For example, donor funding increases have nearly doubled funding per child in the 68 countries, according to one report in The Lancet. Child-related disbursements increased from a mean of $4 per child in 2003 to $7 in 2006. Those for maternal and neonatal health increased from $7 per live birth in 2003 to $12 per live birth in 2006.
However, the report noted that funding still dropped in several countries, stifling attempts for governments to make long-term commitments to health improvements.
"In the seven years until 2015, the next two years before the next Countdown Report will be the most crucial," the study's authors wrote. "With strategic decisions and investments, and a focus on partnerships for results, we have the opportunity to see unprecedented progress in these 68 countries. Or will the 2010 report show more of the same gaps and lives lost?"
Some of the other findings in the special edition include:
- Policy gaps in many of the countries are hindering their progress along with financing woes and human resources issues.
- Tanzania is one of the few African nations on track to meet the goal of reducing child mortality, showing a 24 percent decline from 2000 to 2004. The report credits good program funding and several initiatives such as insecticide-treated nets to prevent malaria, vitamin A supplementation, immunization and exclusive breast-feeding.
- South Africa is suffering major setbacks in meeting its goals because of pregnancy and childbirth complications, newborn illness, childhood illness, HIV and AIDS, and malnutrition. It is one of just 12 countries globally where the child mortality rate has risen since 1990.
Here's more about Countdown to 2015.