Infant Mortality Falls by More than Half in 20 Years, but Disparities among Countries in the Americas Persist
In observance of Universal Children’s Day, PAHO/WHO calls for a redoubling of efforts to improve the overall health of children
Washington, D.C., November 20, 2012 (PAHO/WHO) - Although mortality in children under 5 in Latin America and the Caribbean has fallen from 54 to 23 deaths per 1,000 live births in the past two decades, enormous disparities among and—sometimes even within the countries of the Region—persist.
On Universal Children’s Day, observed on November 20, the Pan American Health Organization/World Health Organization (PAHO/WHO) is calling for a redoubling of efforts in the Region to prevent and reduce mortality and the burden of disease in children under 5 and to strive to improve the overall health of children.
In September, the health authorities of the Americas approved the Strategy and Plan of Action for Integrated Child Health, aimed at improving health and reducing infant mortality through an integrated, multisectoral, rights-based approach that considers the social determinants of health.
The Plan of Action, approved during the 28th Pan American Sanitary Conference of PAHO/WHO, entails a set of services that constitute a portfolio of cost-effective, evidence-based interventions, employing a primary health care strategy with an intercultural and gender approach in which health is considered a right, consistent with the Convention on the Rights of the Child.
“The main idea of this plan is to ensure that children survive, flourish, and lead healthy, happy lives,” said Gina Tambini, Family and Community Health Manager at PAHO.
Between 1990 and 2010, the average mortality rate in children under 5 in Latin America and the Caribbean fell from 54 to 23 deaths per 1,000 live births, representing an average annual decline of 4.3% in under-5 mortality for the Region. If this trend continues, the Region will reach the Millennium Development Goal target of a two-thirds reduction in under-5 mortality by 2015.
However, regional averages for under-5 mortality mask disparities among and within countries. For example, in 2011 it was estimated that Haiti and Bolivia had under-5 mortality rates of 87 and 51 deaths per 1,000 live births, respectively, compared to reported rates of 19 in Colombia, 8 in Chile, and 6 in Cuba.
Most deaths in children are preventable. In countries with high mortality, selected high-impact, low-cost interventions could reduce the number of deaths by more than 50%, but these interventions are not reaching all who need them.
Furthermore, although the prevalence of malnutrition in the Region is low, chronic malnutrition is still one of the most common growth disorders in Latin America and the Caribbean, affecting nearly 9 million children under 5. At the same time, childhood obesity is one of the most serious public health challenges in several countries. Moreover, some 22.5 million children suffer from anemia.
The strategy approved by the health authorities considers child health to be the result of interaction between factors related to health systems and the social determinants of health. Coordination among the various social and government sectors is therefore necessary to improve children’s health.
The Plan of Action calls for expanding regional integrated child health partnerships to strengthen professional associations and collaboration with international organizations in order to promote health interventions and mobilize resources with national partners. The objective is to form a national intersectoral working group for integrated child health in each country so as to develop national practices consistent with country policies, laws, epidemiological profiles, and health system requirements.
Consistent with this strategy, the countries must
- promote the implementation of effective, evidence-based interventions to prevent child morbidity and mortality
- support integrated child health policies as part of general national health plans
- strengthen health services and systems in order to deliver quality care, with alternative strategies for reaching underserved populations
- promote coordination between ministries and other public and academic institutions, as well as between the public and private sectors and civil society to reach a consensus on integrated child health services
- strengthen the capacity of health workers with respect to integrated child health in primary health care facilities
In 1954, the United Nations General Assembly recommended that every country adopt a Universal Children’s Day, to be observed as a day to foster brotherhood and understanding among children around the world, with activities devoted to promoting the well-being of the world’s children [resolution 836(IX)]. The Assembly suggested to governments that the Day be observed on the date that each considered appropriate. November 20 marks the day that the Assembly adopted the Declaration of the Rights of the Child in 1959 and the Convention on the Rights of the Child in 1989.
PAHO, which is celebrating its 110th anniversary this year, is the world’s oldest public health organization. It works with all the countries in the Hemisphere to improve the health and quality of life of the peoples of the Americas and serves as the WHO Regional Office for the Americas.
- Strategy and Plan of Action for Integrated Child Health : CSP28/10
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Photo credit: PAHO/WHO