A newborn child in Sierra Leone has the lowest chance in the world of surviving until age 5, with the prospects almost as bad for children in Angola and Afghanistan, a report released yesterday by the UN's children's fund said.
In 2006, nearly 9.7 million children died worldwide before reaching the age of five, mostly from preventable causes such as diarrhea, malaria or malnutrition, UNICEF said in its annual report.
But progress has been made in several regions and strengthening local health services holds great promise for reducing the child mortality rate, said the 154-page document, The State of the World's Children 2008.
More than 26,000 children under the age of five die each day on average.
In 2006, the latest year for which statistics are available, Sierra Leone had the highest child mortality rate, with 270 deaths per 1,000 births. Angola came second with 260 deaths per 1,000 births, followed by Afghanistan with 257 deaths per 1,000 births.
The worldwide under-5 mortality rate in 2006 was 72 deaths per 1,000 births. The average rate of industrialized countries was six deaths per 1,000 births.
"The loss of 9.7 million young lives each year is unacceptable, especially when many of these deaths are preventable," UNICEF Executive Director Ann Veneman said.
The deaths could be prevented by simple health care measures, such as vaccination, insecticide-treated bed nets and vitamin supplements, the report said. But the measures must be taken all together and applied in each village to reach every child, even in the remotest regions of the world, it said.
"We know exactly what works," said Angela Hawke of UNICEF, referring to strategies the agency has been promoting for some time.
"But we need to make sure that these kinds of services are integrated at the most local level, in the villages where children live," she said, adding that governments and health experts should define the best solutions for each community.
"We want to make sure that there are local health services that really work with properly staffed health centers ... and there's a proper national health plan," Hawke told reporters.
Sierra Leone which suffered an 11-year civil war from 1991 to 2002 and is one of the poorest countries in the world, is, like Angola, Afghanistan and other war-torn regions, unable to offer sufficient health services to its citizens, the report said.
Although there has been progress in many countries and the under-5 mortality rate worldwide has been reduced by 23 percent since 1990, more needs to be done. If the world is to reach the UN objective of decreasing the global child mortality rate by two-thirds between 1990 and 2015, the current rate must be cut in half within the next seven years, the report said.
In Mexico, a program aimed at engaging the poorest families provides financial rewards to parents who bring their children regularly to health clinics to show that they take care of the child's health and nutrition according to a set of criteria. The child mortality rate in Mexico has been reduced by 34 percent since 1990.
But sub-Saharan Africa, where the child mortality rate went down only by 14 percent since 1990, is still the region of greatest concern, the report said.
The data was mainly drawn from statistics and studies by the WHO, the World Bank and the UN Populations Division.
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