Under-five mortality rate marks sharp fall

Under-five mortality rate in Bangladesh is 32 per 1,000 live births, according to new mortality estimates released yesterday by Unicef, World Health Organisation (WHO), United Nations Population Division and the World Bank Group.

The number has significantly dropped from 532,000 deaths in 1990 to 100,000 in 2017. Among them, little over half are newborns who die in the first 28 days of their life, according to a report UNB received from New York.

The government has taken multiple initiatives to address the gaps in newborn care, such as launching the National Newborn Campaign to promote affordable interventions at community and household level.

Early this month, the government launched the National Newborn Health Programme that brings focus to critical interventions in all 64 districts.

To save the lives of the sick and low birth-weight babies, the health ministry is partnering with Unicef and other partners to establish Special Newborn Care Units (SCANUs) in Bangladesh.

The SCANUs provide specialised care for the sick and low birth-weight babies who are most vulnerable and bear the highest mortality risk.

An estimated 6.3 million under-15 children died last year or 1 every 5 seconds, mostly of preventable causes, according to the new mortality estimates.

The vast majority of these deaths, 5.4 million, occur in the first five years of life, with newborns accounting for around half of the deaths.

“Without urgent action, 56 million children under five will die from now until 2030 -- half of them newborns,” said Laurence Chandy, Unicef director of data, research and policy.

“We have made remarkable progress to save children since 1990, but millions are still dying because of who they are and where they are born. With simple solutions like medicines, clean water, electricity and vaccines, we can change that reality for every child.”

According to last year's global statistics, half of all deaths under five years of age took place in sub-Saharan Africa, and another 30 percent in Southern Asia. In sub-Saharan Africa, 1 in 13 children died before their fifth birthday. In high-income countries, the number was 1 in 185.

Millions of babies and children should not still be dying every year from lack of access to water, sanitation, proper nutrition or basic health services, said Princess Nono Simelela, assistant director-general for family, women and children's health at WHO.

“We must prioritise providing universal access to quality health services for every child, particularly around the time of birth and through the early years, to give them the best possible chance to survive and thrive.”

Most under-5 children die due to preventable or treatable causes such as complications during birth, pneumonia, diarrhoea, neonatal sepsis and malaria. By comparison, among children between 5 and 14 years of age, injuries become a more prominent cause of death, especially from drowning and road traffic.

Within this age group, regional differences also exist, with the risk of dying for a child from sub-Saharan Africa 15 times higher than in Europe.

“More than six million children dying before their fifteenth birthday is a cost we simply can't afford,” said Timothy Evans, senior director and head of the Health, Nutrition and Population Global Practice at the World Bank Group.

“Ending preventable deaths and investing in the health of young people is a basic foundation for building countries' human capital, which will drive their future growth and prosperity.”

For children everywhere, the most risky period of life is the first month. Last year, 2.5 million newborns died in their first month.

A baby born in sub-Saharan Africa or in Southern Asia was nine times more likely to die in the first month than a baby born in a high-income country. And progress towards saving newborns has been slower than for other children under five years of age since 1990.

Even within countries, disparities persist. Under-five mortality rates among children in rural areas are, on average, 50 percent higher than among children in urban areas. In addition, those born to uneducated mothers are more than twice likely to die before turning five than those born to mothers with a secondary or higher education.

Despite these challenges, fewer children are dying each year worldwide. The number of children dying under five has fallen dramatically from 12.6 million in 1990 to 5.4 million in 2017. The number of deaths in children aged between 5 and 14 dropped from 1.7 million to under a million during the same period.

UN Under-Secretary-General for Economic and Social Affairs Liu Zhenmin said the new report highlighted the remarkable progress since 1990 in reducing mortality among children and young adolescents.

“Reducing inequality by assisting the most vulnerable newborns, children and mothers is essential for achieving the target of the Sustainable Development Goals on ending preventable childhood deaths and for ensuring that no one is left behind,” he added.