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Whether child ‘survives to the age of 5’ is a game of chance

Rabia, seven months, enjoying a sachet of nutritional peanut paste, with her mum Laila. (Photo by Lucia Zoro/Save the Children.)

Every minute 255 children are born. The chances of survival for these children varies greatly depending on where in the world they are born. Children born in the poorest places a more likely to die, according to a report released today by Save the Children. Overall, child mortality rates are falling. Today, 17,000 fewer children die each day than in 1990. It is a stunning achievement, but too many families in the poorest regions are left behind.

“Whether you survive to the age of 5 is dependent on where you were born, who you were born to and what part of a country where you born,” said Carolyn Miles, Save the Children president and CEO, in an interview with Humanosphere.

According to report The Lottery of Birth, inequality between the wealthiest and poorest in some countries is growing and it means that some parts of societies are eliminating preventable child deaths while others see little change. Indonesia is one example. A child born to one of the 40 percent poorest households was 2.5 times more likely to die than a child born in the top 10 percent. In nearby Vietnam, the rate of child mortality among the Kinh ethic group is is 3.5 times higher than members of other groups. Similar stories from Niger and Honduras are told in the report.

“The issue of inequality cuts across many things, whether you talking about water or child mortality,” said Miles. “The goal of reducing child mortality is not met until it is met for all layers of your society. To get to zero for the top half of the wealth quintile and 20 percent at your lowest is not where you want to be.”

An analysis of 87 countries by Save the Children finds that 78 percent of the countries have at least one group that is seeing slower progress in reducing child deaths as compared to upper level groups. Setting aside inequality, the pace of progress is already slow. The goal to reduce the global mortality rate of children under 5 years old by two-thirds will not be met until 2028. However, the deadline set by the Millennium Development Goals is the end of this year.

The lottery of birth is most pronounced when comparing entire countries against one another. The chance that a child born in Angola (the country with the worst child mortality rate) is 84 times higher than Luxembourg (the country with the lowest child mortality rate). The currently debated Sustainable Development goals, which will replace the expiring Millennium Development Goals, present a chance to close the gap between countries like Angola, Sierra Leone and Chad with the top.

Save the Children makes the case that gains will be made by targeting the toughest places.

“What we found was evidence that focusing on the worst-off kids drove overall progress by 6 percent,” said Miles. “The answer is go for the hardest to reach kids. Not only will you get those kids, but you will make progress on child mortality overall.”

There are already examples of success, she said. Mozambique has reduced its mortality rate by 34 percent overall, largely thanks to the rate falling by more than half for the poorest twenty percent between 1997 and 2011. Malawi did even better by cutting the disparity between urban rural parts of the country in only a decade. The countries are not alone, Kenya, Namibia, Rwanda and Bangladesh also managed to make more equitable reductions.

The report is designed to press on global leaders the importance of child health. Miles is hopeful that leaders will take action to go after the areas where the most preventable deaths are occurring in order to accelerate the current downward trend.

“More and more I think it is about investing as early as we can. Those early interventions are where you can say ‘that is where I get my best return on investment,’ ” said Miles. “It has to be about children. These goals are not about us. We are trying to change life for the 15-year-old today and the child to be born tomorrow.”


About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]