Fewer Asian kids under 5 dying, UN says

New estimates released by the two United Nations agencies yesterday show that the annual number of underfive deaths decreased in the region from nearly 2.2 million in 1990 to 694,000 in 2010.

The agencies say this is a 56percent decline in the region's child mortality in 20 years, translating into more than 4,000 fewer children dying each day.

The new estimates were published in a report called "Levels and Trends in Child Mortality 2011", issued by the UN Interagency Group for Child Mortality Estimation, of which Unicef and the WHO are members.

Despite the progress, the new figures highlight a number of critical challenges for AsiaPacific policymakers. in the leadup to 2015, when countries have committed to achieving the Millennium Development Goal of reducing child mortality by twothirds.

"Much of the success in reducing child deaths in the region has been the result of years of investment in national immunisation programmes," said Unicef's youngchild survival and development adviser for East Asia and the Pacific, Basil Rodriques. "This has led to the number of vaccinepreventable illnesses and deaths decreasing dramatically over the past 20 years, particularly among children aged two to five years.

"But we are now seeing infant and neonatal deaths making up a much higher percentage of child deaths in the region.

According to the new estimates, 79 per cent of child deaths are now occurring in the first year of life, and the vast majority of these children die within a month of being born.

"Tackling this requires different, more systemic approaches if we are to continue to see progress on child mortality," Rodriques said. "It is going to require governments to invest more strategically in healthcare infrastructure and services, especially in rural and remote areas, and to improve the quality and capacity of healthcare personnel."Effective health systems are critical because births cannot be planned and much stronger health systems are needed. The same is true for treating pneumonia and diarrhoeal diseases, the two biggest killers of children in the region. These diseases occur randomly and require the availability of aroundtheclock health services, he said.

Rapid economic growth has made the region one of the most rapidly developing in the world. While a majority of children have benefited from this, increasing social and economic disparities have meant that large numbers of children from vulnerable and socially excluded groups - the poor, ethnic minorities and children in remote and rural areas - remain without adequate healthcare and nutrition.

"The growing disparities throughout the region must be addressed to ensure all communities have access to reliable health services, and not just those living in welloff urban environments," Rodriques said.

"There is clear evidence of how this divide impacts a child's chances of survival. Countries must increase access to health services in rural areas as a key strategy for meeting the Millennium Development Goal on child mortality."