Overview
Protecting supporting and improving the health of children is vital for the Africa we want . Over the past several decades, we have seen dramatic progress in improving the health and survival rate of young children. The number of children dying before the age of 5 in the region was more than halved from 2000 to 2022, and more mothers newborns and children are surviving today than ever before.
However, much more remains to be done to further improve health and wellbeing outcomes for children. The world is facing a double mandate. More than half of child deaths are due to conditions that could be easily prevented or treated given access to health care and improvements to their quality of life.
At the same time, children must also be given a stable environment in which to thrive, including good health and nutrition, protection from threats and access to opportunities to learn and grow. Investing in children is one of the most important things a society can do to build a better future.
In 2022, an estimated 4.9 million children under five died, 2.7 million of them in the WHO African Region. This is equivalent to five children under 5 years of age dying every minute. More than two thirds of these deaths can be attributed to preventable causes. More than a third of all these deaths are in the neonatal period.
The primary causes of death in children under-5 include pneumonia, malaria, preterm birth complications, diarrhoea, and birth asphyxia. Approximately one third of all childhood deaths are linked to malnutrition in the African Region.
Malnutrition makes newborns and children vulnerable to both infectious and non-infectious diseases. One child dies every minute from malaria and over 90% of children living with HIV are infected through mother-to-child transmission.
Children in the Region are about 16.5 times more likely to die before the age of five than children in developed countries. Acute respiratory infections are the leading causes of preventable sickness and death among children. Breastfeeding helps, to build a strong immune system in newborns and young children, protects against infections such as acute respiratory infections and diarrhoea, and confers long-term health benefits
While most healthy children can thrive with their natural defences, malnutrition and children who are not exclusively breastfed can suffer compromised immune systems. Exclusive breastfeeding for the first six months of life is recommended.
Adults who were breastfed as babies often have lower blood pressure, lower cholesterol, lower rates of overweight and obesity, and type 2 diabetes. Breastfeeding contributes to the health and well-being of the mother and can reduce the risk of breast and ovarian cancers.
Congenital anomalies, injuries, and non-communicable diseases (chronic respiratory diseases, acquired heart diseases, childhood cancers, diabetes, and obesity) are the emerging priorities in the global child health agenda. Congenital anomalies affect an estimated 1 in 33 infants, resulting in 3.2 million children with disabilities related to birth defects every year. The global disease burden due to non-communicable diseases affecting children in childhood and later in life is rapidly increasing, even though many of the risk factors can be prevented.
Injuries (road traffic injuries, drowning, burns, and falls) rank among the top 3 causes of death and lifelong disability among children aged 5-15 years. In 2012 violence and unintentional injuries killed an estimated 740 000 children under the age of 15, with the latter accounting for 90% of these deaths.
Similarly, the worldwide number of overweight children increased from an estimated 31 million in 2000 to 42 million in 2015, including in countries with a high prevalence of childhood undernutrition.
WHO works with partners and Member States to improve the lives of all children and meet the targets of Sustainable Development Goals related to the health and wellbeing of children, including target 3.2, which aims to end preventable deaths of newborns and children under 5 by 2030
WHO advocates for health equity through universal health coverage (UHC) and the global availability of and access to technologies, including health products and vaccines to prevent some of the deadliest childhood diseases. WHO also promotes infant and young child feeding, with a focus on exclusive breastfeeding for infants. It has developed and promotes an integrated approach to managing childhood illness that considers all aspects of a child’s health, and a continuum of care throughout the early years to safeguard their developmental outcomes, including the reduction of risk factors for diseases that can arise later in life.
These goals are a collaboration between many WHO departments and coordinated through the Department of Maternal, Newborn, Child and Adolescent Health, and Ageing.
Who is most at risk?
Newborns
2.7 million babies die every year in their first month of life and a similar number are stillborn. Within the first month, up to half of all deaths occur within the first 24 hours of life, and 75% occur in the first week. The 48 hours immediately following birth is the most crucial period for newborn survival. This is when the mother and child should receive follow-up care to prevent and treat illness.
Globally, the number of neonatal deaths declined from 5.1 million in 1990 to 2.7 million in 2015. However, the decline in neonatal mortality from 1990 to 2015 has been slower than that of post-neonatal under-5 mortality: 47% compared with 58% globally. This pattern applies to most low- and middle-income countries. If current trends continue, around half of the 69 million child deaths between 2016 and 2030 will occur during the neonatal period. The share of neonatal deaths is projected to increase from 45% of under-5 deaths in 2015 to 52% in 2030. Moreover, 63 countries need to accelerate progress to reach the Sustainable Development Goal (SDG) target of a neonatal mortality rate of 12 deaths per 1000 live births by 2030.
Prior to birth, a mother can increase her child's chance of survival and good health by attending antenatal care consultations, being immunized against tetanus, and avoiding smoking and use of alcohol.
At the time of birth, a baby's chance of survival increases significantly with delivery in a health facility in the presence of a skilled birth attendant. After birth, essential care of a newborn should include:
- ensuring that the baby is breathing;
- starting the newborn on exclusive breastfeeding right away;
- keeping the baby warm; and
- washing hands before touching the baby.
Identifying and caring for illnesses in a newborn is very important, as a baby can become very ill and die quickly if an illness is not recognized and treated appropriately. Sick babies must be taken immediately to a trained health care provider.
The Sustainable Development Goals (SDGs) adopted by the United Nations in 2015 aim to ensure healthy lives and promote well-being for all children. The SDG goal 3 target 3.2 is to end preventable deaths of newborns and under-5 children by 2030.
Target 3.2 is closely linked with target 3.1, to reduce the global maternal mortality ratio to less than 70 deaths per 100 000 live births, and target 2.2 on ending all forms of malnutrition, as malnutrition is a frequent cause of death for under-5 children. These have been translated into the new "Global Strategy for Women’s, Children’s and Adolescent’s Health" (Global Strategy), which calls for ending preventable child deaths while addressing emerging child health priorities.
To achieve the SDG targets, the global community has set goals and targets for tackling the unfinished child survival agenda to achieve under-5 mortality of 25 or fewer deaths per 1000 live births by 2030. This has been translated into several global initiatives:
- "ending preventable maternal mortality" and "every newborn action plan" to promote universal coverage of high quality maternal and newborn care;
- the "global action plan for the prevention and treatment of pneumonia and diarrhoea";
- a "comprehensive implementation plan on maternal, and infant and young child nutrition" to reduce under nutrition and obesity;
- the "Global Technical Strategy for Malaria" to reduce global malaria case incidence and mortality by 2030;
- the "Global Vaccine Action Plan" to prevent childhood diseases through vaccination; and
- the United Nations Decade of Action on Nutrition 2016–2025 to eradicate hunger and prevent all forms of malnutrition worldwide.
Member States need to set targets and develop specific strategies to reduce child mortality and monitor progress.
