Report: Egypt boosts child survival rate
LONDON --Egypt has made the most progress in reducing child deaths -- and Iraq the least -- according to a new report from Save the Children charity.
In a publication released Tuesday, using data from 1990 to 2005, London-based Save the Children found that gains in child survival were being reversed in the world's poorest countries, including Botswana, Zimbabwe and Swaziland. And in Iraq, the child survival rate is dropping faster than anywhere else.
The report card is a grim reminder that the vast majority of child deaths -- 94 percent -- occur in just 60 developing countries. Of the approximately 10 million children who die every year, most could be saved with a cheap solution, like a net to protect them from malaria or antibiotics to treat pneumonia.
"These aren't intractable problems," wrote Dr. William Foege, of the Emory University School of Public Health, in an accompanying foreword to the report. "It is simply wrong for only the few to have access to all of the tools for survival because of where they live."
Iraq came last in the report's child survival rankings, with a mortality rate that has soared by 150 percent since 1990. Even before the latest war, Iraq was plagued by electricity shortages, a lack of clean water, and too few hospitals. But in 2005, one in eight Iraqi children died before reaching their fifth birthday.
Egypt lowered its child mortality rate by 68 percent, largely by improving care for pregnant women, ensuring the presence of a skilled attendant during childbirth, and providing better family planning help. Since 1994, Egypt has also increased its health spending by 207 percent, though some of this money has come from international donors.
While child survival is increasing worldwide, the progress is uneven. "In Africa we're behind," said Edilberto Loaiza, a social demographer at UNICEF, the U.N. children's agency. "We are not declaring victory just yet," he said.
Save the Children's report also highlighted several poor countries that have made much progress, including Malawi, Nepal, and Tanzania. Making the right choices is critical, according to Dr. David Oot, Save the Children's vice president of health programs. In developing countries, that often means training village health workers, not investing in hospitals. "In many countries, up to 90 percent of newborns are born at home," Oot said. "If you fail to get to those communities, you will not save those lives."
Lucy Zonde, a mother in Malawi, learned the hard way 10 years ago about the value of hospital care. Zonde gave birth to her first child in her home village, Kame. "It was a terrible labor," she told The Associated Press. "I lost a lot of blood and the traditional birth attendants did not seem to know what to do," she recalled. This time, Zonde is hoping to avoid any such complications by visiting a nearby hospital for prenatal checkups.
That is precisely what the Malawi government wants to see. "We know because of the brain drain, there are not enough nurses to go around...so we have to use these traditional birth attendants," Malawi Health Minister Marjorie Ngaunje told the AP. But Ngaunje said that where possible, women are encouraged to deliver babies in hospitals. Birth attendants are also being taught to rush patients to clinics as soon as they spot any signs of complications.
Improving child survival does not always demand more money; experts say that simple behavior changes can be as effective as medicines. Teaching mothers the importance of breast-feeding or delaying the South Asian practice of bathing newborns in cold water, have benefited children worldwide.
"There are a lot of things you can do that don't require a sophisticated health care system," Dr. Robert Black, chairman of the department of international health at the Johns Hopkins Bloomberg School of Public Health, told the AP. Across Africa, Black described how health workers are helping women deliver their babies at home with "safe birth kits," which contain items like a clean plastic mat and a sterile razor to cut the umbilical cord.
Among industrialized countries, Iceland had the best child survival rate, and Romania the worst. The U.S. placed 26th, tied with Croatia, Estonia and Poland. Nearly seven children die for every 1,000 live births in the United States. That was more than double the rate in Iceland, and 75 percent higher than rates in the Czech Republic, Finland, Japan and Slovenia.
To improve child survival, Save the Children called for more investment in inexpensive solutions such as measles vaccines, oral rehydration therapy, and health education for parents. Experts have previously estimated that it would cost US$5 billion to buy the medicines and therapies needed to save 6 million children every year.
"The U.S. spends approximately US$5 billion every two weeks on the war in Iraq," said Black. "It's not an insurmountable thing for the world community to do. Countries just have to make the decision that they want to save children."
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Associated Press writer Raphael Tenthani contributed to this report from Malawi.
