Sub-Saharan African countries continue to battle with the highest child mortality rates in the world. In 2012, the region accounted for around 3.2 million deaths among under-fives (98 deaths for every 1,000 live births), nearly half the total number worldwide. It is also the only region of the world where the numbers of live births and child population are expected to grow substantially over the next two decades. By 2050, 40% of all births will take place in Sub-Saharan Africa and the number of child deaths could therefore rise in the region.
However, there are signs that death rates may stagnate or even reduce, particularly since progress in the rate of decline in under-five deaths has accelerated over time, from 0.8% a year between 1990-95 to 4.1% a year over 2000-2012. High annual rates of decline in some low-income countries indicate that much more could be achieved across the board when countries implement the right policies. According to a new report from the UN's child agency, UNICEF, entitled 'Levels & trends in child mortality', Malawi (71%), Liberia (70%), Tanzania (68%) and Ethiopia (67%) have all reduced their under-five mortality rate by two-thirds between 1990 and 2012.
This significant reduction in Ethiopia means the country has joined other nations (including Liberia, Malawi and Tanzania) in achieving its millennium development goal (MDG) on cutting child mortality ahead of the 2015 deadline. Speaking to the Guardian, the UNICEF country representative for Ethiopia put the success down to "some very bold and extremely ambitious targets" set by the Ethiopian government, which were backed up by "real resources and real commitment sustained over the last 10 years".
Health workers are the key
Part of this commitment involved the training and introduction of 36,000 health workers across 15,000 medical centres in Ethiopia. The UNICEF representative explains that this was "the single most important reason why Ethiopia has reduced its under-five mortality rate". Ethiopia's health minister agreed with this assessment and praised the country's "amazing" health workforce for the results which have been achieved.
However, health officials in Ethiopia understand that the 'easier wins' for cutting child deaths through better medical services have been made. Many child deaths in Ethiopia now occur in the first 28 days of life and they understand that improving survival rates for newborns will be much harder to reduce. This is because such deaths are often linked to poor maternal health and nutrition, which require much more highly-skilled services to improve. Nevertheless, understanding the problem is always the first step and Ethiopia's health ministry seems determined to continue moving forward.