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Goal 4: Reduce Child Mortality


 Goal 4
  • Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate



Progress on Reducing Child Mortality

  • 26 percent of developing countries (36 countries) are on target
  •  37 percent (52 countries) are close to being on target
  •  38 percent (53 countries) are far behind the target

Among the low-income countries, 5 countries are on target:

  •  Bangladesh, Eritrea, Lao PDR, Madagascar, Nepal



Development assistance for health has quadrupled since 1990, peaking at $24 billion in 2008. Health spending by developing-country governments has also peaked (albeit at a much lower level), nearly doubling to reach $240 million during 1995–2006.

Despite these huge funding gains and sharp expansions in access to health services, the quality (or outcomes) of health remains a grave concern progress toward development targets has been uneven. More resources—even when increasing coverage—may not be enough to have a big effect on outcomes. For example, basic immunization rates have expanded, but full immunization coverage—needed for the full impact on child mortality— is much lower.

Since the 1990s, numerous studies have found that public health spending is not concentrated among the poor and that the rich benefit disproportionately from public health subsidies. Apart from Latin America and the Caribbean, the rich receive far greater benefits from public health spending than do poor people (figure3.3). In Sub-Saharan Africa, South Asia, and Europe and Central Asia, the incidence of health spending among the richest fifth of the populace was more than twice that of the poorest fifth.


Improving Children's Health through Sustainable Access to Food, Water, and Energy

Based on socioeconomic and environmental trends, the World Bank projects the population that lacks adequate access to food, water, and energy, and the resulting effect on child mortality. Except for Middle East and North Africa, progress is not enough to reach the MDG target on child mortality; and Sub-Saharan Africa does not even come close by 2030. Accelerated progress significantly improves this situation (see the figure below). This is especially the case in Sub- Saharan Africa, where approximately one-third of the child mortality gap can be achieved by achieving other MDGs.

To achieve the MDG target on child mortality, accelerated growth in the other MDGs is key, particularly access to food, improved drinking water, basic sanitation, and improved energy sources. Of the estimated 10.5 million child deaths annually, the vast majority are from preventable and treatable diseases and conditions, including low dietary energy consumption (underweight), unsafe drinking water and the lack of basic sanitation (diarrhea), and indoor air pollution related to solid fuel use for cooking and heating (pneumonia).



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