Goal 4 Reduce child mortality

Maternal Healthcare

The target for this goal is to reduce by two thirds the number of deaths in children under five.

Background
Over 10 million children under five die each year from preventable illnesses. These include diarrhoea, pneumonia, malaria and HIV and AIDS.

Learning from each other

The Community Health Department of St Stephen’s Hospital, Delhi, India provides health, education and development services to 60,000 people in Sunder Nagari, an urban slum in East Delhi and to 18,000 people in ten rural villages of Gurgaon district in Haryana.

In Gurgaon district, nurses and midwives regularly visit every family in the area, providing health education and a constant link to the services available. One simple idea that they have found very effective is to pair up mothers in similar situations. Health workers look out for mothers who are coping well with looking after their babies and young children, despite little money or resources. They ask these mothers if they would be willing for other mothers to visit them in their homes and provide simple training. The health workers then suggest that mothers whose babies have been malnourished or unwell visit these ‘effective’ mothers.

By visiting them in their homes, chatting about their babies and children and helping to prepare food for the children, the mothers learn and observe all kinds of useful information. Sometimes they become good friends. Sometimes just one visit is made. Though this idea is very new, St Stephen’s staff are very positive about how effective it is proving in reducing repeated cases of malnutrition. Learning from other mothers who are living in equally poor or difficult situations, is proving a very effective way of learning.

Main causes of death in children under five years

CAUSE DEATHS PREVENTIVE ACTION TREATMENT
diarrhoea 22% • breastfeeding
• vitamin A from green vegetables
• clean water
• good sanitation and hygiene
• oral rehydration
therapy would prevent
15% of these deaths
• zinc
pneumonia 21% • breastfeeding
• Hib vaccine
• antibiotics
suffocation
during birth
10% • training of midwives and traditional
birth attendants
• newborn resuscitation
malaria 9% • insecticide-treated bednets • antimalarials
infection
during birth
8% • clean delivery
• breastfeeding
• antibiotics
premature
birth
8% • bednets for pregnant women to prevent
malaria
• keep the baby warm
HIV and AIDS 3% • Nevirapine and replacement feeding x
tetanus 2% • tetanus vaccine for pregnant women
• clean delivery
x
measles 1% • vaccination • vitamin A


Other ideas to meet Goal 4

  • Provide regular de-worming to all schoolchildren in affected areas.
  • Encourage effective immunisation programmes for all children.
  • Promote hand washing and good hygiene.

Progress on Goal 4

Considerable progress has been made in many countries, but this has stopped entirely in sub-Saharan Africa. This goal is unlikely to be met.