1. Group Presentation
on
Child Mortality
Millennium development goals : goal #4
1

2. Introducing Us
Alvi Ehsan
Maimuna Mahmud
Taslima Khanam Lima
Gaulib Haidar
Sudipto Bala(L)
Sunzida Haque
151-2614-630
151-0609-630
132-0225-020
151-0898-630
151-0885-630
151-2131-030
2

3. Millennium Development Goals (MDGs)
• What are MDGs?
MDGs are basically 8 international development goals
established by the United Nations (UN).
• When were MDGs established?
MDGs were established in year 2000 following the Millennium
Summit of the UN.
• How many states committed to achieve the MDGs?
All the UN member states including Bangladesh and at least 23
international organizations.
• When are the MDGs aimed to be achieved?
By the year 2015.
3

4. What are the MDGs? 4

5. What does it mean by Child Mortality?
The death of infants and children under the age of five.
Also known as-
Under-5 Mortality
Baby death
The child mortality rate is the number of children who
die by the age of five, per thousand live births per year
The 4th Millennium Development goal is to Reduce Child
Mortality by two thirds, between 1990 and 2015
5

6. What causes Child Mortality? 6
Pneumonia
13%
Other group 1
Conditions
10%
Congential Anomalies
and other non-
communicable
diseases
7%Injuries
5%
HIV/AIDS
2%
Malaria
7%
Measles
2%
Diarrhoea
9%
Prematurity
2%
Prematurity
15%
Other
4%
Neonatal Tetanus
1%
Congential Anomalies
4%
Neonatal
Sepsis
7%
Intrapartum-related
Complications,
including birth
asphyxia
11%
Pneumonia
2%
Post neonatal
(1-59 months)
Neonatal
0-29 days

7. What causes Child Mortality? 7
Pneumonia
13%
Other group 1
Conditions
10%
Congential Anomalies
and other non-
communicable
diseases
7%Injuries
5%
HIV/AIDS
2%
Malaria
7%
Measles
2%
Diarrhoea
9%
Prematurity
2%
Prematurity
15%
Other
4%
Neonatal Tetanus
1%
Congential Anomalies
4%
Neonatal
Sepsis
7%
Intrapartum-related
Complications,
including birth
asphyxia
11%
Pneumonia
2%
Post neonatal
(1-59 months)
Neonatal
0-29 days

8. Where does Child Mortality take place?
Underdeveloped Countries
Developing
Countries
Developed
Country
8

9. 9

10. What Can we do to prevent Child Mortality?
• Reaching the MDG on reducing child mortality will require universal
coverage with key effective, affordable interventions: care for
newborns and their mothers; infant and young child feeding; vaccines;
prevention and case management of pneumonia, diarrhea and sepsis;
malaria control; and prevention and care of HIV/AIDS. Ensure full
coverage of immunization programs.
• Scale up vitamin A supplementation.
• Pursue exclusive breast-feeding for children <6 months. and breast-
feeding with complementary feeding for children 6-24 month.
10

11. What Can we do to prevent Child Mortality?
• Provide adequate nourishment for poor children.
• Target the underlying socioeconomic causes of child
mortality (ex: mother’s access to employment)
• Prevent and provide effective treatment of pneumonia,
diarrhea, malaria and other infectious diseases.
• Promote comprehensive and universal coverage of
primary health-care systems (with the engagement of
community health workers) accompanied by sustained
delivery of health services and women’s education
programs.
11

12. WHO Strategies-
To deliver these interventions, WHO promotes four main
strategies:
• Appropriate home care and timely treatment of complications
for newborns;
• Integrated management of childhood illness for all children
under five years old;
• Expanded program on immunization;
• Infant and young child feeding.
12

13. 13
Most of all we will need to have
Better & Cheaper National
Health Care System

14. Where is child mortality found the most? 14
Children born to poorer households, to mothers with no education and living in
rural areas face a higher risk of dying in the first 28 days of life
Neonatal mortality rate
by household wealth
quintiles, mother’s
education and
residence, 2005-2013

15. 15

16. Which are the most vulnerable countries
towards Child Mortality?
• About half of under-five deaths occur in only five countries:
1. India
2. Nigeria
3. Democratic Republic of the Congo
4. Pakistan
5. China.
• India (22 percent) and Nigeria (13 percent) together account for
more than a third of all under-five deaths
16

17. Variation of Child Mortality Rate
in the 3 Worlds:
Developed
Countries
Name of Country
Mortality
Rate
Germany 3.46
United Kingdom 4.44
United States 6.17
Developing
Countries
Name of Country
Mortality
Rate
Bangladesh 45.67
Equatorial Guinea 71.12
Nigeria 74.09
17
Underdeveloped
Countries
Name of Country
Mortality
Rate
Niger 86.27
Somalia 100.14
Afghanistan 117.23

18. Measures taken by United States to reduce
Child Mortality
1. PROMOTING ACCESS TO PRENATAL AND INFANT CARE
The Healthy Start program: Provides prenatal health care in more than 100
communities nationwide.
Medicaid & State Children's Health Insurance Program (SCHIP): Provides
prenatal care for eligible mothers and health coverage for millions of
infants from low-income families.
Toll-free prenatal care hotline: Assists pregnant women and others seeking
information on prenatal care, including referrals to local clinics and
physicians.
Childhood immunization initiative: Has increased immunization rates
among children, with 90 percent or more of America's toddlers receiving
the most critical doses of vaccines by the age 2.
18

19. Measures taken by United States to reduce
Child Mortality
2. PROMOTING HEALTHY CHOICES TO REDUCE MORTALITY RISKS
Reducing mother-to-child HIV transmission
Maternal and Child Health (MCH) Services: In an average year, about
60 percent of U.S. women who give birth receive services through MCH
programs.
Reducing teen pregnancy: Infants born to teenage mothers have a
higher mortality rate. HHS directly funds teen pregnancy prevention
programs in more than 2,200 communities - about 47 percent of all
communities nationwide.
3. PROMOTING RESEARCH TO REDUCE INFANT MORTALITY
HHS supports a wide range of medical research to prevent and treat birth
defects, premature birth, SIDS and other life-threatening conditions.
19

20. Bangladesh fighting Child Mortality 20

21. What measures has Bangladesh taken to
reduce Child Mortality?
• Successful programs for immunization
• Control of diarrheal diseases
• Vitamin A supplementation
• Creation of awareness
• Establishment of free health care center in
different districts, towns, villages for mothers
and children
21

22. What was achieved from MDG-4?
Under-5 deaths have continued to decline from 11.6
million in 1990 to 7.2 million deaths in 2011.
• In 2011,
• 2.2 million were early neonatal (0 to 6 days)
• 0.7 million were late neonatal (7 to 28 days)
• 2.1 million were post-neonatal (29 to 364 days)
• 2.2 million were during post-neonatal childhood (1 to 4 years)
Comparing rates of decline from 1990 to 2000 with 2000 to
2011 shows that 106 countries have accelerated declines
in child mortality over the past decade.
22
106
Countries

23. What was achieved from MDG-4?
Currently, the world is reducing under-five mortality than at
any other time during the past two decades.
23
Encouragingly, neonatal mortality is on the worldwide.
Between 1990 and 2012, the world neonatal mortality rate fell by
almost one third, from 33 to 21 deaths for every thousand live
births
decline
The global annual rate of reduction in under five mortality has
accelerated steadily from 1.2 per cent between 1990 and 1995 to
3.9 per cent between 2005 and 2012.
faster

24. What was achieved from MDG-4?
0
10
20
30
40
50
60
70
80
90
NEONATAL INFANT UNDER-5
20
34
46
33
63
90
Global Child mortality rates (1990-2013)
Deaths per 1,000 live births
2013 1990
24
40% 46% 49%
Declined By Declined By Declined By

25. What was achieved from MDG-4? 25
Thenumberofunder-five
deathsis
fallingsteadily
Global under-five and
neonatal deaths,
1990-2013 (in millions)

26. We achieved, but?
Progress on reducing maternal and child mortality is accelerating in
most countries, most developing countries will take many years past
2015 to achieve the targets of MDGs 4,despite overall progress
Four countries show increases in under-5 mortality
While many proven intervention strategies are available for
children, bottlenecks in health systems may prevent these
strategies from being implemented.
26

27. Where is Bangladesh about MDG-4?
Bangladesh has already met the target of reducing under-five
mortality rate: against the target of achieving 48 per 1,000 live
births in 2015, she has already achieved 44 per 1,000 live births in
2011 & 41 per 1,000 live births in 2012
27
0
20
40
60
80
100
120
140
160
1990
144
Target
within
2015
48
2011
44
2012
41
1990 Target within 2015 2011 2012

28. Concluding for a new start!
The overall discussion depicts the picture that almost:
• Two third of the child deaths are preventable with low-tech, evidence based ,cost effective
measure . Some of these can be related to medical side and some of these can be socio
economic perspective, like-empowering women, removing financial and social barriers,
educating women, improving family care etc…
However, there are lots of difference between what should be done and what is actually
happening:
• Mortality rates are falling but not fast enough to meet the aim of reducing the rate by two-
thirds by 2015, the MDG deadline.
• Low-tech, evidence-based, cost-effective measures can be taken.
• Medical related measures:
• Vaccines, antibiotics, micronutrient supplementation, insecticide-treated bed nets, breastfeeding
practices, and oral rehydration therapy
• Socio-economic Measures:
• Empowering women, removing financial and social barriers, educating women, improving family care
28

29. 29