An estimated 7.1 million children and teens up to the age of 24 years died in 2021, according to a United Nations (UN) report released on Tuesday. Sub-Saharan Africa, Central and South Asia bore higher burden of these deaths than other regions. 

This includes five million children under the age of five and 2.1 million children, adolescents and youth aged between five and 24 years’ old. 

The UN Inter-agency Group for Child Mortality Estimation (UN IGME), led by UNICEF, released two reports on 10 January 2023 with the latest data on child mortality and stillbirths. While one report consisted of data on child and youth mortality, the second report estimated that around 1.9 million babies are stillborn every year. According to the World Health Organization (WHO), a stillborn baby dies after 28 weeks of gestation, either before or during birth. 

The reports highlighted that equitable access to high-quality maternal, infant, child and adolescent health care could have prevented these deaths. 

Birthplace matters

The birth location of a child determines its life expectancy, both reports stated. 

More children and youth died in sub-Saharan Africa, and Central and South Asia than in other regions of the world. While the global average of under-five mortality rate in 2021 is 38 deaths per 1,000 live births, it is 74 deaths per 1,000 live births in sub-Saharan Africa.

“Children and youth older than five years old also face the highest probability of dying in sub-Saharan Africa.” 

“More than 80% of under-five deaths and over 70% of all deaths amongst five to 24-year-olds occurred in sub-Saharan Africa and Central and Southern Asia. This unjust burden must be recognised, prioritised and addressed,” the reports added.  

Respiratory diseases, diarrhoea, measles, malnutrition, malaria and newborn conditions are among the top causes of  deaths of newborns and children under the age of five. 

Similarly, the number of stillbirths across the world also differs vastly between regions. Of the 1.9 million estimated stillbirths, around 1.5 million took place in sub-Saharan Africa and southern Asia, according to the UN IGME report. 

“The major causes of stillbirth include pregnancy and childbirth-related complications, prolonged pregnancy, maternal infections such as malaria, syphilis and HIV, maternal conditions especially hypertension, and diabetes, and foetal growth restriction (when an unborn baby is unable to achieve its growth potential and therefore smaller than it should be),” says the WHO. 

Threat to SDGs 

The UN IGME report on child and youth mortality stated that without urgent action, several countries are on the line to miss the Sustainable Development Goals (SDG) 2030 that target ending preventable deaths of newborns and children under the age of five. Achieving this milestone will save 11 million lives across the world, over half of which in sub-Saharan Africa. 

“Without urgent action, 54 countries will not meet the under-five mortality target by 2030 and an even larger number – 63 countries – will miss the neonatal mortality target. Most countries that are off track to meet the SDG target on under-five mortality are in sub-Saharan Africa or classified as low- or lower-middle-income countries,” the report added. 

In 2014, the WHO’s 194 member states endorsed the Every Newborn Action Plan (ENAP), committing to reduce the rate of stillbirths to 12 or fewer per 1,000 total births by 2030. 

“If every country were to meet the ENAP target by 2030, the world would still lose an estimated 13.2 million babies to stillbirth – but, importantly, 2.6 million lives would be saved,” the report pointed out. It also stated that the countries will not meet ENAP’s targets by 2030 if the current pace is maintained.

“Among the 195 countries studied, 131 have already achieved the target and a further 8 are on track to meet it. But 56 countries will miss the target unless urgent and rapid changes to health care systems are made.” 

Immediate intervention crucial

The deaths across ages have decreased since 2000, the reports said. 

“The global under-five mortality rate fell by 50% since the start of the century, while mortality rates in older children and youth dropped by 36 per cent, and the stillbirth rate decreased by 35%. This can be attributed to more investments in strengthening primary health systems to benefit women, children and young people.” 

However, these gains have reduced since 2010 and only through sustained efforts and investments into health systems and services can the situation be improved.

“If swift action is not taken to improve health services, warn the agencies, almost 59 million children and youth will die before 2030, and nearly 16 million babies will be lost to stillbirth.”

To prevent stillbirths, the reports recommended that the evidence and knowledge around the topic be enhanced through better measurement and that every mother and child must be delivered the highest quality of healthcare. 

“Among the 195 countries for which stillbirth estimates are generated, 22 countries have no stillbirth data, and an additional 38 countries lack quality stillbirth data. Many countries with data issues are also high burden: 32% of those without data are in sub-Saharan Africa and 63% are from low- and lower-middle-income countries. Improved evidence and statistics are particularly critical in these settings, where stillbirth rates are likely to be amongst the world’s highest.”

Image Credits: Photo by Alex Pasarelu on Unsplash.