Lancet Global Health: Challenges to reduce newborn and child mortality in resource-limited settings

19 January, 2022

Dear CHIFA colleagues,

A Commentary in the new issue of The Lancet Global Health, and a comment from me below.

CITATION: Challenges on the road to achieving the SDG 3.2 targets in resource-limited settings

Emmanuel Yovo

Lancet Global Health - Comment| volume 10, issue 2, e157-e158, february 01, 2022

Published:February, 2022 DOI:https://doi.org/10.1016/S2214-109X(21)00597-0

The second target of SDG 3, achieve good health and wellbeing for all, is to end preventable deaths of newborns and children younger than 5 years, with all countries aiming to reduce neonatal mortality rate (NMR) by 2030 to at least as low as 12 per 1000 livebirths and under-5 mortality rate (U5MR) to at least as low as 25 per 1000 livebirths.

In The Lancet Global Health, David Sharrow and colleagues from the UN Inter-agency Group for Child Mortality Estimation performed a systematic analysis of a global, regional, and national trends in under-5 mortality from 1990 to 2019, with scenario-based projections up to 2030... [ https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00515-5/fulltext ] Firstly, the highest regional U5MR in 2019 was recorded in the west and central Africa region (94·7 deaths per 1000 livebirths)... Secondly, based on the current trend, 53 countries, of which three-quarters are in sub-Saharan Africa, will need intensified efforts to reach the 2030 targets... Lastly, more than 27 million deaths could be averted from 2020 to 2030 compared with the current trends scenario if all countries achieved the same average U5MR as in high-income countries by 2030. This finding means that currently there is the know-how and potential to prevent the deaths of 26 million people over the next 10 years, and it is unfortunate to know in advance that the path between theoretical knowledge and its actual implementation in real life is full of difficult obstacles to overcome...

There are still significant research needs, more on the implementation and operational research side than on the academic research side, to guide public health interventions in resource-limited countries to reduce U5MR. In children younger than 5 years in 2019, the most recent scientific evidence has shown that neonatal disorders remained the leading cause of death, followed by respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria....

COMMENT (NPW): The key issue is not the specific medical causes of death, but the factors that result in death and morbidity from all causes. In addition to social determinants of health, 'the path between theoretical knowledge and its actual implementation in real life' is critical. This path demands that healthcare providers, from parents to health workers, are empowered to provide appropriate care, including and especially through access to relevant and reliable healthcare inforamtion.

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org