Despite significant progress in reducing global child mortality rates over the last fifteen years, disparities in survival rates among disadvantaged children are widening in many countries, a report from Save Children finds.
The report, The Lottery of Birth: Giving All Children an Equal Chance to Survive (78 pages, PDF), examined differences in child mortality rates by ethnic group, socioeconomic status, geographic region, and the urban-rural divide in fifty-five low- and middle-income countries. Among other things, the report found that between 2000 and 2013, child mortality rates in forty-three countries (78 percent) fell more slowly for at least one group — for example, marginalized ethnic groups or those living in extreme poverty — while disparities increased across all four categories in nine countries (16 percent) — Bolivia, Cameroon, Central African Republic, Chad, Iraq, Niger, Pakistan, the Philippines, and Togo. Although disparities between economic groups and between urban and rural areas have been declining in most of the countries in the study, disparities between regions and ethnic groups have been increasing.
The report also found that approximately 20 percent of the countries analyzed have achieved above-median reductions in child mortality rates while simultaneously reducing inequalities between groups; that group includes Bangladesh, Malawi, Mexico, and Rwanda. The study further notes that more than half the countries where gaps between advantaged and disadvantaged groups have narrowed also have seen faster progress in lowering overall child mortality rates. For example, countries that reduced regional inequalities achieved an average annual reduction in child mortality of 4.7 percent, compared with 4 percent in countries where disadvantaged regions have been left behind.
To end this "lottery of birth" and accelerate progress toward the goal of eliminating preventable child deaths, the report urges the international community, when it comes together in September to agree on a new United Nations development framework, to commit to ambitious targets for improving child and maternal survival, realizing universal health coverage, and ensuring that the poorest, most marginalized, and disadvantaged groups of children are included in those efforts.
"In this day and age, it is unacceptable that so many children's chances of survival across the world are purely a matter of whether or not they were lucky enough to be born into an affluent family who can access quality health care," said Save the Children president and CEO Carolyn Miles. "We know that change is possible. We now have a significant window of opportunity to drive this change; world leaders must do everything in their power to ensure that they grasp this opportunity with both hands."