Saturday, June 30, 2018

SDG 3 and infant mortality: Ambitious goal trounced by ground realities

(This article was first published at, please click on the link to find it)

The Boali maternity hospital lies less than 100 km from Bangui, the capital city of Central African Republic. Here every day a woman cries over her dead child as one in every 24 child dies due to high neonatal death as well as infant mortality as reported by the UNICEF.

The Central African Republic is a country which has no impression on the world map whatsoever. The country contains one of the poorest and most malnourished population in the world. But it tops the list of infant mortality rate with only Pakistan ahead of it, according to the UNICEF report published earlier this year. The infant mortality rate (deaths in the first 5 years of life) in the country is 124 per thousand. These alarming rates are due to a lot of factors, most prominent among which is the lack of doctors and specialists. UNICEF estimates that half of the country’s health infrastructure is managed by unskilled staff or volunteers.
Dr. N-Eloi Mboufoungou says that he is the only practitioner for a population of over 33,000. Assisted by 25 health workers, of whom only 9 are qualified, he can only deplore the lack of follow-up of pregnant women or young children. "Women come for a consultation for their first pregnancy, then they often disappear in nature" he explains.

A 1906 newspaper clipping imploring parents to attend to the cleanliness of their infants. (Image Credit: Wikimedia Commons)

Over 1 million babies are estimated to die within the first hour of their birth while over 2.6 million die in the first 4 weeks of life. In Sub-Saharan Africa, 1 in 9 children dies before age 5, more than 16 times the average for developed regions in which 1 in 152 dies. 165 million children under 5 are stunted (low height for age) in their growth due to poor nutrition during the first 1000 days of life.

WHO estimates that 20% of under-five deaths, or approximately two million deaths annually, could be prevented with existing vaccines. The top three causes of such deaths are estimated to be:
  • Premature birth, 
  • Complications during labour and delivery, and 
  • Infections such as sepsis, meningitis, and pneumonia. 
The UNICEF report brings to light several aspects of maternity health care across the world. It says that such deaths are not because of poor medical conditions mostly, but a major reason is also that the families of the babies are too poor or marginalized to access the care they need.

The five worst countries to be born are Pakistan, followed by Central African Republic, Afghanistan, Somalia, and Lesotho; all low-income countries. While the countries which are safest to be born are Japan, Iceland, Singapore, Finland, and Estonia; all ‘developed’ countries. However, India remains the country with the largest number of newborn deaths overall with 600 thousand infant deaths per year which takes a major share of the world average, i.e. 800 thousand deaths per year.

The Well Being Foundation is one organization that is working tirelessly even in the sub-Saharan deserts of Africa for better health care. With an aim to work only on United Nations’ Sustainable Development Goals three, five and six, the NGO is running programs on midwifery, emergency obstetric and newborn care, infant feeding, etc. The UNICEF has also jumped into action by launching the Every Child ALIVE campaign which aims to demand the health ministers around the world to step up the investments for every mother and her baby.

Other NGOs like the EU-funded Alima are also working in countries like the Central African Republic. They run a hospital in Boda region and has safely delivered over a thousand babies last year. They also provide medical assistance for carrying out Caesarean section surgeries which prevent many inevitable deaths.

Reporter Monica Pinna posted their work on twitter:
The United Nations have already set 17 primary goals of sustainable development. But, as the UNICEF says, we are failing our children. Infant mortality should be one of the top priorities of the governments across the world if we are to achieve the #Envision2030. If the children are not even alive then for whom are we setting such ambitious goals?