Maternal and child health
- 6.9 million children under the age of five died in 2011 globally.
- More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.
- It is estimated that 358,000 women died during and following pregnancy and childbirth in 2008 worldwide, which is equivalent to approximately 1000 women dying every day.
- 93% of the under-five deaths are in six countries of the Western Pacific Region (Cambodia, China, the Lao People's Democratic Republic, Papua New Guinea, the Philippines, and Viet Nam). Almost 65% of these under-five deaths occur in China alone, partly because of its large population. Together with India, Nigeria, the Democratic Republic of Congo, Pakistan, China contributes to about half of under-five deaths worldwide.
- Conditions that cause the highest mortality are preventable and treatable through simple, affordable interventions. Strengthening health systems to provide such interventions to all children will save many young lives.
- Leading causes of death in under-five children are pneumonia, preterm birth complications, diarrhoea, birth asphyxia and malaria. About one third of all child deaths are linked to malnutrition.
- Variations in mortality are noted within and among countries by geographic area, maternal education, rural or urban residence, birth interval, and wealth. Children in low- and middle-income countries are nearly 18 times more likely to die before the age of five than children in high-income countries.
- Skilled care before, during and after childbirth can save the lives of women and newborn babies.
Global response: Millennium Development Goals 4 and 5
The Millennium Development Goals adopted by the United Nations in 2000 aim to decrease child and maternal deaths worldwide by 2015. The fourth Millennium Development Goal (MDG) is to reduce the 1990 mortality rate among under-five children by two thirds. Child mortality is also closely linked to MDG 5 to improve maternal health. The fifth Millennium Development Goal is to reduce by three quarters, between 1990 and 2015, the maternal mortality ratio, and achieve, by 2015, universal access to reproductive health.
Towards Millennium Development Goal 4 in China – reducing child mortality rates
- Reducing child mortality rates is one of the eight Millennium Development Goals adopted by the international community in 2000.
- Chinese children's health status has improved remarkably. Infant mortality and under-five mortality rate continue to decline.
- According to the Ministry of Health, the infant mortality rate dropped from 50.2 per 1000 live births in 1991 to 12.1 per 1000 live births in 2011, while the mortality rate of children under-five dropped from 61 per 1000 live births in 1991 to 15.6 per 1000 live births in 2011.
- According to the Ministry of Health, China met the MDG 4 (national average) in 2007.
- However, preterm birth and low birth weight, birth asphyxia, childhood pneumonia, and diarrhoea are still major threats to infants in some areas of China.
- The incidence of birth defects is rising, and childhood obesity, injuries, psychological and behavioural problems have become increasingly prominent. Special attention needs to be given to migrant children and children left behind by migrant-worker parents.
Towards Millennium Development Goal 5 in China – improving maternal health
- Improving maternal health is one of the eight Millennium Development Goals adopted by the international community in 2000.
- The maternal mortality ratio (MMR) has dropped from 80 per 100,000 live births in 1991 to 26.1 per 100,000 live births in 2011.
- According to MDG 5, by 2015 the MMR should decrease by 75% from the year 1990, which means that in the coming three years, the ratio should fall to 22 per 100,000 to reach the goal.
- The MMR gaps between different regions in China are still present. The overall trend is that the MMR in western region is higher than that in the central and eastern regions.
- The MMR in the eastern, central and western part of China was 17.8/100,000, 29.1/100,000 and 45.1/100,000, respectively, in 2010.
Maternal and child health and health system reform in China
The Government has increased investment in women and children's health through public health reform, focusing on the following key issues:
- Programme on subsidizing rural women for hospitalized delivery;
- Pilot programme on examining breast and cervical cancers among rural women;
- Programme on folic acid supplement to prevent neural tube defects;
- Programme on the prevention of mother-to-child transmission of HIV/AIDS, syphilis and hepatitis B;
- Strengthening basic public health services, including maternal health care, 0-6-year-old children's health care, immunization programmes and health education.
WHO works closely with the Ministry of Health, and other national and international partners to improve maternal and child health in China. WHO is working on the following technical areas:
- Maternal and child health
- Child nutrition
- Maternal and child health information
- Adolescent health
- Reproductive health