The Western Pacific Region had demonstrated significant progress in improving child survival. The overall estimated under five and infant mortality rates reduced by half and the estimated total number of deaths among children under the age of five years decreased
by two-thirds between 1990 and 2009. Five out of seven priority countries (China, the Lao People's Democratic Republic, Mongolia, the Philippines and Viet Nam) are on track to achieve the Millennium Development Goal 4 of reducing child mortality by two-thirds by the year 2015. Intervention coverage for key child indicators has shown improvements in several areas, with variations between countries. In general, essential interventions that are given periodically (vitamin A supplementation and immunization) have better coverage than those that require 24-hour access to services (such as care for the sick child including treatment of pneumonia and diarrhoea) or would need changes in behaviour (exclusive breastfeeding and complementary feeding practices).
However, around 1440 children under the age of five still die everyday. Prematurity, asphyxia and infection are the main causes of deaths in the neonatal period; pneumonia and diarrhoea during infancy and early childhood. In addition, malaria is an important cause of child mortality in Papua New Guinea, Solomon Islands and Vanuatu. Undernutrition contributes to more than one-third of all childhood deaths. Neonatal deaths constitute an increasing proportion (around 54%) of the under-five deaths.
The success of further reducing child mortality is closely linked with the capacities of the health systems to respond to the changing needs of mothers and children and to deliver essential packages of maternal and child health care. At the country level, key policies should ensure the availability and affordability of quality services at all levels of care throughout the continuum from the mother to the child.