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Taking children out of ‘healthcare deserts’

‘No child is born to die’ is the message Save the Children sends across the country today. This is a call to action to ensure that every child lives to see their fifth birthday. While there has been extraordinary progress in reducing child mortality worldwide, about 8.1 million children below five years still died in 2009.  A disproportionate number of these children were born in developing counties and died of preventable and treatable diseases like pneumonia, diarrhoea and malaria.  Many of them lived in a de facto healthcare desert, where even the most basic healthcare is absent. 

Our new report Closing the Gaps estimates that 40 million children – one in seven children in 25 countries with high under-five mortality – are severely deprived of healthcare. Severe deprivation is when a child hasn’t received any vaccines or has had a recent illness like diarrhoea and didn’t receive any treatment. The method for calculating this figure follows a similar exercise as UNICEF’s State of the World’s Children Report 2005. Our update includes Countdown countries with Demographic and Health Surveys data from 2005 onwards.

Countries with the highest mortality burdens have  a huge number of children living in ‘healthcare deserts’: 13 million in India, 8 million in Nigeria and 5 million in Ethiopia. Across the countries we looked at, children from the poorest fifth of the population are three times more likely to be deprived of healthcare than those from the wealthiest fifth of the population. It’s not surprising then that those born into poor households have far less chance of seeing their fifth birthday than those born into rich households. 

As I have argued in a recent paper, poor children face circumstances that make them more vulnerable to diseases and, at the same time, less likely to receive proper medical treatment. Imagine this situation: a child of poor parents falls ill because he or she hasn’t received any of the required immunisations.  The nearest facility is miles away and takes several hours to reach. Once there, it cannot be taken for granted that properly trained and equipped health workers are there to see the child. Or the parents might not be able to pay the required fee since healthcare in many developing countries isn’t free, in which case it’s likely they will be turned away without help.

If  the world is to meet Millennium Development Goal 4, it’s obvious that we have to address the needs of  children who are deprived of health services. We must ensure that vaccines reach those most at risk of diseases. We must see to it that healthworkers are properly trained and equipped, and deployed even in remote areas. Health services should be free at the point of service so poor households can have access to them. If these things happen then children, no matter where they’re born, will have a fair chance of living and thriving.

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