Gillian mellsop representative unicef china office unicef 2012 11
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Gillian Mellsop Representative, UNICEF China office 麦吉莲, UNICEF 驻华代表 2012 年 11 月 PowerPoint PPT Presentation

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Gillian Mellsop Representative, UNICEF China office 麦吉莲, UNICEF 驻华代表 2012 年 11 月. CALL to ACTION 吹响行动的号角 Ending Preventable Child Deaths 消除可预防的儿童死亡 Global roadmap for neonatal, child and maternal survival 改善全球新生儿、儿童、孕产妇生存状况路线图. Overall goal End preventable child deaths

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Gillian Mellsop Representative, UNICEF China office 麦吉莲, UNICEF 驻华代表 2012 年 11 月

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Gillian MellsopRepresentative, UNICEF China officeUNICEF201211


Ending Preventable Child Deaths

Global roadmap for neonatal, child and maternal survival

  • Overall goal End preventable child deaths

  • Interim goals Reach MDGs 4 and 5 by 2015

    In countries with an under-five mortality rate above 20 under-five deaths per 1,000, reduce the mortality rate to 20 deaths or fewer by 2035

  • 2015MDG



Ending preventable child deaths- A vision we share

  • Its the right thing to do-every child deserves a fifth birthday

    • It is within our reach

    • 6.9 million children die each year before their fifth birthday760

  • Nearly all these deaths are preventable with know cost-effective solutions

  • It makes economic sense

    • Improving child survival brings a demographic dividend through fertility declines, reduced mortality and increased economic productivity

    • Reduction in child mortality can result in billions of dollars in direct economic savings-life-saving vaccines along could save 6.4 million lives and $231 billion in productivity by 202020206402310

  • It is an indicator of good governance-child survival reflects national policy promoting investment in equitable social and economic progress

Good progress has been made!U5MR trends, China 1990-201019902010

Source: Level & trends in CM, UN Estimates;

Despite overall progress,China is reducing U5M in an inequitable way

U5MR in provinces in China, 2011

Highest U5MR is 8x more than lowest U5MR:

268,000 children can be saved yearly

should the whole country have the lowest U5MR


2015 target


Source: MCMSS, 2011

ARR by province

ARR (%)

Distribution of causes of U5 mortality:Not all problems receive attention due

Number 3

Birth asphyxia

Neonatal causes: 55%

Number 1




Number 2



Infection: 22%

Source: MCMSS, 2009






Source: Feng XL,Guo S,Yang Q,Xu L,Zhu J,Guo Y. Regional disparities in child mortality within China 1996-2004: epidemiological profile and health care coverage. Environ Health Prev Med.2011 Jul;16(4):209-16.

MMR decrease with hospital delivery rate increase

  • 1:

  • 2.

  • 3. 1 23

  • 4.1234

  • 5.:1)234

Geographic focus: 10 provinces contribute 60% of all child death60%

  • Accelerating progress in these province can have significant impact on under- five mortality

  • It needs to collaborate more closely with the high burden provinces to overcome barriers to successful, sustainable child health programs

  • The child mortality burden is disproportionately concentrated in poor and marginalized communities

  • Equity-based approaches focusing on expanding services and reducing disparities in essential services and out-of-pocket expenditures for the poor have the potential to achieve a 50% reduction in U5MR among the most excluded populations50%

  • Effectively increasing health outcomes for the poor requires:

    • Enacting policies to expand health care coverage, e.g., enacting free health care as a constitutional right or enacting task-shifting regulations

    • Community-based delivery platforms providing packages of essential health services

    • Minimizing barriers to use, e.g., eliminating user fees or reducing transport costs

    • Significant barriers exist e.g. populations hard to locate, hard to reach, little political voice, may have special needs and therefore solutions need to be adapted



2010 2015 2015

  • Five causes account for over 80% of child deaths: Prematurity/low birth weight, birth asphyxia, congenital birth defects, pneumonia and injury. 80%/

  • Provinces must systematically prioritize the top causes of mortality and the interventions that have the largest potential for sustained

  • Provinces must address neonatal conditions to reach their U5MR targets Underlying factors such as nutrition





  • MDG45





Chinas Health Minister signed the Pledge:starting point for Chinas child survival strategy

  • 1. Encourage government to sign the Pledge

  • 2. Support government-led efforts to develop evidence-based action plans and milestones for accelerating declines in preventable child deaths

  • Implementation of LiST

  • LiST

  • 3. Reinforce government-led efforts to monitor national and sub-national progress on maternal, newborn and child survival

  • Development of standard indicator list

  • 4. Build cross-sectoral child survival strategies

  • Implementation of ECD pilot project

  • 5. Strengthen coordination and scale up action

  • Rally partners around child survival strategy


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