Wardlaw Tessa, You Danzhen, Hug Lucia, Amouzou Agbessi, Newby Holly
Data and Analytics Section, Division of Data, Research, and Policy, United Nations Children's Fund (UNICEF), 3 United Nations Plaza, New York, NY10017, USA.
Reprod Health. 2014 Dec 6;11:82. doi: 10.1186/1742-4755-11-82.
The world has made enormous progress in improving child survival since 1990, reducing the under-five mortality rate by nearly half from 90 to 46 deaths per 1,000 live births in 2013. Currently, the global under-five mortality rate is falling faster than at any other time over the past two decades. Yet, progress is insufficient to meet the Millennium Development Goal 4 (MDG 4) which calls for reducing the under-five mortality rate by two-thirds between 1990 and 2015. If current trends continue in all countries, the world will not meet the target until 2026, 11 years behind schedule. To accelerate progress in child survival, focusing on the newborn is critical since the share of all under-five deaths occurring in the neonatal period (the first 28 days of life) is increasing. Globally, 44 per cent of the 6.3 million under-five deaths occurred in the neonatal period in 2013. Many of these deaths are easily preventable with simple, cost-effective interventions administered before, during and immediately after birth. However, UNICEF's analysis reveals a remarkably high degree of variability in the utilization and quality of services provided to pregnant women and their babies. Furthermore, quality care is grossly lacking even for babies and mothers in contact with the health system. The latest levels and trends in child mortality as well as the coverage and quality of key maternal and newborn care from pregnancy through childbirth and the postnatal period are the subject of the new UNICEF report Committing to Child Survival: A Promise Renewed Progress Report 2014 released recently in September.
自1990年以来，全球在改善儿童生存状况方面取得了巨大进展，五岁以下儿童死亡率从每1000例活产90例死亡降至2013年的46例，几乎减半。目前，全球五岁以下儿童死亡率下降速度比过去二十年的任何时候都要快。然而，进展仍不足以实现千年发展目标4（MDG 4），该目标要求在1990年至2015年期间将五岁以下儿童死亡率降低三分之二。如果所有国家都保持当前趋势，世界要到2026年才能实现这一目标，比计划落后11年。为加快儿童生存方面的进展，关注新生儿至关重要，因为五岁以下儿童死亡中发生在新生儿期（生命的前28天）的比例正在上升。2013年，全球630万五岁以下儿童死亡中有44%发生在新生儿期。通过在出生前、出生时和出生后立即采取简单且具成本效益的干预措施，许多此类死亡是很容易预防的。然而，联合国儿童基金会的分析显示，为孕妇及其婴儿提供的服务在利用和质量方面存在显著差异。此外，即使是与卫生系统有接触的婴儿和母亲也严重缺乏优质护理。儿童死亡率的最新水平和趋势以及从孕期到分娩及产后关键母婴护理的覆盖范围和质量是联合国儿童基金会最近于9月发布的新报告《致力于儿童生存：重申承诺进展报告2014》的主题。
