Save the Children DME Strategy Capacity Building

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Why Equity Matters Lessons from Ethiopia
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Outline

• Background
• Survival Gap
• Why Equity Matters
• What Can Be Done

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Background

• 9.7 million children under age 5 die each year
• 4.8 million in Sub-Saharan Africa
• Sub-Saharan Africa has an average child mortality
  of 160 per 1,000 live births compared to 6 per
  1,000 in the UK
• The biggest killers of children worldwide are
  newborn complications, pneumonia, diarrhea and
  malaria
• Using existing, low-cost tools and knowledge, we
  could save more than 6 million of the 9.7 million
  children who die every year from easily
  preventable or treatable causes

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The importance of equity

• A childs chance of making it to his or her fifth
  birthday depends to a great extent on the country
  where the child is born, and family income
• Virtually all child deaths (99 percent) occur in
  developing countries in settings of poverty
• The gap in child death rates between the richest
  and poorest regions of the world has increased in
  recent decades
• Within countries, death rates among the poorest
  children are higher. On average, a child in the
  poorest fifth of a population is twice as likely
  to die as a child from the richest fifth
• Attempts to reduce child mortality without
  addressing inequity will fail to reach highest
  risk children, and is likely to be inefficient

5
National wealth does not necessarily result in
improved child mortality

• Wealth and Child Mortality
• Country GNI per person U5 Mortality
• Rate per 1000
• Angola 2334.85 260
• Sierra Leone 805.95 271
• Mali 1033.10 218
• Ethiopia 1054.63 127

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Ethiopia - Equity along the continuum of care
Source DHS 2005
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Why Equity Matters
In Ethiopia, if all children had the same
mortality rate as the richest (close the gap)
then deaths would be reduced by 20 (80,000
children/yr)
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What Can Be Done

• 1. Design health care programs to better target
  the poorest and most marginalized mothers and
  children.
• 2. Strengthen basic health systems to ensure
  universal coverage
• 3. Deliver a basic package of maternal, newborn
  and child health care that takes into account the
  realities for poor people in developing
  countries.
• 4. Invest in community health care workers to
  reach the poorest of the poor with essential
  lifesaving care.
• 5. Increase government support for proven
  solutions that save childrens lives.

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From Commitment to Actions

• World governments are committed to MDG4
• However, the goal of reducing under-five
  mortality by two-thirds will not be achieved
  globally by 2015, at the current rates of
  progress
• If we are to close the child survival gap,
  additional resources are required.

Equity must be addressed and outcomes measured
when assessing progress towards MDG 4
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Thank You