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Fewer Children Dying in Poor Countries

The World Health Organization says there has been a sharp drop in the number of deaths among children under age five. The just released report, World Health Statistics 2009, shows 27 percent fewer children died in 2007, the last year for which statistics were compiled, than in 1990.

The World Health Statistics Report shows about nine million children died in 2007 compared to 12.5 million in 1990. It says some countries are making good progress toward meeting the U.N. Millennium Development Goal of cutting child deaths by two-thirds by 2015. But it says many other countries, particularly in sub-Saharan Africa, will fail to reach that target.

This year's report focuses on how well countries are doing in reaching eight-stated Millennium Development Goals, including cutting poverty by half and reducing child and maternal mortality. The results are mixed.

For example, the report says progress is being made in bringing down child deaths, but there has been little or no movement in maternal and newborn health.

It says an estimated 37 percent of deaths among children occur in the first month of life, and most in the first week of life. It says most infant deaths happen in regions where maternal mortality rates are the highest.

Coordinator in WHO's department of Health Statistics and Informatics, Carla Abou-Zahr, says there are a whole range of issues that hold countries back.

"You cannot say it is just lack of resources or it is just lack of commitment," said Abou-Zahr. "Usually there are very weak institutions in many of these countries. Many of them are emerging from conflicts. And, sub-Saharan Africa in particular, especially in Eastern and Southern Africa are facing major problems of HIV, which has had a huge impact on especially child mortality, life expectancy in general. So, that is being a factor that is constraining for the progress for those countries."

But Abou-Zahr hastens to add that countries in Africa do not present a uniformly bleak picture. For instance, she says signs of improvement can be seen in places such as Tanzania and Rwanda.

The report argues building a health system that is efficient and really works is not purely a financial matter. Many elements are involved.

But WHO Health Statistics and Informatics Department Director Ties Boerma says money talks when it comes to providing good health.

"If we look at per-capita health expenditure, in the low income countries, it is $22 per capita," said Boerma. "In the high-income countries, it is $4,012. Another one. Doctors for 10,000 people. In Africa, there are two doctors for 10,000 people. In the European region, there are 32 doctors for 10,000 people."

In one of its many statistical graphs, the WHO study shows money can mean the difference between life and death. It notes three out of 1,000 children under age five die in Iceland, Sweden and Finland compared to 262 child deaths per 1,000 live births in Sierra Leone.