The unfinished child survival revolution: the role of nutrition

Abstract

Since an impressive reduction in child mortality in the 1970s to early 1990s improvements have slowed down, and more than 10 million children die annually under the age of 5 years. Most of these deaths occur in relatively few countries, mainly in South Asia and Africa south of the Sahara. Given the causal links between nutrition and mortality in infancy and childhood it is of great importance to assess the role of nutrition in further improvements in global child survival. This study assessed what proportion of global under-five deaths could be prevented by available and efficacious nutrition interventions, through a review of recent papers of child survival and the role of nutrition in the prevention under-five deaths in a global perspective. It was found that undernutrition is an underlying cause in more than half of global under-five deaths. Most deaths are caused directly by bronchopneumonia, diarrhoeal diseases, diseases of the newborn, malaria, measles and H IV/AIDS. Specific and proven efficacious nutrition interventions could prevent more than one third of the current 10 million child deaths. The most important nutrition-related interventions are exclusive breast-feeding, zinc supplements for treatment and prevention, complementary feeding, vitamin A supplementation and oral rehydration therapy. The coverage of many of these efficacious interventions is usually low. The potential role of nutrition interventions to promote global child survival is great. Child survival issues and the role of nutrition in preventing child deaths must be reintroduced on international health agendas. This is a prerequisite for reaching the fourth Millennium Development Goal, a reduction in child deaths by two-thirds before 2015. Keywords: breast-feeding; complementary feeding; oral rehydration therapy; prevention; under-five mortality; undernutrition; vitamin A; zinc