6 Reduce child mortality
Where we are?
Since the beginning of 2000, China has implemented the programme “Reducing Maternal Mortality and Eliminate Neonatal Tetanus”. By the end of 2011, the program had covered 2,297 counties, involving a total population of about 830 million and a total input from the central budget of RMB 2.13 billion. The Chinese Government has put in a large amount of earmarked funds to train medical personnel at local levels, install basic equipment, build Obstetric Emergency Centers and help poorer segments of the population, etc. At the same time, relevant departments have further strengthened legal assistance for women and children. Criminal activities against women and children have been effectively controlled. In 2010, Chinese Premier Wen Jiabao made commitments at the UN Summit on MDGs that the country will significantly expand its investment in the health care for women and children, strengthen the capacity building for maternal and child health (MCH) services, and enable more Chinese women and children to have better health care services. In 2012, Chen Zhu, Minister of Health, pointed out that in the next five to ten years, China will establish a basic medical and health care system covering urban and rural women and children, improve the MCH services system, ensure equal access of women and children to basic healthcare services, and constantly improve the health of women and children.
Target 4A: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate
The Chinese government has worked continuously to provide healthcare services for children and to improve children’s health by introducing legislation, strengthening management, cooperating with NGOs and conducting international cooperation and exchanges. With these efforts, child healthcare in China has made remarkable progress. Infant mortality rates have come down from 50.2 in every thousand in 1991 to 10.3 in 2012. Similarly, the mortality rate of children under five has dropped from 61.0 in every thousand in 1991 to 13.2 in 2012. This indicates that China has achieved this MDG ahead of schedule.
The government has prioritized child healthcare and has strengthened legislation, strengthened the rural healthcare system, and set up successful programmes, including ‘Reducing Maternal Mortality and Eliminating Neonatal Tetanus’ and ‘Resuscitation of Newborn’. Free services have also been provided to promote children’s physical and mental development. Free services like health checks are available to children in the 0-6 age group though programmes to provide equal access to basic public health services.
Challenges remain in dealing with the gap between regions in the child mortality rate. The main problems affecting children’s health are also different between urban and rural areas. In developed areas with a low mortality rate, the major problems plaguing children’s health are birth defects, accidental injury and other non-infectious diseases. While in poor rural areas the main causes of child mortality are premature delivery, low birth weight, asphyxia and infections such as neonatal tetanus.
The health insurance system for children remains to be improved. The costs of medical services are often unaffordable to the poor. Health problems are one of the major causes that drag a family into poverty. Also, although the national monitoring system for maternal and child mortality has been improved in recent years, accounting for child mortality rates and immunization coverage among unregistered and floating populations remains a challenge. Finally, some basic intervening measures that may have significant impacts on child survival have not been fully implemented in the poorest regions, including newborn screening and counselling on appropriate feeding.
Targets for MDG4
- Reduce by two thirds the mortality rate among children under five
- Under-five mortality rate
- Infant mortality rate
- Proportion of 1 year-old children immunised against measles