Growing rich-poor divide threatens child health in Asia-Pacific, finds UN report

5 August 2008

While child survival in Asia and the Pacific – where half of the world’s children live – has improved considerably, deepening economic disparities have meant that the region’s poor are often unable to access proper health care, according to a new report by the United Nations Children’s Fund (UNICEF).

In this year’s State of Asia-Pacific’s Children 2008, UNICEF notes that the region’s robust economic growth, the fastest in the world since 1990, has lifted millions out of poverty and led to numerous improvements, including in child and maternal health.

However, the economic boom has also led to a widening gap between rich and poor which has left millions of women and children unable to access proper health care, says the report, which examines the latest trends in child and maternal health.

“The divide between rich and poor is rising at a troubling rate within sub-regions of Asia-Pacific, leaving vast numbers of mothers and children at risk of increasing relative poverty and continued exclusion from quality primary health-care services,” the report says.

Pneumonia, diarrhoea and malnutrition are the major causes of child death in the region. But vast inequities in income, geography, gender and ethnicity are essentially what stand in the way of children surviving and thriving, according to UNICEF.

The report notes that public health expenditure in the region remains well below the world average of 5.1 per cent, with South Asia spending only 1.1 per cent of gross domestic product (GDP) and 1.9 per cent being spent in the rest of Asia-Pacific.

Also, as more services within countries are privatized and the government share of health budgets diminishes, public facilities become more run down and health workers leave for better paid jobs in the private sector or outside the country.

UNICEF points out that the ability of India and China to accelerate progress in the areas of child and maternal health will greatly impact global achievement of the health-related Millennium Development Goals (MDGs) – the set of anti-poverty targets world leaders pledged to achieve by 2015.

It is a “fundamental truth” that unless India achieves major improvements in health, nutrition, water and sanitation, education, gender equality and child protection, global efforts to reach the MDGs will fail, states the report, which adds that China too needs to make significant strides to regain early progress it made in child survival.

In 2006, 2.5 million child deaths occurred in these two countries, accounting for nearly a third of all child deaths: India (2.1 million) and China (415,000).

The report also notes that South Asia is the only sub-region in the world where female life expectancy is lower than male life expectancy and where girls are more likely to be underweight than boys.

“Unless discrimination against women and girls is addressed as part of overall strategies to improve child and maternal health, high rates of maternal and child mortality will remain stubbornly entrenched,” says the report.

What is needed now, according to UNICEF, is political will and strategies to scale up investment in public health services that specifically target the poorest and most marginalized.

The report urges all governments, international agencies, non-governmental organizations (NGOs), civil society and the private sector to “consolidate and deepen” recent gains in the region by extending critical health services. Among other things, it calls for boosting public health care spending by at least 2 per cent to make quality public health care services affordable to the poorest people.


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