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RCOG statement on The Lancet study on child mortality across the world

News 6 May 2014

The Lancet has published a paper looking at global, regional and national levels of neonatal, infant and under-5 mortality from 1990 to 2013.

The findings come from a new study coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, USA.

Looking at 188 different countries, the researchers calculated overall mortality rates for children under five, and they analysed mortality rates for subdivided age categories.

They generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), post neonatal (29–364 days), childhood (1–4 years) and under-5 (0–4 years) age groups.

The paper states that only 27 developing countries are expected to achieve MDG 4 – to reduce child mortality by two-thirds from 1990 to 2015.

The mortality rate in the UK for children under five is 4.9 deaths per 1000 births.

Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“Neonatal deaths are extremely difficult for women and their families to come to terms with and the causes are often multifactorial and sometimes unknown.

“We need to understand why they happen so that we can prevent them in the future. The RCOG is keen to focus particularly on reducing intrapartum stillbirths and early neonatal deaths.

“Maternity services are coping with more births and more complex cases, for example, rising obesity rates. In 2009, 10% of mothers who had a stillbirth or whose babies died in the neonatal period had a BMI of 35 or more.

“Maternal obesity is a key public health concern and pregnant women who are obese need to know about the possible risks to them and their baby.

“Moreover, as hospital delivery units are busier there is an ever-increasing need for the provision of 24-hour consultant presence on the delivery suite. There is an urgent need to invest in more consultants and midwives in order to provide high quality care. Action is also needed to improve staffing ratios and the present tariff, and therefore overall funding for maternity care does not enable the majority of Trusts to get anywhere near their optimal staffing ratios.

“Recognising the national financial constraints, the College would like greater emphasis on the importance of maternity care for improving pregnancy outcomes.

“On a global scale, more needs to be done to address childhood mortality in developing countries. The worldwide effort to achieve the UN Millennium Development Goals has had significant impact in a number of countries but there is still much work to do.

“The College is already playing a role in influencing the post-2015 environment as a member of the Partnership for Maternal, Newborn and Child Health (PMNCH), which brings together organisations focused on improving the health of women and children.”