Aarti Dhar

NEW DELHI: India and China hold the key to the world meeting health-related millennium development goals (MDGs), according to the United Nations Children’s Fund.

In its report on State of Asia-Pacific’s Children 2008, the UNICEF says unless India makes major achievements in health, nutrition, water and sanitation, education, gender equality and child protection, global efforts at reaching the MDGs will fail. China too needs to make significant strides to regain the early progress it made in child survival.

In 2006, 2.5 million child deaths occurred in the two countries accounting for nearly one-third of all child deaths.

Deepening disparities

However, the region’s robust economic growth, the fastest in the world since 1990, has lifted millions out of poverty. Child survival, regarded by the UNICEF as a key test of a nation’s progress in human development and child rights, has improved considerably. But gains have been overshadowed by deepening disparities in that health care often fails to reach the poorest.

The report also underscores a disturbing trend across the region: public health expenditure remains well below the world average of 5.1 per cent, with South Asia spending only 1.1 per cent of the gross domestic product and the rest of Asia Pacific, 1.9 per cent. In addition, as more services within countries are privatised and the government’s 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.

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

In India, one in every three women is underweight, putting them at risk of having lowbirth weight babies, which are 20 times more likely to die in infancy than healthy children.

Civil conflict also affects a child’s chance of survival – the two countries where a child has the hardest struggle to survive and thrive beyond his or her fifth birthday are Afghanistan and Pakistan. On the other hand, Sri Lanka, despite its civil strife, has cut child deaths by half since 1990 and stands out as a country that has budgeted well for children.