The following information from the World Health Organization (WHO) fact sheet provides an overview of the WHO’s policy trends.
First, let’s look at survival rates and health outcomes [2]. In 2019, 5.2 million children under the age of five died of preventable and treatable diseases, including 1.5 million in the first 11 months of life and 1.3 million in the first four years of life, with the rest being newborns born less than 28 days after birth. The most common causes of death among children under 5 years of age are premature birth-related complications, birth-related respiratory disorders/trauma, pneumonia, congenital anomalies, diarrhea, and malaria.
Second, undernutrition is associated with 45% of child deaths [3]. In 2019, 144 million children under the age of five worldwide were underdeveloped, 47 million are frail (too thin for their height), while 38.3 million are estimated to be overweight or obese. Approximately 44% of infants between 0–6 months of age are exclusively breastfed. Few children receive safe and nutritionally appropriate supplemental foods, and in most countries, less than a quarter of infants aged 6–23 months meet age-appropriate standards for dietary diversity and frequency. If all children between the ages of 0–23 months received optimal breastfeeding, it is estimated that more than 820,000 children under the age of 5 could be saved each year. Breastfeeding is associated with higher intelligence quotient (IQ), higher school attendance, and higher earnings in adulthood. If breastfeeding can improve child development and reduce health care costs, it can contribute to economic benefits not only for individual families but also at the national level.
Third, this is a focus on improving survival and health in newborns. Although neonatal deaths have declined from 5 million in 1990 to 2.4 million in 2019, children face the greatest risk of death in the first 28 days of life [4]. In 2019, 47% of under-five deaths will occur in the neonatal period, with about 1/3 of these deaths occurring on the day of birth and 3/4 occurring within the first week of life. Children who die within 28 days of birth suffer from conditions and diseases related to lack of quality care at birth and skilled care and treatment immediately after birth and in the first few days of life. Premature birth, birth complications (birth asphyxia and lack of breathing), infections, and congenital anomalies are the most common causes of neonatal deaths. Women who receive midwife-led continuity of care (MLCC), provided by internationally trained professional midwives, are 16% less likely to lose their child and 24% less likely to experience preterm birth.
The fourth is violence. Violence against children includes any form of violence against a person under the age of 18, whether by a parent or other caregiver, peer, romantic partner, or stranger. It is estimated that one billion children between the ages of 2 and 17 experience physical, sexual, or emotional violence or neglect in a single year [5]. Childhood experiences of violence are lifelong. Experiences of violence in childhood can affect lifelong health and well-being, but evidence from around the world shows that violence against children is preventable.
The fifth topic is children’s cancer. Four hundred thousand children and adolescents between the ages of 0 and 19 are diagnosed with cancer each year [6]. The most common childhood cancers are leukemia, brain tumors, lymphoma, and solid tumors such as neuroblastomas and Wilms tumors. In high-income countries, where comprehensive treatment is available, more than 80% of children will survive cancer, while in low- and middle-income countries (LMICs), cures are estimated at 15–45%. Most childhood cancers are curable with generic drugs and other treatments such as surgery and radiation therapy. Treatment of childhood cancer is cost-effective in all income settings. Avoidable deaths from childhood cancer in LMICs are due to lack of diagnosis, misdiagnosis or delayed diagnosis, barriers to receiving treatment, treatment abandonment, death from toxicity, and high recurrence rates.
Sixth, let’s look at child abuse: among children aged 2–4, three out of every four children or 3 million children suffer physical punishment or psychological violence on a daily basis [7]. Among children aged 0–17 years, 1 in 5 girls and 1 in 13 boys are victims of sexual violence.
Finally, there are various new threats including climate change, air pollution, obesity, and traffic accidents. Greenhouse gas emissions, which lead to climate change and ecosystem destruction, threaten the lives of all children. Children are vulnerable to the health effects of indoor and outdoor air pollution, which according to a 2016 report is responsible for about 7 million deaths annually. More than 250 million children are at risk of not enjoying their developmental potential. One hundred and twenty-four million children and adolescents are affected by obesity. Children are frequently exposed to commercial marketing that promotes addictive substances and unhealthy products. Road traffic accidents are the leading cause of death among children and adolescents, putting more than one billion children at risk each year.
