The 'lottery of birth': How to give every child an equal chance for a better life

Amina holds her 7-month-old baby Habib at an outpatient center in northeastern Ethiopia. She waits to receive a nutritional peanut paste for her son, who has been recently discharged from the stabilization center. Photo by: Seifu Assegid / Save the Children.

One of the most fundamental and universal rights of every human being is the right to life. But while several international policies aim to defend that right, including health provisions in the expiring Millennium Development Goals, a significant number of people — specifically children, minority groups and the poor — still struggle to live long, productive lives.

Why does a child born in a more affluent city or household have better chances of survival than one mired in poverty or living in the furthest corner of the world? Why, for example, is a child in Sierra Leone 20 times more likely to die under the age of 5 than a child of the same age range in the United States?

The answer lies in tackling a complex, intertwined set of causes including the lack of access to health and sanitation services, deficient infrastructure and unequal economic opportunities for sustenance. There is no quick fix.

Save the Children President and CEO Carolyn Miles shared with Devex that while the advances in child mortality strategies reflect a declining trend in the past few years, the progress is unequal and does not paint the reality on the ground where money, race and birthplace remain critical factors for a child’s chance of survival.

“The inequalities in child survival … are a direct violation of every child’s right to start in life,” she told Devex. “The ‘lottery of birth’ is a symptom of the global pursuit of sustainable and inclusive development being severely off track. Particular groups of children continue to be left at the back of the line by development progress, simply because of where they happen to be born or the status of their parents.”

World Bank data shows a general decline in child mortality — or the number of deaths per 1,000 live births — in the past two decades. This means 17,000 fewer children die every day that could eventually be productive members of society. This is a laudable achievement, largely shaped by a concerted effort of the international community to standardize certain development goals.

But to expedite this decline of preventable child mortality, is a more multidisciplinary and targeted approach needed?

Miles shared that while the general concept of reducing child mortality is through the strengthening of health systems that give access to basic health care services and treatments for even the poorest people at low or no cost, “focusing solely on treating specific diseases and conditions that are killing children directly will only get us so far.”

And so should global development efforts and funding focus on broader health system reforms, health network infrastructure, or ensuring swift access to health care in remote areas? Is there a need for a change of approach here?

“Inequalities in child survival are symptomatic of, and driven by, wider social and economic ills — inequalities in education, infrastructure, economic opportunity, political and accountability,” Miles said. “We need an integrated, multidimensional approach to tackling preventable child mortality and its wider, multidimensional drivers. It’s the only way to achieve long-term impact for the poorest and most marginalized.”

Indeed, data from a Save the Children report released Thursday suggest that a holistic approach is associated with 6 percent faster progress in a decade on average.

However, Miles said that these encouraging figures should not remain as figures forever. Stakeholders should dig deeper in the data, since many more groups of children are still being neglected and marginalized. This, Miles said, should be a constant reminder as the international community prepares to usher in a new global development blueprint in September.

“We’re pushing hard to ensure that the post-2015 global development framework … is strong enough to drive forward change from international to local levels,” she said. “We need to see a commitment enshrined in the framework that no post-2015 target will be considered met unless it’s met for all — rural and urban, girls and boys, remote regions, as well as capital cities and poor people, as well as the more affluent.”

Other notable recommendations from the report include the call for national governments to review national and sector-specific policies and plans to support the achievement of post-2015 goals and targets, and a heightened commitment from all stakeholders — donors, multilateral agencies, civil society and private sector — to provide technical and financial support, create enabling environments, cooperate and collaborate and “hold themselves and each other accountable” moving forward.

Is a holistic approach the key to reducing child mortality and inequality and opening up more equitable and comprehensive pathways? Have your say by leaving a comment below.

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About the author

  • Lean 2

    Lean Alfred Santos

    Lean Alfred Santos is a Devex development reporter focusing on the development community in Asia-Pacific, including major players such as the Asian Development Bank and the Asian Infrastructure Investment Bank. Prior to joining Devex, he covered Philippine and international business and economic news, sports and politics. Lean is based in Manila.

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