Under 5 years old mortality remains a worrying pattern
Substantial global progress has been made in reducing child deaths since 1990 and the global under-five mortality rate has dropped by 53 %. Yet, child survival remains an urgent concern and still an estimated 15,000 children suffer premature death every day.
Sub-Saharan Africa and particularly West and Central Africa remains the region with the highest under-five mortality rate. Overall, 1 child out of 13 dying before his or her fifth birthday (75% of the death occur before 2 years of life) – far higher than the average ratio of 1 in 147 in high-income countries.
Three main killers are accountable for more than 50 % of deaths: pneumonia, malaria, diarrhoea. Malnutrition is a contributing factor in almost half of deaths of under 5 years old.
A growing proportion of neonatal mortality
The decline in neonatal mortality from 1990 to 2015 has been slower than that of post-neonatal under-five mortality. Therefore, neonatal mortality represents today 44 % of under-5 mortality.
3/4 of neonatal deaths occur within the first 7 days and 1/3 within the first 24 hours of life. Three causes account for 3/4 of all neonatal deaths that is preterm birth complications, neonatal infections and intrapartum related events/asphyxia.
Neglected diseases – Neglected social patterns
Non-Communicable and Congenital Diseases account for 13% of under-five deaths. Sickle Cell Disease is estimated to contribute to 9 % of all under-five mortality through its complications.
Adolescents do represent a specifically vulnerable population group. It is estimated that 1.3 million adolescents suffered premature death in 2012, violence being the leading cause of death especially when it comes to young males. Pregnancy/childbirth complications is the second leading cause of death in this age group. Indeed 11% of all deliveries are in girls 15-19 years. An estimated 2 million adolescents are living with HIV.
Why the Paediatric Days?
In global terms, paediatric tools and guidelines need to be adapted to our theatres of operations. Indeed, most evidence-based practices were generated in high income countries and are often not transposable as such. Operational research efforts therefore need to be consented in the direction of generating new tools and adapting existing ones in the meantime.
Moreover, emerging challenges can only be tackled thanks to a global and collective paediatrics community engagement - antimicrobial resistance (AMR) - a rapidly growing threat to children’s survival, especially new-borns, is but a good example of these new challenges.
With a view to contribute to a response to MSF paediatric operational challenges, MSF launched the first edition of the paediatric days in 2016.
The MSF Paediatric Days is a two-day event that aims at catalyzing the Paediatric knowledge, expertise and practices from MSF’s fieldworkers and MSF’s HQ staff, along with academia and other NGOs. The Paediatric Days also aim at mobilizing interest among the non-MSF Paediatric professionals (MDs. nurses, both specialized and non-specialized) in reinforcing MSF’s teams with professionals who are committed to developing innovative ways to treat our most vulnerable patients – children.
The main event objectives are:
- To identify gaps in knowledge, research, and development of medicine and diagnostics geared towards paediatric patients in humanitarian settings.
- To understand the latest evidence and adapt practice as much as possible.
- To generate possible solutions and useful recommendations for contexts where MSF and other humanitarian organizations work.
- To participate in bringing paediatrics to the frontline of MSF priorities.
The scientific report of the conference is available here.