One of the Millenium Development Goals that really gives us clear message is “Reduce by two thirds, between 1990 and 2015, the under-five mortality rate”. Children are the present and future workers in economy sector, caregives of their families, stewards of the environment, innovators of technology, they are the future us. Unfortunately, we are still far from reaching these utopia. Currently, almost 10 million children under the age five die in every corner of the world. Some 40 percents of under five deaths occur within the first month of life, and some 70 percent occur within the first year of life. The estimation of total under five years old population today is around 620 million (US Census Bureau,2011), which means for every 62 childs, 1 dies.
Figure 1 Child Mortality Rate Map
We may think that child mortality rate is very connected with social-economic condition. Children of poor families living in unhealthy environments are more likely to become ill due to increasing exposure to health risks. Besides, they have very limited access to get proper care. We do realize that main causes of what happened in remote areas in developing countries, like Sub-Saharan Africa or little in South Asia, are mainly because the disparity of health facilities and quality of services among regions. It is understandable that the only way to deal with that kind of problems is by providing proper funding to build infrastructure needed. Otherwise those areas , the problem is DIFFERENT.
Figure 2 Children Death Under 5 Age by Location [1]
The statistic shocks us that in areas like industrialized countries and developing countries, the mortality rates of babies under 5 years old remains high. The table below conclude the current condition when we number the mortality rates of babies under 5 years old by income level per country.
Table 1 Under-five mortality rates by country income level (Deaths per 1,000 live birth per year) [UNICEF2004]
| Income Level | Under-five mortality rate |
| Industrialized countries | 7 |
| Developing countries | 88 |
| Poorest countries | 120 |
For one thing, two or more potentially fatal infectious diseases of childhood can occur simultaneoulsy. Totally, one quarter of children deaths are caused by diseases such as pneumonia, diarrhoea, malaria and measles. Yet, these disease are actually preventable by giving proper vaccination. Many programs regarding vaccination have been established and ran by organization in various countries, but unfortunately, some parents still aren’t aware of the importance of giving their children proper vaccination. Thus, it is very crucial for the children under the age of five to receive vaccination due to their low immune systems. Then,we also found that although not listed specifically as a cause of death, undernutrition (low weight for age) contributes greatly to child mortality. 148 million of under 5s are underweigh for their age. 52,5 percent of all postneonatal childhood deaths are associated with undernutrition : 60.7 percent die of diarrhea, 57.3 percent die of malaria, 52.3 percent die of pneuomnia and 44.8 percent die of measles. Ensuring adequate nutrition of children under five could prevent more than 2.8 million deaths caused by these diseases (Caulfield and others 2004). We also found that in some developed countries, there have been problems with teenage pregnancy and early parenthood rates. Supporting young parents enables them to take proper care of their children due to less emotional and practical support. There is a great need to help develop parenting skills and enhance the chance of both mother and child life (National Children Bureau 2006) .
The strategy for reducing the under five-mortality rate is shifting. Providing complete health care system is very important for children, much can be accomplished without the involvement of the health system. The strategy is known as health intervention by the acronym GOBI-FFF, stands for Growth monitoring, Oral rehydration, Breastfeeding, Immunization, Food supplementation, Family planning and Female education. Exclusive breastfeeding for the first six months and appropriate complementary feeding could prevent almost 20 percent of childhood deaths in many countries. Teaching mothers and other primary caretakers on how to recognize the early signs of potentially fatal illnesses and where to seek care for them are also essential [2].
The question is, is everyone aware about that? Many of the interventions that are proven effective can be implemented at the household and community levels but it depends largely on the behaviour of mothers and families, the role of health facilities and professional health cares are supportive. Do we all know about those matters? A series of researches on child survival suggests several potential approaches to improve equity in order to reduce child mortality are mandatory. Those approaches are to improve knowledge and to change care-seeking behavior as the top on our to-do list (Victoria and others 2003).
[1] Level & Trends in Child Mortality Report 2010 : Estimated Developed by the UN Inter-agency Group for Child Mortality Estimation , prepated by UNICEF
[2] UN Millennium Project Task Force on Child Health and Maternal Health Document