The Lancet special issue highlights RMNCH

The 8 June 2012 Issue of The Lancet had several commentaries and articles on reproductive, maternal, newborn and child health (RMNCH). They included:

Comment: Towards ending preventable child deaths

Margaret Chan, World Health Organization and Anthony Lake, UNICEF

Thanks in large part to the increased attention to maternal and child survival brought about by the Millennium Development Goals (MDGs),1 the world has made substantial progress in reducing child mortality over the past two decades. The number of deaths among children younger than 5 years has declined from more than 12 million in 1990 to 7.6 million in 2010.2 The mortality rate in children under 5 years has dropped from 88 deaths per 1000 livebirths in 1990 to 57 in 2010—a 35% reduction.2 The rate of decline in the under 5 mortality rate has accelerated from 1.9% a year from 1990 to 2000 to 2.5% a year from 2000 to 2010.

Building a future for women and children

Countdown 2012 Report Writing Group

The Countdown 2012 Report Writing Group comprised Cesar Victora, Jennifer Bryce, Jennifer Requejo, Zulfiqar Bhutta, Mickey Chopra, Peter Berman, Bernadette Daelmans, Andres de Francisco, Joy Lawn, Elizabeth Mason, Holly Newby, Carole Presern, and Ann Starrs. We declare that we have no conflicts of interest.

Countdown to 2015: Maternal, Newborn and Child Survival is a unique initiative in the global health landscape. Conceived in 2003 by The Lancet Child Survival Series team,1 Countdown includes academics, governments, representatives of multilateral and bilateral agencies, professional associations, non-governmental organisations, and other members of civil society who share the common goal of increasing accountability for progress towards the fourth and fifth Millennium Development Goals (MDGs). The fourth report of Countdown will be launched on June 13, 2012, at the Child Survival Call to Action, following previous successful reports launched at events in London (2005), Cape Town (2008), and Washington (2010).

Tackling pneumonia and diarrhoea: the deadliest diseases for the world's poorest children

Geeta Rao Gupta

On June 8, 2012, UNICEF released a report, Pneumonia and diarrhoea: tackling the deadliest diseases for the world's poorest children, that presents a compelling argument for greater action for all children, but especially the most vulnerable, on these leading causes of child deaths. Pneumonia and diarrhoea together account for nearly a third (29%) of all deaths among children younger than 5 years, a loss of more than 2 million lives each year.

Keeping promises for women and children

Carole Presern, Flavia Bustreo, James Droop, Helga Fogstad, Ann Starrs, Henrik Axelson, Julio Frenk

The health of women and children has received unprecedented international attention in recent years. The UN Secretary-General's Global Strategy for Women's and Children's Health,1 which was launched in Sept, 2010, defined clear priorities for action to reduce maternal, newborn, and child mortality in 49 high-burden, low-income countries. It also called for a Commission on Information and Accountability to recommend a framework for global reporting. One of the ten recommendations called for the constitution of an independent Expert Review Group that will analyse whether commitments are being fulfilled, whether or not (and why) progress is being made, and will recommend actions to strengthen impact in the few short years left before the deadline for achieving the health-related Millennium Development Goals.

Global child survival: beyond numbers

Zulfiqar A Bhutta

The remarkable progress made over the past decade in reducing the burden of child mortality is commendable. From an estimated annual child mortality rate of 10 million in 2000,1 now corrected to 9•6 million deaths, Li Liu and colleagues' study2 in The Lancet suggests that there are 2.0–2.4 million fewer deaths ever year, with major reductions in the number of deaths from diarrhoea, pneumonia, and measles. Differences in methodological approaches aside, the overall figures for child mortality are similar to those published last year by Lozano and colleagues.

Measles: the burden of preventable deaths

Walter A Orenstein, Alan R Hinman

Measles has been, and remains, a major killer of children around the world. Despite the introduction of the measles vaccine in 1963, measles caused an estimated 2.6 million deaths in a single year as recently as 1980.1 In The Lancet, Emily Simons and colleagues2 estimate that, after more than 45 years of measles vaccine availability, the disease caused nearly 140 000 deaths in 2010.

Preterm birth: new data on a global health priority

Nils-Halvdan Morken

Preterm birth is defined as birth before 37 completed weeks or 259 days of gestation1 and comprises spontaneous-onset preterm deliveries (by far the largest subgroup of preterm births) and provider-initiated preterm births (owing to maternal or fetal compromise). Spontaneous preterm birth has been characterised as an enigma,2 but both spontaneous preterm birth and the entire preterm delivery syndrome3 are far more than that. Preterm birth is a major health issue and the most important clinical problem in obstetrics and neonatal medicine.

ARTICLES

Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000

Li Liu, Hope L Johnson, Simon Cousens, Jamie Perin, Susana Scott, Joy E Lawn, Igor Rudan, Harry Campbell, Richard Cibulskis, Mengying Li, Colin Mathers, Robert E Black, for the Child Health Epidemiology Reference Group of WHO and UNICEF

Child survival strategies should direct resources toward the leading causes of child mortality, with attention focusing on infectious and neonatal causes. More rapid decreases from 2010–15 will need accelerated reduction for the most common causes of death, notably pneumonia and preterm birth complications. Continued efforts to gather high-quality data and enhance estimation methods are essential for the improvement of future estimates.

National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications

Hannah Blencowe, Simon Cousens, Mikkel Z Oestergaard, Doris Chou, Ann-Beth Moller, Rajesh Narwal, Alma Adler, Claudia Vera Garcia, Sarah Rohde, Lale Say, Joy E Lawn

The burden of preterm birth is substantial and is increasing in those regions with reliable data. Improved recording of all pregnancy outcomes and standard application of preterm definitions is important. We recommend the addition of a data-quality indicator of the per cent of all live preterm births that are under 28 weeks' gestation. Distinguishing preterm births that are spontaneous from those that are provider-initiated is important to monitor trends associated with increased caesarean sections.

Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data

Emily Simons, Matthew Ferrari, John Fricks, Kathleen Wannemuehler, Abhijeet Anand, Anthony Burton, Peter Strebel

Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum towards the 2010 global measles mortality reduction goal. Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles.

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