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February 2013

Toward a World Where Children Do Not Drown

Author Affiliations

Author Affiliations: The Alliance for Safe Children, Atlanta, Georgia (Dr Linnan); and The Royal Life Saving Society Australia and International Life Saving Federation, Sydney, New South Wales, Australia (Mr Scarr). Dr Giersing is a consultant for child development and was formerly UNICEF Country Representative to Vietnam and Bangladesh and Director of Communication, UNICEF, New York.

JAMA Pediatr. 2013;167(2):110-111. doi:10.1001/jamapediatrics.2013.948

In the 3 and a half decades of the child survival revolution, great progress has been made in increasing the survival of children. Globally, the infant mortality rate has decreased from 127 to 40 per 1000 live births since 1960, a decrease of more than two-thirds, leading to an increase in life expectancy from 56 years in 1970 to 70 years at the global level in 2010.1 This is an unprecedented achievement in child health. It is in large part due to a laserlike focus on combating the causes of death that were thought to account for the great majority of all infant and early child deaths—birth-related causes, infectious diseases, and nutritional deficiencies. These have been at the core of the child survival revolution. In learning how to provide maternal health education, access to maternal and child health services, immunization, breastfeeding, and proper sanitation, we learned how to help neonates and older infants survive the first, most deadly year of their lives. In doing this, we reduced the period of greatest peril to the first month of life, the neonatal period, where now well over half of all infant deaths occur. We took great satisfaction in the steady decrease in these diseases and told ourselves the significant work remaining was an additional focus on this neonatal period to continue making rapid downward progress on infant and child deaths.

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