A/HRC/27/31
Strategy for Women’s and Children’s Health, and the Commission on Information and
Accountability for Women’s and Children’s Health.
7.
The primary purpose of the present technical guidance is to assist States and nonState actors to improve the realization of the right of the child to health and survival by
providing guidance on reducing child mortality and morbidity in accordance with human
rights norms, standards and principles.
8.
The guidance is primarily directed towards health decision-makers and policymakers but is also relevant to other sectors, such as the finance and education sectors, as
well as to parliamentarians, the judiciary, civil society, health service providers, national
human rights institutions, donor States and the private sector, as well as intergovernmental
agencies.
II. Child mortality and morbidity
9.
Most child mortality is due to a small number of diseases and conditions. Globally,
43 per cent of such deaths occur among babies aged 0−28 days (newborn babies)5 and are
mainly due to pre-term birth complications, birth asphyxia and trauma, and sepsis. After the
first 28 days, until the age of 5 years, the majority of deaths are attributable to infectious
diseases such as pneumonia (22%), diarrhoeal diseases (15%), malaria (12%) and
HIV/AIDS (3%).6 The vast majority of conditions and diseases that lead to death among
children under 5 years of age are preventable and treatable through cost-effective
interventions.
10.
The risk factors associated with the leading causes of death in newborn babies are
multiple and complex. They include complications during pregnancy and childbirth, such as
bleeding, hypertension, prolonged and obstructed labour and infections, and lack of timely
access to skilled care during and after birth.
11.
The main risk factors associated with the leading causes of death in children aged
between 1 month and 5 years include low birth weight, lack of breastfeeding,
undernutrition, overcrowded conditions, indoor air pollution, unsafe drinking-water and
food, lack of sanitation and poor hygiene practices. In some regions, HIV and malaria are
also significant risk factors.
12.
Undernutrition is estimated to be associated with 45 per cent of child deaths
worldwide.5 Undernutrition is also strongly correlated with vulnerability to infections and
to delayed physical and mental development.
13.
Many of the leading causes of mortality among children are also the primary causes
of morbidity. Coughing, diarrhoea and fever are the commonest reasons for children to
attend health services, and severe pneumonia, diarrhoea and malaria are the commonest
causes of severe illness requiring hospital treatment. Other infections, disability arising
from congenital malformations or pre-term birth, and nutritional deficiencies also
contribute to child morbidity globally.
14.
A high burden of child morbidity is attributable to violence against children,
including physical, sexual and psychological violence, which exists in every country and
occurs in various settings, including the family, institutions and the community.7
5
6
7
4
United Nations Inter-agency Group for Child Mortality Estimation., 2012.
WHO, Global Health Observatory.
A/61/299; A/HRC/22/31.
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