All children have the rights to survival, developing and reaching their full potential without discrimination, bias or favouritism. The Convention on the Rights of the Child also draws our attention to the need to fight discrimination: "irrespective of the child's or his or her parent's or legal guardian's race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status." In recent times, the world has made tremendous progress in reducing the inequities that formerly prevented millions of children from getting a good start in life, being nourished and cared for, and being able to go to school. This Unicef publication outlines many of the milestones achieved for the world's poor and marginalised children to date, as well as many of the remaining gaps.
It examines seven sectors that are critical to progress for children: i) health; ii) HIV and AIDS; iii) water, sanitation and hygiene; iv) nutrition; v) education; vi) child protection; and vii) social inclusion. In each sector, there are stark contrasts between global advances on one hand and the urgent, unmet needs of the world's most vulnerable children on the other.
Over the past 25 years, the world has made dramatic improvements in child and maternal mortality. Between 1990 and 2015, mortality rates for children under age 5 fell by 53 per cent. However, in 2015, an estimated 5.9 million children died before reaching age 5. Children from the poorest families are, on average, nearly twice as likely to die before their fifth birthday as those from the wealthiest families. Between 2001 and 2014, HIV infections declined in every age group, but most rapidly for children under age 5. That decline was driven by success in preventing mother-to-child transmission of HIV and expanding the provision of antiretroviral therapy (ART). Despite overall progress in increasing access to ART, children lag behind adults in receiving treatment. In low- and middle-income countries, just 31 per cent of children under age 15 who were living with HIV received ART in 2014, compared with 40 per cent of adults and adolescents 15 and older.
Since 1990, overall progress in water, sanitation and hygiene has been staggering. Global progress in access to water masks wide disparities between regions. More than 660 million people still lack access to improved drinking-water sources. Nearly half of them live in sub-Saharan Africa and 1 in 10 people living in the same region depends on surface water for drinking. Dramatic declines in stunting, a key marker of under-nutrition, indicate real progress for the world's children. Between 1990 and 2014, the global rate of stunting among children under age 5 fell by 40 per cent. However, about one quarter of children under age 5 are stunted. At the same time, the world has seen a growing upward trend in obesity among children - another form of malnutrition. From 2000 to 2014, the number of overweight children under age 5 increased from 31 million to 41 million.
More children now than ever before are enrolling in primary school at the appropriate ages, contributing to a primary school net enrolment ratio of more than 90 per cent worldwide. The Education for All (EFA) initiative has been a major factor in improving enrolment. But while primary school enrolment has been increasing steadily, the reduction in the number and proportion of out-of-school children has stalled since 2007, largely because of population growth in sub-Saharan Africa. More than one third of the primary-school-aged children who remain out of school live in conflict-affected countries. Surging conflict and political upheaval across the Middle East and North Africa, for example, have prevented more than 13 million children from going to school.
By many indicators, children are better protected today than they were at the outset of the Millennium Development Goals (MDGs) era. For children under age 5, the global proportion of birth registration - which helps to safeguard their access to essential services such as education and health care - rose from 58 per cent to 65 per cent between 2000 and 2010. Nonetheless, children continue to feel the devastating effects of protection abuses, including violence. Data from a wide-scale cross section of countries indicate that violence against children is prevalent. Even, on average, about four in five children between the ages of 2 and 14 are subjected to violent disciplinary methods at home. Key indicators of progress on social inclusion are revealed in many of the preceding statistics in this report, which show a narrowing of gaps in access to services as well as improved outcomes for children from historically marginalised groups. To the extent that figures from various sectors show equity gaps are shrinking, with some aspects of social inclusion improving, more work remains to be done.
Beyond facts and figures, the report also features selected stories about children and families that highlight equity-focused approaches to both humanitarian crises and longer-term development, because action on both fronts will be needed to achieve the newly adopted Sustainable Development Goals (SDGs). Above all, this well-documented Unicef publication underscores why equity is so important: because all children have the rights to surviving, thriving and reaching their full potential, whoever they are and wherever they live.
The writer is an independent researcher.
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