Child Survival Campaign

Some 22,000 children under five die each day (Unicef 2009). Most would have survived, just if the basic health care taken for granted in rich nations would have been available to them. Almost all lived, and died, in poor countries. The solutions are known and available, but are not reaching those who need them. A few diseases, like pneumonia, measles and diarrhoea are the biggest killers of young children today causing more than 90% of deaths in children under five.

The survey

At the beginning of 2009 the Global Movement for Children commissioned surveys to explore the attitude of the middle classes towards high child mortality. The surveys were conducted in eight developing countries: India, Cambodia, Kenya, Mali, Nigeria, Bolivia, Ethiopia and Zambia.  The surveys measured middle classes awareness of child mortality as well as willingness to act in order to reduce it.

Main Findings:

1. Middle class is concerned with high child mortality rates and is disappointed with the recent progress  

The issue of high child mortality rates generates a lot of concern within middle classes. Overwhelming majority (90% on average) considers child mortality a serious problem. Middle classes point to government’s inaction over the past years as its principal cause. However, middle classes believe negative trends can be reversed and child mortality can be considerably reduced, if there is political will.

2. Middle class calls for action

Middles classes demand from governments more profound and rapid actions to reduce child mortality.  Governments are believed to have capabilities and necessary resources to cope with the problem. Civil society is considered an important actor and contributor to alleviating child mortality, however cannot replace government. The government is the only body capable of introducing structural changes allowing to solve the problem in the long term. Civil society’s impact, although very appreciated, is limited and tentative.

3. Governments need to rebuild trust  


Government must rebuild trust among the middle classes. Without reciprocal trust, efficient cooperation on tackling high child mortality between government and middle class citizens will not be bring desired results. As the polls reveal, currently the level of trust is low (e.g. in Bolivia 64% of citizens distrust the government!). Decisive fight against corruption (corruption was the most frequently mentioned by the respondents), increasing transparency, dismantling bureaucracy are the first steps towards new, open and trust-based relationship.

4. Middle class believes the change is possible

Middle class believes that the future may be better for children if there is enough political will and long-term commitment to tackle the problem. People believe that with doubled efforts the Millennium Development Goal 4 (reduce child mortality by two thirds) can be achieved by 2015.

5. Need for information/education

The polls brought into light middle class poor knowledge on child mortality. Society is under-informed. There is a lack of proper educational systems. TV, newspaper and radio are the main sources of information. People largely underestimate child mortality rates. Majority is unaware of child mortality causes and solutions as well as never heard of the Millennium Development Goals.

6. Middle class wants to get involved.

According to the survey the middle class is not only concerned but also wants to help solve the problem. It is a job for governments to provide spaces for involvement especially for those who don’t know how to help (significant percentage of responders declared willingness but does not know how to help).

What needs to change

Government in poor countries should place child survival and basic health care on top of their agenda, as some countries are doing with very positive results. This implies improving the allocation of resources to health care and nutrition. 

Donor countries should, on their side, increase spending on basic health care and nutrition in developing countries.

How the change can be achieved

These changes can be achieved by:

(a) Engaging middle classes and key influencers in pushing for better healthcare for all children: ensuring they are well-informed and aware of the reality on their countries, and providing opportunities for engagement for middle classes and key influencers to create the enabling environment for government to implement the policy changes required.

(b) Engaging the direct beneficiaries in strengthening the demand for delivery of effective interventions to improve child health: This is because health services are failing poor people. This is not due to lack of knowledge for preventing and treating illnesses but rather by the fact that health systems are trapped in a web of failed relationships of accountability. The GMC campaign will catalyse constructive and organised engagement of local communities and children in negotiating with bureaucrats and politicians would increase the chances of effecting positive change towards meeting the child mortality target.

The Follow-up

The Global Report with the survey’s outcome is the basis for the communications campaign to ensure action from the governments in the South and the North. The GMC’s partner – The Partnership for the Maternal Newborn and Child Health (PNMCH) – takes the lead in designing and implementing the campaign.

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