Key Facts on Access to Healthcare

• Between 5.7 and 8.4 million deaths (up to 15% of overall deaths) are attributed to poor quality health care each year in low and middle-income countries (LMICs).
• Sixty per cent of deaths in LMICs occur due to poor quality health care, whereas the remaining deaths result from non-utilization of the health system.
• Inadequate quality of care imposes costs of US$ 1.4–1.6 trillion each year in lost productivity in LMICs.
• It is estimated that high quality health care could prevent 2.5 million deaths from cardiovascular disease, 900,000 deaths from tuberculosis, 1 million newborn deaths and half of all maternal deaths each year.
• Globally, one in 8 health care facilities has no water service, one in 5 has no sanitation service, and one in 6 has no hand hygiene facilities at the points of care.
• An estimated 1.8 billion people, or 24% of the world’s population, live in fragile contexts that are challenged in delivering quality health services. A large proportion of preventable maternal, childhood and neonatal deaths occur in these settings.

The UN Political Declaration on UHC adopted by world leaders in September 2019 reaffirmed the commitment to progressively cover one billion additional people by 2023 with quality essential health services, with a view to cover all the world’s people by 2030.

Children: improving survival and well-being

• In 2019 an estimated 5.2 million children under 5 years died mostly from preventable and treatable causes. Children aged 1 to 11 months accounted for 1.5 million of these deaths while children aged 1 to 4 years accounted for 1.3 million deaths. Newborns (under 28 days) accounted for the remaining 2.4 million deaths.
• An additional 500,000 older children (5 to 9 years) died in 2019.
• Leading causes of death in children under-5 years are preterm birth complications, birth asphyxia/trauma, pneumonia, congenital anomalies, diarrhoea and malaria, all of which can be prevented or treated with access to simple, affordable interventions including immunization, adequate nutrition, safe water and food and quality care by a trained health provider when needed.
• Older children (5-9 years) had one of the largest declines in mortality since 1990 (61%), due to a decline in infectious diseases. Injuries (including road traffic injuries and drowning) are the leading causes of death among older children.

Sub-Saharan Africa remains the region with the highest under-5 mortality rate in the world, with 1 child in 13 dying before his or her fifth birthday, 20 years behind the world average which achieved a 1 in 13 rate in 1999.

Two regions, sub-Saharan Africa and central and southern Asia, account for more than 80 per cent of the 5.2 million under-5 deaths in 2019, while they only account for 52 per cent of the global under-5 population.

Half of all under-5 deaths in 2019 occurred in just 5 countries: Nigeria, India, Pakistan, the Democratic Republic of the Congo and Ethiopia.

Nigeria and India alone account for almost a third of all deaths.

Top 10 countries with the highest numbers of deaths for children under-5 years, 2019

The Sustainable Development Goals (SDGs) adopted by the United Nations in 2015 were developed to promote healthy lives and well-being for all children. The SDG Goal 3.2.1 is to end preventable deaths of newborns and under-5 children by 2030. There are two targets:

1. Reduce newborn mortality to at least as low as 12 per 1000 live births in every country; and

2. Reduce under-5 mortality to at least as low as 25 per 1000 live births in every country.

In 2019, 122 countries have met the SDG target for under-5 mortality and a further 20 countries are expected to meet the target by 2030 if current trends continue.

However, accelerated progress will be needed in 53 countries, which will not achieve the target by 2030 on current trends.

Meeting the SDG target would reduce the number of under-5 deaths by 11 million between 2019 and 2030. Focused efforts are still needed in sub-Saharan Africa and South-East Asia to prevent 80 per cent of these deaths.

Children: new threats to health

• Greenhouse gas emissions leading to climate change and ecological degradation existentially threaten the lives of all children.
• Children are vulnerable to adverse health effects from indoor and outdoor air pollution which causes an estimated 7 million deaths per year (2016).
• Over 250 million children are at risk of not meeting their development potential (2017).
• There are 124 million children and adolescents affected by obesity (2016).
• Children are frequently exposed to commercial marketing promoting addictive substances and unhealthy commodities.
• Road injury is the leading cause of death for children and young people; more than 1 billion children are exposed to violence every year.

Progress on indicators of child health and well-being is currently stalled across the Sustainable Development Goal (SDGs) - No country is currently providing the conditions needed to support every child to grow up and have a healthy future.

(Data on Access to Healthcare is sourced from: WHO, World Bank, Our World in Data, Gapminder and OECD)