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Sierra Leone, Angola and Afghanistan have worlds highest child mortality, UNICEF report says
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    GENEVA — A newborn in Sierra Leone has the lowest chance in the world of surviving until age 5, and the prospects are almost as bad for children in Angola and Afghanistan, according to a U.N. report released Tuesday.
    In 2006, nearly 9.7 million children died worldwide before their fifth birthdays, mostly from preventable causes such as diarrhea, malaria or malnutrition, the U.N. Children’s Fund said in its annual report.
    More than 26,000 children under 5 die each day on average.
    But progress has been made in a number of regions and strengthening local health services holds great promise for reducing the child mortality rate, said the document, ‘‘The State of the World’s Children 2008.’’
    In 2006, the latest year for which statistics were available, Sierra Leone had the highest child mortality rate, with 270 deaths per 1,000 births. Angola was second with 260 deaths, followed by Afghanistan with 257.
    The rate worldwide in 2006, in contrast, was 72 deaths per 1,000 births. The average rate in industrialized countries was six deaths per 1,000 births.
    ‘‘The loss of 9.7 million young lives each year is unacceptable, especially when many of these deaths are preventable,’’ said UNICEF Executive Director Ann Veneman.
    Sub-Saharan Africa, where the rate has dropped only 14 percent since 1990, is the region of greatest concern, the report said. It is home to 28 of the 30 countries with the highest child mortality rates.
    Simple health care measures, such as vaccinations, insecticide-treated bed nets and vitamin supplements, would prevent many of the deaths, the report said.
    ‘‘We know exactly what works,’’ said Angela Hawke of UNICEF, referring to strategies the agency has been promoting for some time.
    ‘‘But we need to make sure that these kinds of services are integrated at the most local level, in the villages where children live,’’ she said, adding that governments and health experts should design the best solutions for each community.
    ‘‘We want to make sure that there are local health services that really work with properly staffed health centers ... and there’s a proper national health plan,’’ Hawke told The Associated Press.
    Sierra Leone, where a civil war raged from 1991 to 2002, is unable to offer sufficient health services to its citizens, like many war-torn countries such as Angola and Afghanistan, the report said.
    Steven Ngaujah, a nurse at Brookfields Community Hospital in Sierra Leone’s capital, Freetown, said many parents in his community are too poor to bring children in for checkups.
    Annie Brima, also a nurse in the capital, said, ‘‘When these children fall ill, instead of the mothers taking them to the nearest hospital immediately, they prefer to ’pepper doctor’’’ — treat them at home.
    Although the overall under-5 mortality rate has been reduced by 23 percent since 1990, progress must be sped up to reach a U.N. goal of decreasing the 1990 rate by two-thirds before 2015. The current rate must still be halved to meet the target, the report said.
    Considerable progress has been made in a number of regions. In East Asia and the Pacific, central and eastern Europe, Latin America and the Caribbean, child mortality has been cut roughly in half since 1990, to below 30 deaths per 1,000 births, the report said.
    Nearly one-third of the 50 least developed countries, including the Maldives, East Timor, Nepal and Malawi, have reduced child mortality rates by at least 40 percent since 1990.
    In Mexico, a program aimed at engaging the poorest families provides financial rewards to parents who bring their children regularly to health clinics. The child mortality rate there has been reduced by 34 percent since 1990.
    Sub-Saharan Africa, too, has its bright spots. Mozambique, for example, has seen a 41 percent drop in child mortality after the government and aid agencies trained community educators to teach the country’s rural population about cheap health practices, such as breast-feeding, oral rehydration therapy and mosquito nets.
    The report mainly relied on data drawn from studies by the World Health Organization, the World Bank and the U.N. Population Division.
    Associated Press writer Clarence Roy-Macaulay in Freetown, Sierra Leone, contributed to this report.

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