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Ethiopia has met the Millennium Development Goal 4 (MDG 4) on child survival, jointly announced the Ministry of Health (MoH) and UNICEF on September 13th. Ethiopia has been able to reduce its under-five mortality rate by two thirds between 1990 and 2012. The under-five mortality rate was one of the highest in the world with 204 deaths per 1,000 births; current statistics show that it has now declined to 68 deaths per 1,000 births.
“Achieving ambitious targets in the social sectors has been a central pillar of the Government’s Growth and Transformation Plan. It is now clear that the key policy choices that we made in the health sector were the right ones,” said Dr Kesetebirhan Admasu, the Federal Minister of Health.
Globally, the annual number of deaths among children under five years of age declined from an estimated 12.6 million in 1990 to 6.6 million in 2012. Over the past 22 years, the world saved the lives of around ninety million children that may otherwise have been lost.
Ethiopia has made a significant contribution to this success; each year, around 235,000 more children survive to their fifth birthday, which was not the case 20 years ago. The success is said to have been driven by political commitment, advances in science and technology, and improvements in health, nutrition and family planning services, particularly in rural areas.
According to statements from the MoH and UNICEF, Ethiopia has been at the forefront when it comes to ensuring basic services for women and children in the country.  In particular, by bringing basic health services to the doorsteps of the rural population, the Health Extension Programme has made a significant contribution. Since 2003, more than 38,000 Health Extension Workers who draw government salaries, the majority of them being young women, have been deployed to over 15,000 health posts across the country.  
“In many ways the progress made in the health sector in Ethiopia has become a  powerful global symbol of what can be achieved in resource-constrained environments, and has given many international partners renewed faith in the enterprise of development,” said Peter Salama, UNICEF’s Representative in Ethiopia. He also stated that Ethiopia has become the child survival benchmark for other countries, implicitly challenging them to do more for their own children.
Child survival facts show that Sub Sahara Africa, Middle East and North Africa are the only regions that have experienced a consistent acceleration in the pace of reducing under-five deaths since 1990. Since 2005, Sub Sahara Africa has been reducing its rate of child mortality five times faster and more, than during the 1990 to 1995 period. The region has registered a 45 percent decline in the under-five mortality rate from 1990 to 2012.
Globally, the leading causes of death among children under-five include pneumonia which accounts for 17 percent, pre-term birth complications 15 percent, diarrhoea 9 percent and malaria 7 percent, among other causes. Malnutrition is associated with 57 percent of under-five deaths.
Suggested solutions for the problems includes investment in maternal care, specifically labour and delivery care, and other high-impact interventions including care during the 24 hours around the time of birth, early breastfeeding and good hygiene. In Ethiopia, 90 percent of mothers give birth at home and recent surveys show an improvement of 25 to 30 percent in big regions in the country.
Studies also show that reducing child deaths by 4.25 per 1000 children born to mothers with low levels of education can result in an almost 8 percent increase in GDP per capita 10 years later.