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0 to 4 years

Improving infant health

Baby in Bujumbura, Burundi

Some 5.4 million children under the age of five (around half of them newborns) died worldwide in 2017 – that is around 14,800 every day.

Most of these deaths occurred during labour and birth or were due to preventable or treatable diseases. Respiratory tract infections, diarrhoea, malaria and measles are frequent causes.

What Germany is doing

As well as strengthening healthcare systems, improvements need to be made in many other areas if the number of cases of mortality and illness is to be reduced. Examples include gender equality, nutrition, education, drinking water provision and waste water disposal.

German development cooperation is active in all these areas, the aim being to improve – both directly and indirectly – childrenʼs and young peopleʼs chances of survival.


Professional support during pregnancy and birth

A pregnant woman during a routine examination in a hospital in Monrovia, Liberia.

A key, direct starting point of German development cooperation for enhancing infant health is improving the care available to pregnant women and mothers. This can, for instance, help prevent premature births, complications during the birth process and infections in the first few days of a childʼs life.

That can only be achieved if women receive professional support, which needs to begin during pregnancy and continue after a baby is born. Effective medical treatment, including even resuscitation measures, and good neonatal care must be available when a crisis arises during pregnancy or an emergency occurs during labour and birth. Adequate supplies of medicines are essential, for example to treat premature babies.


Strengthening healthcare systems

An anesthesiologist examining a medical device in a regional hospital in Tanzania

Almost all those countries which have a high maternal and/or child mortality rate lack trained professionals and sufficient funding to pay for their healthcare systems. That is why German development cooperation focuses on measures to strengthen healthcare systems.

The objective is to give all children and their mothers access to reliable basic medical services provided by trained medical staff who can treat respiratory tract infections, diarrhoea and malaria, for instance. Such therapies often save lives, especially those of the under fives.

Further information about the activities of the Federal Ministry for Economic Cooperation and Development (BMZ) to strengthen healthcare systems is available here.


Integrated management of childhood illnesses

Children in a mother-child facility in Burundi.

Germany promotes the integrated management of childhood illnesses (IMCI) in its partner countries, the aim being to improve childrenʼs overall health. The strategy was developed in 1992 by the United Nations Childrenʼs Fund (UNICEF) and the World Health Organization (WHO). It covers a broad range of measures which are implemented at various levels.

IMCI is implemented jointly by health services, communities and families. One objective is to get schools to include health issues in their curricula. Programmes to improve water supply not only include plans to install new pipes, for example, but also incorporate training on health and hygiene education.

Germany also promotes simple measures which have proved every effective and can help more children survive, including

  • exclusively breastfeeding infants for the first four to six months,
  • sleeping under impregnated mosquito nets and using effective medicines to treat malaria,
  • treating pneumonia with antibiotics, and
  • vaccinating against six important illnesses.

Saving lives through vaccination

Vaccination of a child in Bangladesh

Vaccination is one of the most effective means of preventing illness, saving lives and thus also taking the pressure off healthcare systems. Because of this, the BMZ supports vaccination programmes for children. Its cooperation with the Global Alliance for Vaccinations and Immunisation (Gavi) is one important element in this work. This public-private partnership (PPP) comprising numerous institutions, governments and private-sector companies supports vaccination programmes and strengthens the necessary healthcare systems.

Germany has been supporting the work of Gavi, the Vaccine Alliance since 2006. In the period between 2016 and 2020 alone the BMZ is providing a total of 600 million euros in funding to the Alliance, making Germany its fourth largest governmental donor.

Gavi helped vaccinate some 640 million children between 2000 and 2016. According to the Alliance, past vaccination programmes and campaigns have helped to prevent more than nine million deaths in developing countries.

Further information about Gavi, the Vaccine Alliance is available here.


BMZ Initiative on Rights-Based Family Planning and Maternal Health

Mothers and children in Abdi Buch, Eastern Ethiopia

The BMZ instituted its Initiative on Rights-Based Family Planning and Maternal Health in 2011 as part of German activities within the context of the G8. Its objective is to ensure that all children in Germanyʼs partner countries are wanted and all pregnant women receive professional support. German Development Minister Gerd Müller has announced that the initiative will be extended to at least 2019 and that an additional 100 million euros will be made available annually.

German support in the project regions has, among other things, ensured that

  • in the period between 2011 and 2016 more than 19 million couples were able to protect against unplanned pregnancies for a certain length of time,
  • 16,000 health professionals were qualified in midwifery, and
  • 3.3 million births were supported by trained professionals.

Further information about the BMZ Initiative is available here.


Examples of Germany's international cooperation in the field of children's health

As part of the global fight against disease, the BMZ supports organisations like the World Health Organization (WHO) and the United Nations Childrenʼs Fund (UNICEF) in carrying out targeted, large-scale campaigns, for example to treat diarrhoeal diseases, malaria and respiratory tract infections at an early stage.

The BMZ has been represented on the Board of the Partnership for Maternal, Newborn and Child Health (PMNCH) since 2017. This alliance of more than 1,000 member organisations is committed to achieving those Sustainable Development Goals (SDGs) which refer to maternal and child health.

The BMZ supports the United Nations Population Fund (UNPFA) and the International Planned Parenthood Federation (IPPF). In 2017 it contributed 22 million euros in funding to the UNFPA and 6 million euros to the IPPF.

Germany supports the goal of eradicating polio worldwide and has provided a total of more than 550 million US dollars in funding to the Global Polio Eradication Initiative (GPEI) in the period since 1988.

The BMZ also contributes to the Global Fund to Combat AIDS, Tuberculosis and Malaria (GFATM) to help improve the health of children and young people.


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