The United Nations Children Fund (UNICEF) has launched its annual global flagship report, \'State of the World\'s Children 2008\' in New Delhi. The new report highlights the number of children who die below the age of five years. The new report goes beyond the numbers to suggest actions and initiatives that should lead to further progress.

The new information in \'State of the World\'s Children 2008\' is drawn from household survey data as well as material from key partners, including the World Health Organization and the World Bank.

The approach to child survival that the report advocates sees the best disease-specific initiatives combined with investment in strong national health systems to create a continuum of care for mothers, newborns and young children that extends from the household, to the local health centre, to the district hospital and beyond.

The report is of great significance as approximately four million babies die globally, each year in their first month of life. The highest rate of neonatal death is found in sub-Saharan Africa where, on average, one child in every six dies before their fifth birthday. However, the largest absolute number of newborn deaths occurs in South Asia, of which India bears the greatest burden - one million.

\"Community-level integration of essential services for mothers, newborns and young children, and sustainable improvements in national health systems can save the lives of many of the more than 26,000 children under five who die each day,\" said Ann M. Veneman, UNICEF executive director at the global launch. \"The report describes the impact of simple, affordable life-saving measures, such as exclusive breastfeeding, immunization, insecticide-treated bed nets and vitamin A supplementation, all of which have helped to reduce child deaths in recent years\".

UNICEF country representative in India Dr Gianni Murzi said, \"We can reduce child mortality in India through these interventions and the sustained strengthening of health systems with increased community participation. Integrated health, nutrition and sanitation interventions are essential to make a significant dent in the problem of child survival in the country\".

\"The world will not achieve the millennium development goals (MDGs) without India. In order to do this, proven and cost effective interventions must be scaled up without delay. The government, UN, civil society, private sector as well as academic institutions must unite for Indian children in a concerted and urgent effort,\" he said.

The report emphasizes the need to empower local communities to provide immediate assistance to sick or severely malnourished children while seeking transfers to medical facilities. These communities generate necessary demand for quality health care and their engagement is vital if marginalized and remote populations are to be reached.

\"Stepping up investment in health systems will be crucial if we are to meet the child health targets set by the United Nations, but progress can be made even when health systems are weak,\" said Dr. Margaret Chan, director-general of the World Health Organization from Geneva. \"Innovative programmes in many countries show that an integrated approach where each child is reached with a package of interventions at one time can bring immediate benefits\", he added.

The report provides examples of successful government initiatives in India. The Integrated Management of Neonatal and Childhood Illnesses (IMNCI) initiative promotes neonatal health and survival while low cost interventions in the Integrated Child Development Services (ICDS) significantly improve health care for infants and young children leading to nutritional improvements in a short period of time.