The Global Report on Preterm and Stillbirth was published in February by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS). The report shows that newborn deaths account for 42 percent of mortality in children under the age of five.

Forty-two percent equals nearly six million deaths annually from stillbirth or preterm birth complications. Despite that, progress is being made.

In September 2000, following a decade of progressive United Nations conferences and summits, world leaders came together to create the Millennium Development Goals (MDGs) - one of these goals is to reduce the newborn death rate to one third of the 1990 rate (12.7 million) by 2015. The latest data from GAPPS show progress, but further reduction by roughly two million annual deaths is needed to reach the MDG for 2015.

As president of Every Child Succeeds (ECS), a public-private partnership devoted to decreasing infant mortality rates in Greater Cincinnati, I understand the dynamic task our world is facing to reduce global child mortality.

Most recent data from 2006 lists infant mortality rates in the city of Cincinnati at 11.3 deaths per 1,000 births, and 10.9 in 2007 for Hamilton County. These numbers are significantly higher than state and national averages that stood at 7.7 for the state of Ohio in 2007, 7.5 for Kentucky in 2006 and 6.7 nationally in 2006.

Since its inception, ECS has effectively reduced infant mortality rates of its members’ infants to 4.7 deaths per 1,000 births. (For perspective, one of the world’s lowest infant mortality rates is found in Sweden at 2.4 deaths per 1,000 births.)

While we’re pleased with these results, it’s difficult to refrain from imagining “what if”?

The time intensive nature our quality based home visitation program also makes it cost intensive. We diligently manage costs and only spend what is absolutely necessary. But at the end of the day, we only have enough funding to help about a third of the mothers in our service area who qualify for our help.

So we wonder, what if we had the resources to help twice as many moms? Or all of the moms that qualify? What impact could we have on the mortality rate that is much higher than it should be?

Our hope for the future is to lower rates under 5 deaths per 1,000 births - on par with some of the best in the world - but we’ll need national legislation to support our efforts and provide new initiatives for expanding health care.

On March 23rd, at Northern Virginia Community College, President Obama signed health care overhaul into law, by approving the budget reconciliation bill. This bill potentially generates billions of dollars for improving US infant mortality rates - in addition to other initiatives. Specifically, within the health care bill, is a financial commitment of $1.5 billion over five years for at-home visiting programs like ECS.

Let us hope, as outlined in this bill, that local practices and programs continue to receive national attention.

After all, national health concerns and disparities are simply magnifications of local issues. If we’re to succeed globally in reaching the child mortality MDG for 2015, we must continue with local initiatives in order to achieve success across the nation; thereafter, we can implement programs across the world

Every Child Succeeds was founded in 1999 by three organizations - Cincinnati Children's Hospital Medical Center, Cincinnati-Hamilton County Community Action Agency and United Way of Greater Cincinnati. Since then, it has served more than 15,000 families through more than 330,000 home visits. Sixteen local agencies provide the home visits, adhering to program, training and evaluation standards established by Cincinnati Children's, where the ECS offices are located.

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