Marking World Health Day, WHO today launched 'The world health report,' which calls for greater access to life-saving interventions and a "continuum of care" approach to start before pregnancy and extend into the baby's childhood. Hundreds of millions of women and children have no access to potentially life-saving care with often fatal results, the report says.

About 530 000 women a year die in pregnancy or childbirth, more than three million babies are stillborn, more than four million newborns die within the first days or weeks of life, and altogether 10.6 million children a year die before their fifth birthday, according to WHO's latest figures.

In The World Health Report 2005 - Make every mother and child count, WHO estimates that out of a total of 136 million births a year worldwide, less than two thirds of women in less developed countries and only one third in the least developed countries have their babies delivered by a skilled attendant. The report says this can make the difference between life and death for mother and child if complications arise.

According to the report, almost 90% of all deaths among children under five years of age are attributable to just six conditions. These are: acute neonatal conditions, mainly preterm birth, birth asphyxia and infections, which account for 37% of the total; lower respiratory infections, mostly pneumonia (19%); diarrhoea (18%); malaria (8%); measles (4%); and HIV/AIDS (3%). Most of these deaths are avoidable through existing interventions that are simple, affordable and effective. They include oral rehydration therapy, antibiotics, antimalarial drugs and insecticide-treated bednets, vitamin A and other micronutrients, promotion of breastfeeding, immunization, and skilled care during pregnancy and childbirth. To reduce the death toll, the report calls for much greater use of these interventions, and advocates a "continuum of care" approach for mother and child that begins before pregnancy and extends through childbirth and into the baby's childhood. This in turn requires a massive investment in health systems, particularly the deployment of many more health professionals, including doctors, midwives and nurses. "For optimum safety, every woman, without exception, needs professional skilled care when giving birth," the report says, adding that continuity of care for the newborn in the following weeks is vital.

"This approach has the potential to transform the lives of millions of people," Dr LEE Jong-wook, WHO Director-General said adding, "Giving mothers, babies and children the care they need is an absolute imperative."

The report focuses on those developing countries where progress in maternal and child health is slow, stagnating or has even gone into reverse in recent years. Within such countries, less than half of mothers and newborns receive care, but by no means the full range of what they need. Make every mother and child count is a wide-ranging study of the obstacles to health facing women before and during pregnancy, in childbirth, and in the weeks, months and years that follow for them and their children. It pays particular attention to the plight of newborns, whose specific needs have "fallen between the cracks" separating maternal and child care programmes.

It is being published in the "report card year" of the United Nations' Millennium Development Goals (MDGs), two of which are to improve maternal and child health drastically by the year 2015. The latest available data show that total public health expenditure for the 75 countries with the biggest problems amounts to US$ 97 billion per year. The report calculates that this amount needs to be increased by an average of US$ 9 billion a year for each of the next ten years in order to increase access to care in those countries to a level that would permit them to move towards and even beyond the MDGs.