Once children develop pneumonia, prompt and effective treatment saves lives. Yet, globally less than two thirds of children (60 per cent) with pneumonia (excluding China) are taken to an appropriate health-care provider. The highest levels of care-seeking for pneumonia are found in South Asia and East Asia and the Pacific (excluding China), with 65 and 64 per cent respectively. On the other hand, in Sub-Saharan Africa less than half of all children with suspected pneumonia and taken to an appropriate health provider (49 per cent).
Too few children with pneumonia are receiving appropriate care
Proportion of children under five with suspected pneumonia taken to an appropriate health-care provider, 2007–2012
* Excludes China.
Note: Estimates are based on a subset of 66 countries with available data for 2007–2012, covering 70 per cent of the global under-five population (excluding China, for which comparable data are not available) and at least 50 per cent of the under-five population in each region. Data coverage was insufficient to calculate the regional average for CEE/CIS and Middle East and North Africa region.
Source: UNICEF global databases 2012, based on Multiple Indicator Cluster Surveys, Demographic and Health Surveys and other national surveys.
Antibiotic treatment for pneumonia
Globally, less than a third of children with suspected pneumonia receive antibiotics (31 per cent), with South Asia averaging 24 per cent.
Importantly, not all children with suspected pneumonia should receive antibiotics, only those classified as having pneumonia (based on a rapid respiratory rate counted by a health worker), according to WHO and UNICEF Integrated Management of Childhood Illness guidelines. And not all children so classified have true pneumonia, but in settings without adequate diagnostic tools, the guidelines provide a common standard by which health workers can classify bacterial pneumonia illness in need of presumptive antibiotic treatment.
Disparities in essential coverage - While boys and girls with suspected pneumonia are almost equally likely to receive antibiotics, gaps exist between children in rural and urban areas. On average, children with suspected pneumonia in urban areas are more likely to receive antibiotics than are children in rural areas (See country level data).
Information on disparities by household wealth is limited, but nearly all low-income countries with available data show a wide gap in antibiotic use for suspected childhood pneumonia between the poorest and richest wealth quintiles.
The poorest children are less likely to receive antibiotics for suspected pneumonia
Percentage of children under five with suspected pneumonia receiving antibiotics, by household wealth quintile, low-income countries, 2006–2011
Note: Subnational estimates are often bracketed by large confidence intervals, so results should be interpreted with caution. Low-income group is based on the World Bank July 2011 classification (see http://data.worldbank.org/about/country-classifications/).
Source: UNICEF global databases 2012, based on Multiple Indicator Cluster Surveys, Demographic and Health Surveys and other national surveys. Published in ‘Pneumonia and Diarrhoea: Tackling the deadliest diseases for the world’s poorest children’ UNICEF 2012.
Liu L, Johnson HL, Cousens S, et al, for the Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379: 2151–61.
UNICEF Global databases, 2012.
UNICEF, Pneumonia and Diarrhoea: Tackling the deadliest diseases for the world’s poorest children, UNICEF, New York, 2012.
UNICEF, Pneumonia: The forgotten killer of children, UNICEF and World Health Organization, New York and Geneva, 2006.