Behind every preventable child death is a disempowered mother.
And it is no coincidence that child deaths are concentrated in the places with the greatest numbers of disempowered mothers -- India, Nigeria, Democratic Republic of Congo, Pakistan and Ethiopia. Half of all child deaths occur to mothers in these five countries.
But the experience of losing a child is not evenly spread among all mothers there. It is often a small minority of women who experience most of the child deaths. Several studies in Africa and South Asia have found that among vulnerable populations an estimated 20 percent of mothers experience 80 percent of all child deaths.
Who are these 20 percent of mothers who are suffering the loss of not only one child, but of several, and how can we empower them to prevent the deaths of their children?
In a study across three states in northern Nigeria the 1,267 child deaths recorded were experienced by just 591 mothers. The study showed that 253 mothers had lost one child, but the remaining 338 had lost an average of three children.
This study also found that the mothers who lost children differed most from their peers not in income or level of education as you might expect, but in the level of social support or help they received raising their children.
The mothers who had nobody to turn to for support, who rarely or never had anyone to help look after their children, and who felt that they were not respected by their peers were much more likely to have children die before they turned 5. Mothers who experienced this lack of social support and who had more than four children were particularly at risk of experiencing more than one child death.
This is why it is so important that when we talk about child survival we talk about mothers. Organizations like the MDG Health Alliance and Johnson and Johnson have joined forces to increase the focus on supporting the world's most vulnerable mothers in the hopes of achieving Millennium Development Goal 4 -- a two-thirds reduction in the 1990 child mortality rate by 2015.
Achieving this goal would mean preventing the deaths of 4.4 million children. Based on the Nigeria study, those deaths would be endured by 2 million of the world's most vulnerable mothers who are in need of additional support.
With less than 1000 days to achieve Millennium Development Goal 4, what if we all decided to focus on those 2 million mothers? What if we decided that identifying and surrounding them with the support they need to raise their children is the very best strategy for preventing 4.4 million child deaths?
These 2 million mothers are in so many ways the most important mothers in the world. The fate of 4.4 million children rests in their hands and, currently, their hands alone. Let's join hands to change that.