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Dakshri, a 23-year-old woman who has just given birth to a child, sits in the post-delivery ward at a community health centre in the remote village of Chharchh, in Madhya Pradesh, India on February 24, 2012. An innovative free maternity ambulance service is trying to increase the number of babies born in clinics.VIVEK PRAKASH/Reuters

As rising economic powers, China and India are gaining in global stature and influence. Both are building up their military capacities; China has just sent its first female astronaut into space.

Yet there is a gaping area of neglect that persists: the annual death of large numbers of children under five from wholly preventable and treatable diseases, including pneumonia, diarrhea, birth complications, newborn infections and malaria.

Globally, child mortality has dropped from 12 million to 6.9 million in the last 22 years. That is a monumental achievement. Some poor countries have made impressive progress, including Laos and East Timor, while others such as Afghanistan and Democratic Republic of Congo continue to struggle.

But according to a new report by World Vision, of the 10 most affected countries, four of the top five are middle-income. Among them is India, where 1.65 million children under five die every year of preventable disease, and China, with 249,000 deaths. "Both countries have stated they intend to reduce these inequalities and have programs, but they're not doing enough," notes the report, released on Monday.

China and India – as well as Indonesia – should consider diverting more resources to women and children living in rural and impoverished parts of these countries who lack access to basic health care.

Better nutrition for expectant mothers, promotion of breastfeeding, regular handwashing and access to micronutrients and vaccines can have a dramatic impact. China has invested in health-care insurance and reduced its child mortality rate. But stunting remains a problem in rural areas. And, thanks to the "hukou" registration system, hundreds of millions of migrants who move to cities lack legal residency status and cannot access health care.

In India, infant mortality varies by state and between socio-economic groups, from 73 per 1,000 children in Uttar Pradesh to 15 in Kerala. Some traditional customs, including birthing at home without an attendant, put women at risk.

To strengthen their credibility and influence – as well as economic potential – India and China should consider the enormous pay-off of investing more in maternal and child health, and protecting the vulnerable from unnecessary and early death.