UNICEF is calling for a big increase in health spending after its report shows some Pacific countries scoring badly in an international table of child mortality rates.
Solomon Islands and Papua New Guinea have the highest rates of child mortality in the Pacific region with 73 out of every 1,000 children dying before they are five years old.
In UNICEF's report called the State of Asia-Pacific's Children 2008, Kiribati, the Marshall Islands and the Federated States of Micronesia also perform badly.
Pacific countries on track to achieve the Fourth Millennium Goal of reducing child mortality rates by two thirds between 1990 and 2015 are Tuvalu, Vanuatu, Nauru, Samoa, Tonga, the Cook Islands, Fiji, Palau and Niue.
UNICEF's New Zealand Executive Director Dennis McKinlay says there is much that can be done to lower child mortality.
"Improve training of personnel, improved facilities in the region - that would be a really big step - even just the education of mothers would be a big step forward so that mothers knew more about how to care for their children. There are other issues like malaria, waterborne diseases and so on that are also factors in terms of the child mortality rates and there could be more done in those areas as well."
Dennis McKinlay of UNICEF New Zealand.