Child Mortality

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Some more facts about Child Mortality

1) Child Mortality: Global Contrasts

Of the 20 countries in the world with the highest child mortality (probability of death under 5 years of age), 19 are in Africa, the exception being Afghanistan.
A baby born in Sierra Leone is three and a half times more likely to die before its fifth birthday than a child born in India, and more than a hundred times more likely to die than a child born in Iceland or Singapore.
Fifteen countries, mainly European but including Japan and Singapore, had child mortality rates in 2002 of less than 5 per 1000 live births.

2) Child Mortality: Gender and Socioeconomic Differences

Throughout the world, child mortality is higher in males than in females.
There is considerable variability in child mortality across different income groups within countries. Data collected by 106 demographic and health surveys in more than 60 countries show that children from poor households have a significantly higher risk of dying before the age of 5 years than the children of richer households.
Child mortality rates among the poor are much higher in Africa than in any other region despite the same level of income used to define poverty. The probability of poor children in Africa dying is almost twice that of poor children in the Americas.

3) Child Survival: Improvements For Some

The last three decades have witnessed considerable gains in child survival worldwide. Global child mortality decreased from 147 per 1000 live births in 1970 to about 80 per 1000 live births in 2002.
Although child mortality has fallen in most regions of the world, the gains were not consistent across time and regions.
In 16 countries (14 of which are in Africa) current levels of under-5 mortality are higher than those observed in 1990.
In nine countries (eight of which are in Africa) current levels exceed even those observed over two decades ago. HIV/AIDS has played a large part in these reversals.
Analyses from the demographic and health surveys show that, while child mortality has increased in many of the African countries surveyed, the gap between poor and non-poor populations has remained constant over time in this setting.
In contrast, there has been a widening of the mortality gap between poor and better-off groups in the Americas, where overall child mortality rates have fallen. This indicates that survival gains in many regions have benefited the better-off.
The reduction in child mortality has been much slower in rural areas, where poor people are concentrated, than in urban areas. These analyses suggest that health interventions implemented in the past decade have not been effective in reaching poor people.
Losses in child survival in the countries described above are at odds with impressive gains in some African countries. Despite the ravages of the HIV/AIDS epidemic in Africa, eight countries in the region have reduced child mortality by more than 50 per cent since 1970. Among these are Gabon, the Gambia and Ghana.

4) Countries with Large Absolute Returns in Child Mortality since 1970

Overall, at least 169 countries, 112 of them developing countries, have shown a decline in child mortality since 1970.
Oman has had the most striking reduction, from 242 per 1000 live births in 1970 to its current rate of 15 per 1000 live births, which is lower than that of many countries in Europe.
The lower mortality countries of the Eastern Mediterranean Region experienced an impressive decline in child mortality, which has been accompanied by a reduction in the gap between countries' child mortality levels since 1970.
Child mortality has also declined substantially in the Americas. The most striking proportional reductions in mortality have been seen in Chile, Costa Rica and Cuba, where child mortality has decreased by over 80 per cent since 1970. There have also been large absolute reductions in child mortality in Bolivia, Nicaragua and Peru. In contrast, Haitian child mortality rates are still 133 per 1000: almost double the mortality rate of Bolivia, the next highest country in the Americas.
An interesting pattern of child mortality trends has been observed in several eastern European countries. Here, child mortality initially increased or remained constant during the 1970s, only to decline after 1980. This may to some extent be attributed to a more complete registration of child and infant deaths during that period. Interestingly, while adult mortality levels increased in the early 1990s, child mortality continued to decline. There is no other region where this particular pattern of mortality has occurred in such a systematic manner, and the reasons for the trend remain poorly understood.

5) Causes of Death in Children

Infectious and parasitic diseases remain the major killers of children in the developing world, partly as a result of the HIV/AIDS epidemic. Although notable success has been achieved in certain areas (for example, polio), communicable diseases still represent seven out of the top 10 causes of child deaths, and account for about 60 per cent of all child deaths. Overall, the 10 leading causes represent 86 per cent of all child deaths.
There has also been a modest decline in deaths from measles, although more than half a million children under 5 years of age still succumb to the disease every year.
Malaria causes around a million child deaths per year, of which 90 per cent are children under 5 years of age. In this age group the disease accounts for nearly 11 per cent of all deaths.
The overall number of child deaths in India has fallen from approximately 3.5 million in 1990 to approximately 2.3 million in 2002. This impressive decline is a result of a reduction in overall child mortality rates of about 30 per cent, and a decline in total fertility rates of around 10 per cent.
A similar picture is emerging in China, where the number of child deaths has decreased by 30 per cent since 1990, owing to a reduction in child mortality of 18 per cent and a 6 per cent decline in total fertility. As in India, the most notable change in the cause-of-death pattern in China over the past decade is an increase in the proportion of pre-natal deaths.

6) The African crisis of child mortality

About 90 per cent of all HIV/AIDS and malaria deaths in children in developing countries occur in sub-Saharan Africa, where 23 per cent of the world's births and 42 per cent of the world's child deaths are observed. The immense surge of HIV/AIDS mortality in children in recent years means that HIV/AIDS is now responsible for 332 000 child deaths in sub-Saharan Africa, nearly 8 per cent of all child deaths in the region.