Tag Archives: child mortality

Can better data save 7 million children from dying each year?

Guest post By Ted Caplow, director of Whole New World Foundation

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Zuhair A. Al-Traifi

My son spent the first weeks of his life in intensive care, attended by a team of neonatologists. My wife and I could do little more than watch, until one day the doctors asked our permission to proceed with an elective procedure. My immediate impulse was to track down more information about the risks involved so I could maximize my son’s chance of survival.

In developed countries, immersed in the information age, we are accustomed to supporting our decisions with data. Unfortunately, in the rest of the world, the struggle to save children’s lives takes place without the benefit of adequate information. Despite great reductions in child mortality over the past 30 years, more than 18,000 children under the age of five still die every day.

International authorities classify these deaths as “preventable,” meaning that modern medical knowledge and technology could save these children, but it fails to reach them. More support for studying the true impact of life-saving interventions could help bridge this gap.

A 2014 Gates Foundation report estimates that over the past three decades the international community has donated $5,000 in health care interventions for each child’s life that was saved in the developing world. At that rate, it will take $33 billion in additional global spending to save the 6.6 million lives under five that are still lost each year. This large sum will be difficult to raise, so directing funding to the most cost-effective interventions is a priority.

Frustratingly, despite the enormous resources dedicated to combating child mortality, there remains a widespread lack of data on the efficacy of individual intervention programs. There are several reasons for this situation.

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Somali mothers and their babies wait for vaccines at a health center in Mogadishu, Somalia. One million children still die at birth every year due to lack of care.

Child mortality worldwide is down, but it’s not always clear why

Somali mother cradles her malnourished, ill child
Somali mother cradles her malnourished, ill child
UN

Child mortality is widely recognized as an indicator of a community’s overall health, with reductions in child deaths often cited as evidence of the impact of a particular intervention.

Two high-profile events in Washington, DC, and Johannesburg, South Africa recently celebrated the progress made worldwide in reducing maternal and child deaths over the past twenty years – and called for greater international investment to sustain and build on the success. That’s based on the assumption we already know which interventions are succeeding under real-life conditions, and which ones are most effective.

Yet linking cause and effect, even with a global health gold standard like child mortality, is not always a simple matter.

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MatMortLancet2014

Most nations, except US, making progress against maternal & child deaths

MatMortLancet2014
The Lancet, IHME

Two studies published today in The Lancet, both of them led by researchers at the University of Washington, report a sharp decline in maternal mortality and child deaths worldwide since 1990.

The United States, as USA Today also notes, joins Afghanistan and El Salvador as one of eight nations where these positive trends don’t apply.

While the number of deaths related to childbirth is lower in the U.S. than in most poor countries, the richest country in the world is still belongs in the same category as developing nations when it comes to maternal mortality trending. Continue reading

Challenging the claim that saving kids lives reduces population growth

A leading aid and development expert is challenging a popular claim made by Bill and Melinda Gates, health statistics wizard Hans Rosling and others in the humanitarian community often cited to counter the concern that saving kids lives in poor countries will exacerbate global population growth.

It is sometimes described as the ‘virtuous cycle’ because it shows how preventing child deaths actually reduces birth rates! Here’s Rosling making the case in his always entertaining style:

The gist here is that as you reduce childhood mortality rates in poor communities, families have less kids. Birth rates go down and, over time, the economic well-being of these communities rises along with other health indicators. Put another way, when poor families see fewer of their kids dying young, they stop having 10 kids if they only need five to work the farm and provide for the family.

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African child with cerebral malaria

Visualizing what we know – and don’t know – about child mortality in Africa

The significant progress made against child mortality around the world over the last two decades is frequently cited as one of the biggest success stories of international development.

Much more remains to be done, but it’s worth looking at what we know – and don’t know – about this propitious decline in child deaths.

Between 1990 and 2010, death rates among children under 5 decreased by 43% in sub-Saharan Africa, according to the Global Burden of Disease Study 2010 (GBD 2010). The screen grab below shows how deaths from different diseases and injuries in this age group decreased over time. Three major categories of diseases played key roles in driving this decline: diarrhea, lower respiratory infections, and other infectious diseases; neonatal disorders; and neglected tropical diseases and malaria.

Death rates in children under 5 years, sub-Saharan Africa, 1990-2010

Child Mortality Africa What interventions deserve credit for these declines? GBD researchers have not yet done a formal study to pinpoint all the reasons for the drop in child mortality, but a deep dive into the data can reveal likely causes. Continue reading

Think things are bad? Here are 14 Reasons the World is Getting Better

Roughly 10% of the whole world lives in extreme poverty, the youngest nation is falling apart and inequality is rising just about everywhere. That is only a sliver of the terrible things happening around the world right now. Thinking about (and reporting on) such topics can get depressing and lead one to think that all is bad.

The fact is, the world is getting better across just about every measure. Extreme poverty is at an all time low, more girls are getting an education and fewer children are dying. There is a long way to go, but progress is being made.

In short: People are living longer, less hungry and better connected than 10 years ago. How awesome is that?

For those of you feeling a bit down, here are a fourteen reasons to be optimistic, according to vlogger and author John Green:

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MDGs

Visualizing progress on 3 Millennium Development Goals (MDGs)

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

MDGsProgress toward the current Millennium Development Goals (MDGs) and establishing new goals after 2015 are a hot topic of discussion this week at the UN General Assembly in New York City.

In today’s post, we’ll use Global Burden of Disease Study 2010 (GBD 2010) data to explore how much progress countries have made in three key health MDGs, 4, 5 and 6, the first two focused on reducing child mortality and maternal mortality while the latter is on halting the spread of diseases such as HIV/AIDS and malaria.

MDG 6 is arguably the highest-profile goal and one that’s seen tremendous progress – halting or reversing the spread of HIV/AIDS, tuberculosis, and malaria. By 2010, antiretroviral therapy financed by country governments and donors had succeeded in reversing the rise in HIV/AIDS deaths at the global level.

Below is a figure showing donor funding (also known at IHME as development assistance for health, or DAH) for HIV/AIDs from IHME’s report Financing Global Health 2012: The End of the Golden Age?

Funding HIV AIDS

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Child mortality down, but still too many millions of poor children dying

That’s the gist of a new report from UNICEF, which celebrates the significant reductions made over the years in reducing the number of children dying mostly in poor countries and mostly from easily preventable causes like hunger, lack of clean water and lack of access to basic health care.

The numbers are, like most global statistics, large and abstract but compelling nevertheless: In 1990, something like 12 million kids were dying before they reached five years old. Today, despite population growth, the estimate is closer to 6 million child deaths under age five.

That’s a major reduction, but it still means 18,000 young children are dying from mostly preventable causes every day.  As UNICEF’s director in the organization’s announcement of the report says:

“Yes, we should celebrate the progress,” said Anthony Lake, UNICEF Executive Director. “But how can we celebrate when there is so much more to do before we reach the goal?  And we can speed up the progress – we know how, but we need to act with a renewed sense of urgency.”

Many are crediting the setting of the Millennium Development Goals, which nearly 15 years ago established reducing global child mortality as one of the eight primary goals of the international community.  But as this graphic from the World Bank illustrates, declining child mortality has been the trend for a long time – well before the MDGs were established.

Under 5 Mortality
World Bank

So why are child deaths on a decline, and what should be done to maintain this trend? Much of the overall progress has been in China, almost certainly due to the health improvements that often accompany economic gains. Yet China, India, Nigeria, Pakistan and DR Congo remain the countries with the highest numbers of premature child deaths.

Many experts contend what’s needed now is less a ranking of mortality country-by-country and more focus on what’s happening to specific populations by various causes. This is due to the fact that many of the poorest people live in middle-income countries and death comes sometimes from political or social drivers as much as from infectious disease.

Martin Drewry, director of London-based Health Poverty Action, said a deeper look reveals to what extent discrimination and ethnic persecution correlates with child death rates. Drewry wants more attention to this:

“The report makes a very brief reference to disparities in mortality within countries, but it is vital that this disparity becomes a driver for deciding development priorities and resource allocations,” he said. Here’s a report from his organization making the case for ‘disaggregating’ the data.

“People from ethnic and cultural minorities frequently have poorer health outcomes than the national average,” contended Drewry. “Health Poverty Action is calling for health data to be broken down by ethnicity. The disparities between different groups within countries needs to be made visible and this information used to drive strategy.”

Other news stories or blog posts on the UNICEF report:

CBS Child deaths down, but many still dying

VOA Child mortality reduced by half

ONE How many children survived to see their 5th birthday?

UN Dispatch Child mortality way down