Child survival improving worldwide–except in America

Contrary to many earlier gloomy estimates, researchers in Seattle have found substantial reductions in child mortality worldwide.

They also found the U.S. does far worse than most of the rest of the developed world, including much less wealthy countries like Croatia or Estonia.

“Previous estimates had shown child deaths falling slowly and neonatal deaths nearly at a standstill,” said Julie Knoll Rajaratnam, a global health researcher at the University of Washington’s Institute for Health Metrics and Evaluation. Rajaratnam was lead author of the study published in the current issue of The Lancet.

Earlier estimates had shown mortality among children younger than 5 years declining only slowly worldwide over the last few decades, with neonatal mortality largely remaining consistently high in poor countries. The Seattle team decided to take a more in-depth look at a lot more data, analyzing more than 16,000 different reporting systems in 187 countries (census reports, birth histories, hospital records, etc.) and applying some fairly sophisticated mathematics.

They discovered more improvement than had previously been reported, with under-5 mortality in children dropping from 11.9 million deaths in 1990 to 7.7 million deaths in 2010 – a 35 percent reduction in two decades. Many poor sub-Saharan countries showed improvement, such as Ethiopia cutting its child mortality rate exactly in half from 202 deaths per 1,000 live births in 1990 to 101 deaths per 1,000 births in 2010. And contrary to expectations, neonatal death rates are falling even faster.

The primary purpose of the report was to examine how many countries are on target to achieve this portion of a massive international assistance project known as the Millennium Development Goals. Though most Americans remain oblivious to this ambitious project, it has likely helped to focus the international community’s previously highly disorganized and often counterproductive attempts at assistance. Most poor countries are still far from achieving these goals aimed at reducing poverty, improving health, education and general well-being.

Many initiatives, especially over the past decade, have made MDG Goal 4 — improving child survival — a renewed top priority in global health. The Gates Foundation’s largest funded project GAVI, which is aimed at getting basic immunizations to children, is already estimated to have prevented 3-4 million deaths in the last decade.

Though U.S. child mortality rates were not a primary focus of the article, it’s perhaps worth noting this new estimate hasn’t improved our ability to keep kids alive. We still rank way down on the list among developed countries, 42^nd place to be precise, below Croatia, Estonia and Hungary.

Thumbnail Photo: USAID

Tom Paulson covered science, medicine and global health as reporter for the Seattle Post Intelligencer from 1987 to 2009, before the print version of the paper closed and PI became the online news site. Now he continues to report as a freelance and blogs about the local global health scene at his website: A Page from Tom Paulson.

Tags: Child Mortality, Gates Foundation, Global Health, IHME

Category: Global Health, Global Health Seattle, Tom Paulson