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The decline in child mortality: a reappraisal
O B Ahmad1, A D Lopez, M Inoue
1Global Programme on Evidence for Health Policy, World Health Organization, Geneva, Switzerland.
Bulletin of the World Health Organization
|December 2, 2000
Summary
Global under-five mortality rates declined in the 1990s, but progress slowed, especially in Africa and Asia. HIV/AIDS and economic issues hinder further reductions in child survival rates.
Area of Science:
- Global Health
- Demography
- Pediatrics
Background:
- Child mortality remains a significant global health challenge.
- Trends in under-five mortality rates (U5MR) vary significantly by region and country.
- Previous studies by international organizations have documented these trends.
Purpose of the Study:
- To examine and document country-specific trends in under-five mortality rates during the 1990s.
- To provide updated estimates of U5MR and historical trends from 1950-2000.
- To identify regions with sustained improvement versus those with setbacks.
Main Methods:
- Analysis of country-specific under-five mortality data for the 1990s.
- Updating and synthesizing estimates from UNICEF, World Bank, and UN data.
- Comparative analysis across WHO regions and country income levels.
Main Results:
- An estimated 10.5 million children aged 0-4 died in 1999, a 17.5% decrease from the previous decade.
- Africa has the highest U5MR (approx. 15%), contrasted with Europe (<2%).
- The decline in U5MR decelerated in most WHO regions during the 1990s, with notable exceptions in Southern Africa (HIV) and parts of Asia (economic difficulties).
Conclusions:
- While overall child mortality has decreased, the slowdown in progress is concerning, particularly in Africa and South-East Asia.
- High HIV prevalence and economic challenges impede further reductions in child survival.
- Sustained reductions in child mortality are unlikely without effective HIV/AIDS control.