Under-5 Mortality in Central America: 1990-2016
Franz Castro1,2, Adriana Benavides Lara3, Ana Garcés4
1Gorgas Memorial Institute for Health Studies, Panama City, Panama.
Pediatrics
|December 28, 2020
Summary
Under-5 mortality rates in Central America significantly decreased by 65% between 1990 and 2016, with most countries meeting the SDG 3.2.1 target. Improvements in nutrition, water, sanitation, hygiene, vaccination, and contraception coverage were linked to reduced child mortality.
Area of Science:
- Global Health
- Pediatrics
- Public Health
Background:
- Under-5 mortality rates (U5MRs) remain a critical global health challenge.
- Sustainable Development Goal (SDG) 3.2.1 aims to reduce U5MRs to ≤25 deaths per 1000 live births by 2030.
- Assessing regional progress and identifying key mortality drivers are essential for targeted interventions.
Purpose of the Study:
- To calculate changes in U5MRs in Central American countries from 1990 to 2016.
- To evaluate progress towards SDG 3.2.1 targets.
- To identify major causes of under-5 death and examine associations with SDG indicators.
Main Methods:
- Ecological study utilizing Global Burden of Disease Study 2016 estimates for Central American nations.
- Analysis of U5MRs, cause-specific mortality rates, and regression coefficients.
- Linear mixed-effects regression model to assess associations between SDG indicators and U5MRs.
Main Results:
- U5MRs declined by 65% from 1990 to 2016; most countries achieved SDG 3.2.1 by 2016.
- Diarrheal diseases were the leading cause in 1990, while lower respiratory infections (LRIs) were leading in 2016.
- Congenital birth defects were a primary cause, except in Honduras (preterm birth) and Guatemala (LRIs); improved nutrition, WASH, vaccination, and contraception correlated with reduced U5MRs.
Conclusions:
- Central America has demonstrated substantial reductions in under-5 mortality.
- Addressing LRIs and rising noncommunicable causes is crucial.
- Enhancing SDG indicators is vital for equitable child survival progress in the region.
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