Child health: equity in the non-industrialized countries

Significant improvements have been made in infant and child survival globally in recent decades. In spite of a substantial literature describing achievements to date and strategies for continuation of this progress, there has been relatively little attention directed toward the issue of equity in global child health outcomes. This paper briefly reviews global improvements in child health outcomes over the past four decades, but then provides evidence that there has been substantial variation in these improvements, both between nations and within non-industrialized nations. The identifying characteristics of high risk populations are summarized. The specific diseases and disease complexes associated with mortality in populations with different mortality rates are presented as background to a discussion of the anticipated increase in 'effort' (both personnel and material resources) that will be necessary for sustained improvement in child survival. In this context, the Acquired Immunodeficiency Syndrome is likely to further increase disparities in health outcomes. Finally, prospects for increased equity in the future are discussed.