The decline in child mortality: a reappraisal

Citation: Ahmad, Omar B., Lopez, Alan D., Inoue, Mie (2000) The decline in child mortality: a reappraisal. Bulletin of the World Health Organization (Volume 78) (RSS)
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Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)

Summary

This study aims to reappraise child mortality trends. Dramatic decreases in child mortality (under 5) after WWII leveled off around the 1980s. The child and maternal health initiatives implemented in developing countries had never been properly evaluated for effectiveness, thus producing speculation that narrowly-focused health programs had led to "substitution effects" (replacing one disease problem with another). Cause pathways for determinites of child mortality (both proximate and distal) were never established. About 10.5 million children under 5 died in 1999, 99% occurring in countries characterized by elevated child and adult mortality. For the entire globe, a child born in 1999 has a 6.7% chance of dying before age 5, compared to 9.6% in 1990 and 25% in 1950. The rate of decline in child mortality had a substantial increase in the 1960s and 1970s, peaking at 12% in the later 1970s. The rate of decline leveled off in the 1980s. Main findings: -child mortality declined in all regions from 1970-1994 -Europe had lowest child mortality throughout the period, followed by the Americas, Western Pacific, Eastern Mediterranean, South-East Asia, and Africa -The Eastern Mediteranean had the steepest decline from 170 deaths/1000 in the early 1970s to 50/1000 in the early 1990s. -Africa had the poorest performance Africa: mean mortality rate decreased from 264/1000 in the 1950s to 152/1000 in the late 1990s. The heterogenieity structure in child mortality has remained stable. Algeria, Gabon, and Gambia have had over 40% reduction in child mortality in the 80s and 90s. Botswana, Zambia, and Zimbabwe have had the largest increases in child mortality. Southeast Asia: decrease from 222/1000 to 90/1000 Western Pacific: decrease from 154/1000 to 48/1000. Mongolia and Papua New Guinea did not achieve child mortality reductions. Eastern Mediterranean: decrease from 238/1000 to 71/1000. Heterogeneity remained stable. Afghanistan, Djibouti, and Somalia contributed little to the reductions Americas: decrease from 140/1000 to 38/1000. Heterogeneity reduction. Europe: decrease from 63/1000 to 19/1000. Early transition.