Public Health

Study: Child Deaths In Developing World Overstated

Aminat Makebo mourns the death of her granddaughter in Ethiopia.

Aminat Makebo (left) grieves the death of her granddaughter at a medical center run by Medecins Sans Frontieres in Kuyera, Ethiopia, Sept. 2008. Roberto Schmidt/AFP/Getty Images hide caption

itoggle caption Roberto Schmidt/AFP/Getty Images

Deaths of children in developing countries are lower than estimates put out byUNICEF just two years ago – a lot lower, according to the Institute for Health Metrics and Evaluation.

In an article published online in the medical journal Lancet, the institute's found 820,000 fewer deaths of children under five worldwide than UNICEF had. The lower estimate means there's more progress being made toward meeting a key goal of reducing child mortality by two-thirds by 2015.

But at issue is how much progress is being made. If things look too rosy, support for aid could be jeopardized.

According to the Lancet article, child deaths have been declining in every region of the world by an average of 2 percent since 1990. Still, nearly 8 million kids under 5 are expected to die this year. Half of those deaths occur in Africa, a third in south Asia.

In many countries, child mortality remains a major problem. For example, deaths in children under age 5 for Ethiopia in 1990 was 202 per 1,000 live births, one of the highest in the world. By 2010, the rate had dropped by half to 101 per 1,000 births. Today, no country has a rate of mortality that was as high as Ethiopia's in 1990.

The child mortality data is a kind of war of numbers, and whose numbers more accurately reflect what's going on in developing countries.

Since there isn't that much data to work with in many developing countries, most numbers are estimates. The IHME asserts its numbers are more accurate that benefited from more data than UNICEF used. We called UNICEF for comment and didn't get an immediate response.

This isn’t the first time conflicting data about health in the developing world has vexed policymakers and journalists alike – last month’s reports on the number of women who die during pregnancy or in childbirth are Exhibit A.

Still, IHME says its data showing vast improvements in child health is a cause to celebrate. "One of the biggest achievements of the past 20 years has been this incredible progress in countries that historically have had the highest child mortality in the world," said Dr. Christopher Murray, IHME director and the co-author of the paper.

It's important to note, he says, that the investments of donors are beginning to pay off. The IHME research conducted was funded by the Bill and Melinda Gates Foundation.

UNICEF attributes the improvements to the emphasis governments were beginning to place on child survival and primary care, and to the scale up of HIV treatments and prevention of mother to child transmission of HIV.  Organizations like UNICEF rely to some degree on analyses provided by member countries, and are therefore likely subject to pressure from those countries.

But there is concern that if such interventions don't continue to receive financial support, child mortality could go up again.

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