In September of 2000, the United Nations General Assembly adopted the Millennium Declaration, from which emerged the 8 Millennium Development Goals (MDGs) that the members of the international community had agreed to try to achieve by 2015. Recently, the 4th MDG (reduce the under 5 child mortality rate to 66% of 1990 levels) drew particular interest from the international community. Child mortality is measured in number of deaths per 1000 live births, and according to a recent article in the Economist, Africa is currently experiencing some of the biggest falls in child mortality.
Of the 20 African countries surveyed by the World Bank, 16 have recorded declines in their child mortality rates. Senegal, Rwanda, and Kenya have recently seen declines in child mortality by over 8% per year. Twelve other countries, including Uganda and Ghana, have recorded declines over 4% per year. These rates far exceed the global decline of 2.8% per year. The two regions, Sub Saharan Africa and Northern Africa have seen total declines of 28% and 68% respectively since 1990. Rarely do we hear such good news in development!
Though the remarkable trend in the decline of child mortality in Africa is astounding, the trend in non African countries deserves some applause as well. East Asia in particular has seen a 58% drop in child mortality between 1990 and 2008. Among these countries are Bangladesh, Lao People’s Democratic Republic, and Nepal, all of whom have seen declines of 60% or more.
Currently, 9 million children die each year around the world before they reach their 5th birthday. The highest rate of child mortality continues to still be found in Sub-Saharan Africa. There are many factors influencing the child mortality rate in developing countries. Children in rural households have a higher risk of dying before they reach the age of five than children in urban settings. Children from the poorest households are 2-3 times more likely to die than children from richer households. For example, in a survey from 66 countries, children from the poorest 20% of households are twice as likely to die than the richest 20%. In addition, a mother’s education is a very powerful determinant of child survival. A child’s chances of survival increase with the level of education the mother receives.
Countries that have seen drastic decreases of child mortality have implemented successful immunization programs. Bangladesh for example, in a partnership with WHO and UNECEF, conducted the world’s largest measles campaign, vaccinating over 33 million children under the age of 10 over a 20 day period in 2006. Since 1990, the child mortality rate in Bangladesh has decreased by 57%. Malaria is one of the major causes of child mortality in Africa.The Nothing But Nets Campaign, has distributed over 3 million insecticide treated anti-malaria nets to communities throughout Africa since 2006. Nothing But Nets works with partners such as the UN, the Gates Foundation, Exxonmobil, and has contributed to the 33% decline in malaria mortality in Africa over the last decade.
People such as Jeffery Sachs, an economist at Columbia University, claim that the huge drop in child mortality in Africa is attributed to the vast amounts of foreign aid being poured in, which is demonstrated by his Millennium Villages Project. Supporters of the Millennium Villages point out the 700% increase in the use of anti malaria bed nets and the 350% increase to clean water access in target villages. These achievements deserve some recognition off course. However, Michael Clemens of the Centre for Global Development notes the lack of transparency and independent verification of the raw data in the assessments. Furthermore, the debate on not having control villages stirred up further questions on the exact cause behind the improvements. World Bank economists argue that these improvements would have happened anyways, without the Millennium Villages Project. Foreign aid is an important aspect in reducing child mortality in Africa and the developing world, but it is not the decisive factor. The Economist article cites that better policies, better government, new technologies, foreign aid and investment are all contributors.
Despite the achievements and progress in meeting MDG 4, many countries still have high rates of child mortality. Only 31 developing countries including Egypt, Tunisia and Mongolia have or are expected to meet MDG 4 by 2015. On the bright side, 106 countries have shown a faster decline in child mortality rates between 2000 and 2010 than in the previous decade. Even though most developing countries might not meet MDG 4 in 2015, their improved progress is touted as unexpectedly good news in development.