An unprecedented study mapping child deaths over almost two decades finds that the likelihood of a child reaching age five varies more than three-fold among zones in Ethiopia.
The study finds that in Ethiopia, 198,492 children died before their fifth birthdays in 2017, as compared to 430,852 in 2000. The highest mortality rate at the zone level in 2017 was 89.3 in Afar Zone 1. The lowest was 29.3 in Addis Ababa.
Neonatal disorders were the biggest cause of deaths before age 5 in both 2000 and 2017, according to the Global Burden of Disease study, but the total number of deaths decreased by more than 30 percent during the study period. Diarrhea and respiratory infections were also major contributors to child deaths.
“However 96,000 babies are dying every year from neonatal causes,” the National Situation Analysis of Children and Women report of Ethiopia said, “872,000 are not fully vaccinated.”
Even though stunting of children under the age of five declined from 58 percent in 2000 to 37 percent to date, there are 5.4 million children who are too short for their age, according to the data.
“The current rate of reduction needs to redouble if Ethiopia is to meet the sustainable development goals,” it said. On the child marriage, the report said a notable reduction has been witnessed with the prevalence declining from 60 percent in 2005 to 40 percent in 2016.
“However, Ethiopia still has 15 million child brides, six million of whom were married before the age of 15.”
The report said the number of children registering schools for education has increased but “…currently, 2.6 million children aged 7-14 years are not enrolled in a school and more than half are girls.”
In regards to access to and use of water, it said, “The proportion of people using unsafe water declined from 75 percent in 2000 to 31 percent in 2016.”
The report is the first of its kind, mapping child deaths in 99 low-and middle-income countries at the level of individual districts, provinces, and municipalities.
Published recently in the journal Nature, the findings include precision maps illuminating health disparities within countries and regions often obscured by national-level analyses. An interactive visualization accompanying the report compares child death rates from year to year.
The report, conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine, looks at countries where more than 90 percent of child deaths occurred in 2017. Across all countries studied, the likelihood of a child dying before age 5 varied more than 40-fold at the district level.
Researchers estimated that if every district in the low-and middle-income countries studied had met the Sustainable Development Goal (SDG) target of at least as low as 25 child deaths per 1,000 live births, 2.6 million fewer children would have died. If every district within a country rose to the level of the best-performing district in that country, the estimated number of deaths averted rises to 2.7 million.
The vast majority of the 17,554 districts among the 99 nations studied saw improvement in lowering child deaths, but levels of inequality between districts were more variable over the study period. Despite major gains in reducing child deaths over the past 20 years, the highest rates of death in 2017 were still largely concentrated where rates were highest in 2000.
“It is as reprehensible as it is tragic that, on average, nearly 15,000 children under age 5 die every day,” said Dr. Simon I. Hay, the senior author on the report and Director of the Local Burden of Disease (LBD) group at IHME.
“Why are some areas doing so well, while others struggle? In order to make progress, we need to enable precise targeting of interventions, such as vaccines. Our findings provide a platform for nations’ health ministers, clinicians, and others to make focused improvements in health systems.”
The report reveals areas of success where strategies could be replicated across and within countries, according to Dr. Hay.
A growing proportion of child deaths are occurring in areas with low overall death rates. Neonatal mortality (death occurring in a child’s first 28 days) and infant mortality (death in the first year of life) are both increasing as a percentage of total child deaths. These trends highlight the need for tailored approaches.
The Ethiopian Herald October 31, 2019
BY GIRMACHEW GASHAW
