Decreasing Child Mortality in Developing Countries An Introduction

1
Decreasing Child Mortality in Developing
CountriesAn Introduction

• Prepared by Cindy Jian
• March 2006

2
How serious is this issue?

• Close to 11 million children die every year
  before reaching their fifth birthday. (World
  Health Organization WHO, 2006).
• That equates to about 20 per minutes
• Or 30 thousand per day
• (WHO)

3
What are some major causes?

• Most of the child deaths are related to numerous
  causes such as
• Pneumonia
• Diarrhoea
• Measles
• Malaria
• Neonatal Causes
• Malnutrition
• (WHO, 2006)

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Where do most of the deaths occur?

• Almost all of the deaths occur in low and
  middle-income countries, namely countries in
  sub-Saharan Africa and South Asia (WHO, 2006).
• The child mortality rates at Kenya are as high as
  126 in males and 120 in females per 1000 live
  births (WHO, 2006).

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What factors have shown a consistent relationship
with the change in mortality rate?

• Fertility behaviours
• Nutritional status
• Breastfeeding
• Maternal and child health status
• Environmental health factors
• Socioeconomic factors

(Rutstein, 2000)
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What else can affect it?

• Female autonomy
• Education
• The provision of accessible health services
• Adequate nutrition
• Immunization
• Effective antenatal and obstetric services
• (Sandiford, Morales, Gorter, Coyle, and Smith,
  1991).

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What is the Force Field Analysis Model?
http//www.12manage.com/methods_lewin_force_field_
analysis.html
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What are some restraining forces for this issue?

• For some conditions leading to child mortality,
  the underlying causes and risk factors are not
  yet understood (Jones, Steketee, Black, Bhutta,
  Morris The Bellagio Child Study Survival Study,
  2003).
• There is a large variation of major causes of
  death in different developing countries (Black,
  Morris Bryce, 2003).

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What are some restraining forces for this issue?
(Contd)

• The lack of appropriate and adequate resources,
  especially money in terms of the countries
  government and its individual people.
• The lack of education among the people in the
  countries where they do not realize that their
  behavioural patterns contribute to the death of
  their children or that they do not know how to
  help their sick children.

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What are some restraining forces for this issue?
(Contd)

• Local governments policies on distribution of
  funding.
• Military-oriented government.
• More money to arm force
• Unstable and non-peaceful life
• Language barriers.
• Different cultural background and beliefs.

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What are some of the driving forces for this
issue?

• The developed countries have recognized that
  child mortality in developing countries is an
  issue that needs change.
• They realize that interventions need to be
  implemented as the determinants of health of the
  children are not being met.

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What are some of the driving forces for this
issue? (Contd)

• There are agencies available that are offering
  systemic supports for health professionals going
  abroad to provide voluntary work in developing
  countries.
• Many valuable programs have been developed to
  target specifically on changing child mortality
  in developing countries.
• Results have shown that the interventions
  implemented have proven to be effective.
• (Bryce et al., 2003)

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What are some of the driving forces for this
issue? (Contd)

• Agencies, such as the WHO, have numerous valuable
  evidence-based research results that can support
  community practice and implementations in
  developing countries that would improve their
  child mortality rate.
• WHO has the support of World Bank for mission
  funding.

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What is currently being done and/or has been done
in the past?

• Various international organizations, have already
  developed campaigns and other initiatives that
  help developing countries in many different ways.
  
• World Health Organization (WHO)
• World Vision
• United Nation Childrens Fund (UNICEF)
• In addition, there are internationally organized
  medical teams, where nurses, doctors and other
  health care professionals deliver health care in
  developing countries.
• Doctors without Borders
• Despite the positive results that have come from
  these campaigns and initiatives, interventions to
  reduce child mortality are not reaching the
  children who need them most, particularly in very
  poor countries
• (Bryce et al., 2003).

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• Lets change it!

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What strategies are we planning to utilize to
deal with this issue?

• Child Survival Outreach Teams
• Involving SchoolsSetting up a regular clinic in
  developing countries to count towards community
  practicum experiences.

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What to teach the community?

• The importance of breastfeeding to reduce
  neonatal deaths.
• How to breastfeed correctly.
• Complications of breastfeeding.
• The importance of hand-washing to reduce the
  incidence of diarrhoea and other health
  conditions.
• How to hand-wash properly.

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What to teach the community? (Contd)

• The importance of oral-rehydration for treating
  diarrhoea and other common childhood conditions.
• The use of insecticide-treated nets to reduce
  mortality rates due to malaria.
• Recognizing the signs of illness, when and where
  to seek medical help.

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What can we do when we are students?

• Establishing connections with WHO
• Offering suggestions on modifying course
  curriculum
• Designing a webpage
• Preparing teaching tools
• Fund raising
• Starting up a clinic at Kenya
• Offering workshops to local professionals
• and enthusiastic individuals.

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References

• Black, R. E., Morris, S. S. Bryce, J. (2003).
  Where and why are 10 million children dying every
  year? The Lancet, 361(9376), 2226-2234.
• Bryce, J., el Arifeen, S., Pariyo, G., Lanata, C.
  F., Gwatkin, D., Habicht, J., et al. (2003).
  Reducing child mortality Can public health
  deliver? The Lancet, 362(9378), 159-194.
• Jones, G., Steketee, R. W., Black, R. E., Bhutta,
  Z. A., Morris, S. S., The Bellagio
  Child Survival Study. (2003). How many children
  deaths can we prevent this year? The
  Lancet, 362(9377), 65-71.
• Rutstein, S.O. (2000). Factors associated with
  trends in infant and child mortality in
  developing countries during the 1990s. Bulletin
  of the World Health Organization, 78(10),
  1256-1270.
• Sandiford, P., Moroles, P., Gorter, A., Coyle,
  E., and Smith, G.D. (1991). Why do child
  mortality rates fall? An analysis of the
  Nicaraguan experience. American Journal of Public
  Helath, 81(1), 30-37
• 12manage. (2006). Force field analysis. Retrieved
  March 12, 2006 from http//www.12manage.com/method
  s_lewin_force_field_analysis.html
• World Health Organization. (2006). Goal 4 Reduce
  child mortality. Retrieved March 10, 2006 from
  http//www.who.int/mdg/goals/goal4/en/index.htm
• World Health Organization.(2006). Kenya, The
  world health report 2005. Retrieved February 27,
  2006, from http//www.who.int/countries/ken/en/ind
  ex.html