PHM-Exch> CHILD DEATHS DROP BY NEARLY 30 PER CENT, SAYS UN HEALTH AGENCY (2)

[Claudio Schuftan]

From: George Kent kent at hawaii.edu    (author of The Politics of Children's
Survival, 1991, and Children in the International Political Economy, 1995)


Depending on how you look at it, one could argue that the rate of progress
in improving child survival rates has been exceedingly slow, and not
something the world should point to with pride. For many years now, the
number of child dying before their fifth birthdays each year has been stuck
at around ten million a year. That is an incredibly high number, one that
does not seem to trouble the world very much.
Also, notice the following claim:

""The decline in the death toll of children under five illustrates what can
be

achieved by strengthening health systems and scaling up interventions, such
as
insecticide-treated mosquito nets for malaria and oral rehydration therapy
for
diarrhoea, increased access to vaccines and improved water and sanitation in
developing countries,” said Ties Boerma, Director of WHO’s Department of
Health
Statistics and Informatics.


The suggestion here is that the decline is largely due to the interventions.
But it is also partly a natural phenomenon, a result of the well-known
"demographic transition" that always occurs with broad social and economic
development.

I am reminded of the way in which the US Agency for International
Development's Child Survival Program used to boast about how child mortality
had declined in so many of the countries in which it was working. USAID
failed to mention that the rate also declined in roughly the same degree in
countries in which it was not working. Saying that child mortality declined
in the countries in which USAID was working is not the same as saying it
declined BECAUSE it was working there.

What evidence do we have that, overall, the long term declines in child
mortality (slow as they may be) are mainly due to the interventions, and not
to the demographic transition?
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