Reducing Child Mortality: Focusing on Equity

Kim Mulholland

Outline

1. Focus on child survival before the MDGs2. MDG43. Progress of MDG44. Eritrea- case study5. Why equity?6. Gaps in coverage7. Problems with data8. Policy recommendations

Child mortality as an indicator of socio-economic development

• In 1980, according to UNICEF:– 12% of all children in the world died before

their 5th birthday– 20% of all children in sub-Saharan Africa died

before their 5th birthday

Trends in under 5 mortality, 1955-1999

0

50

100

150

200

250

300

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90-94

95-99

AfricaM EastS AsiaAsia/PacificAmericasEurope

Bull WHO, 2000;78:1182

MDG4

Goal 4: Reduce Child MortalityReduce by two-thirds between 1990 and 2015,

the under five mortality rate.Health Indicators:• Under five mortality rate• Infant mortality rate• Proportion of one year old children

immunised against measles

Progress towards MDG4

• 68 priority countries (Countdown)• 16 on track (26 insufficient progress, 26 no

progress)- 50% increase since 2005.• Only one country on track from Africa (Eritrea)• 84% of the countries which are making no

progress are from the African region.