The number of children under five dying has declined substantially in the past 20 years and the rate of decline is speeding up, according to a report in The Lancet medical journal. Some developing countries are doing surprisingly well, but rates in the US and Britain are not good by developed world standards — for reasons that are not clear.

In a study funded by the Bill and Melinda Gates Foundation — which seems to be a companion piece to this one on falling maternal death rates — Dr Christopher J L Murray and colleagues analysed data from 187 countries and found a global decline in early childhood deaths from 11.9 million in 1990 to a predicted 7.7 million this year. The UN’s Millennium Development Goal of reducing these deaths by two-thirds from 1990 to 2015 will probably still not be reached, but the picture is a lot better than many experts thought.

Especially encouraging are accelerated declines in sub-Saharan Africa over the past 10 years, particularly where governments have focused on child survival and primary care.

Dr Murray suggests that vaccines, AIDS medicines, vitamin A supplements, better treatment of diarrhoea and pneumonia, insecticide-treated bed nets to prevent malaria and more education for women are among factors that have helped lower death rates.

Further to the last point — about “education for women” — the New York Times report includes the necessary ritual bow to birth control:

Dr. Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health, a group administered by the World Health Organization, said that an important factor in the improvements was “reduced fertility” — women having fewer children, and leaving more than two years between pregnancies, which both increase their children’s odds for survival. Dr. Bustreo noted that nearly a million babies a year died from asphyxia at birth, for lack of simple, routine resuscitation measures. Focusing on those techniques could save many lives, she said.

Despite 50 years of “efficient” contraception, and goodness knows how much “education” about it, some rich countries have lost momentum since 1990. The US has slipped from 29th place in the child mortality ranks to 42nd — even while it reduced child mortality by 42 per cent (other countries had higher reductions). Dr Murray puts it down to the nation’s “fragmented, poorly planned healthcare system,” reports the Los Angeles Times.

Other countries with slow rates of decline include Britain, New Zealand and South Korea, which have all fallen in the international rankings since 1990. All three are still ahead of the U.S.

I can think of one thing those four countries have in common: high rates of induced abortion. The UK, the US and New Zealand also have relatively high rates of child abuse and resulting deaths. I wonder if these things are related.

Carolyn Moynihan

Carolyn Moynihan is the former deputy editor of MercatorNet