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Child and infant mortality rates are sensitive indicators not only of child
health, but also the general well-being of a society.
Infant mortality rates, in particular, reflect the attention paid to the health of mothers and
newborns as well as the effectiveness of health systems.
Child mortality is seen as an important barometer of the effect of wider
economic and social conditions on child heath. It measures an outcome of the
development process rather than an input (such as expenditure on health). It is
also known to result from a wide variety of factors such as the availability of
maternal and child health services (including prenatal care), the level of
immunisation, income and food availability in the family, and the availability
of safe drinking water and basic sanitation.
Most deaths of children under five years are attributable to acute respiratory
infections (mostly pneumonia), diarrhoea, malaria, measles, HIV/AIDS and
neonatal conditions. Malnutrition is the largest contributor to child
mortality, present in half of all cases.
Definitions and sources
Infant mortality rate is defined as the number of infants dying before reaching
one year of age, per 1,000 live births in a given year.
Child mortality is defined as the number of infants dying before reaching five
years of age, per 1,000 live births in a given year.
Mortality rates are produced from the harmonised estimates of the World Health
Organization, The United Nations Children's Fund (UNICEF), and the World Bank, based mainly on household surveys,
censuses, and vital registration, supplemented by World Bank estimates based on
household surveys and vital registration.
Long term trends
In the long term, UNICEF reports, there has been significant improvement in
child survival with a 60 per cent fall in global child mortality rates since 1960
(State of the World’s Children 2008, UNICEF, 2008). However the variation
between countries remains enormous, with mortality rates in the worst performing
countries several hundred times those of developed countries.
Increasing age of motherhood and the use of fertility treatments in developed
countries have resulted in infant mortality rates in countries with historically
very low rates, such as Sweden, levelling off or even increasing in recent
years.
How comparable are the data?
Some of the international variation in infant mortality can be attributed to
differences in defining a ‘live’ birth. In developed countries, perinatal
deaths (deaths occurring in the first four weeks) account for up to two thirds
of all infant mortality. This means that the definition of a live birth can
significantly affect the infant mortality rate. In several countries such as
the US and Canada, all births are counted as live if they show any sign of
life, regardless of pre-maturity or size. This includes births that other
countries may define as ‘still born’ and tends to skew the mortality rates
upwards. In contrast, former Soviet Republic countries, for example Belarus and
Russia, tend to exclude very small babies born alive, but with less that 28
weeks gestation and who die within seven days of birth.
Data for countries with less developed health care systems sometimes only count
births that take place in hospitals and health centres. Oman is one example.
These types of variations on definitions are typically highlighted by footnotes
within the data.
Finding data on infant and child mortality
The following databanks can be used to assist in the study of child mortality.
Access to these databases is free for the UK academic community through ESDS
International.
The World Bank’s World Development Indicators contain global annual time series
data on child and infant mortality for over 200 countries and 18 regional
groups running from 1960 up until the latest available year. Reducing child
mortality is one of the eight UN Millennium Development Goals, and the World
Development Indicators is the source database used by policymakers to measure
individual country progress against the overall target of cutting the mortality
of under-fives by two-thirds by 2015.
Eurostat New Cronos provides comparative time series data on infant and child
mortality for European countries, regions, cities and urban zones.
The UN Common Database contains tables that disaggregate child and infant
deaths by gender and age, and can be used to examine the differences in child
mortality rates between urban and rural areas. The data are annual time series
and cover all countries from the 1960s onwards. Quinquennial estimates and
projections of child and infant mortality rates for all countries up to the
year 2050 can also be found in this database.
Source: World Bank World Development Indicators, ESDS International
For further information or to access the datasets referred to in this case study
see:
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Case study 3: Measuring child and infant mortality
