Journal of Pediatric Nursing (2015) 30, 414–415
HOT TOPICS DEPARTMENT Column Editor: Deborah L. McBride, MSN, RN, CPN, CPON, CCRN
Deborah L. McBride, MSN, RN, CPN, CPON, CCRN
New Trends in Global Childhood Mortality Rates Deborah L. McBride PhD, RN ⁎
Kaiser Permanente Oakland Medical Center, Berkeley, CA Received 13 November 2014; accepted 17 November 2014
A NEW STUDY has reported a significant decline in global child mortality rates which has occurred since 2000 (Liu et al., 2014). According to the authors, a major transition in child survival is occurring, with an estimated 6.3 million children under the age of 5 dying in 2013, compared to 9.9 million in 2000, although high rates stubbornly persist in parts of African and South Asia. Nearly half of the 3.6 million fewer deaths annual childhood deaths in 2013 than in 2000 resulted from reductions in deaths from pneumonia, diarrhea, and measles. The report attributed the progress to broad healthcare interventions over the years against infectious diseases, including increased immunizations and the use of insecticide-treated mosquito nets, as well as improvements in health care for expectant mothers and success fighting the effects of diarrhea and other dehydrating illnesses. Leading causes of death varied by region of the world: infection in sub-Saharan African and preterm birth complications in southern Asia. India, Nigeria, Pakistan, Democratic Republic of Congo and China had the highest numbers of child deaths, together contributing to around half of all child and neonatal deaths in 2013. Two countries, India and Nigeria, accounted for nearly one-third of all deaths among children younger than 5. The report also reported that the gap in mortality rates between the richest and poorest families has fallen in all regions of the world, except for sub-Saharan African, which continues to be the riskiest region for a young child. According to the report, a child born in Angola, which has the world's highest rate—167 deaths per 1,000 live births—is 84 times more likely to die before he or she turns 5
⁎ Corresponding author: Deborah L. McBride, PhD, RN. E-mail addresses: [email protected], [email protected].
http://dx.doi.org/10.1016/j.pedn.2014.11.003 0882-5963/© 2015 Elsevier Inc. All rights reserved.
than a child born in Luxembourg, which is the lowest rate of two per 1,000. The researchers used the latest “Nearly half of the available data and modeling methods to examine what caused 3.6 million fewer deaths in children under the age of deaths annual child5. They collected vital registration hood deaths in 2013 databases and verbal autopsy data than in 2000 resulted worldwide and compared mortality from reductions in rates in neonates and children under deaths from pneuthe age of 5 between 2000 and 2013. In countries with inadequate monia, diarrhea, vital registration, an updated autopand measles.” sy-based multi-cause model was used to derive numbers of deaths by causes. The report projects that, if current trends continue, in 2030 4.4 million children under 5 years will die and 60% of these will occur in sub-Saharan Africa. However, the authors note that with increased commitment to preventing the most important causes of child deaths, this number could be nearly halved, to just 2.8 million deaths. The authors identified the challenges that need to be overcome. Foremost, there is a need for more resources for vaccines and to pay for more health workers and clinics. In addition, instead of spending the money that is available to pay for large hospitals and intensive care units in the capital city, more money needs to be spent addressing the needs of the rural poor, where most of the child deaths are. Developing interventions to prevent prematurity should to be a top priority going forward because of the large number of deaths that occur in the first month of life. The authors noted that delaying pregnancy until a girl is 17 or 18 increases the chance of a child surviving fivefold. In
New Trends in Global Childhood Mortality Rates addition, being sure that the mother is well nourished before becoming pregnant and avoid getting malaria, HIV or syphilis increases the chance of survival. Also, encouraging “kangaroo mother care,” or skin-to-skin care, which can replace the need for incubators for premature babies who have difficulty keeping their body temperature up will reduce newborn mortality. Finally, the report notes the importance of other types of investments that indirectly affect health, primarily increasing girl's education because of the close relationship between girls that are educated and the fact that their children are less likely to die of diseases. In addition, the report noted the importance of increasing the number of community health workers who are able to reach out, diagnose and treat common illnesses which is particularly important in the poorest countries where health systems are not fully established. According to the authors under-5 mortality rates are important because they are barometers of other problems and
415 are considered to be an indicator of a country's quality of life. In addition, the under-5 mortality rates are sometimes seen as a measure of civilization because newborns, premature babies and children under-5 are the most vulnerable members of society who rely completely on the values and care that society provides its members. The report provides needed data to track progress, inform priority setting, assist in the creation of appropriate interventions and rally the global health community to reduce the number of child deaths.
Reference Liu, L., et al. (2014). Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: An updated systematic analysis. Lancet, http://dx.doi.org/10.1016/S0140-6736(14) 61698-6.
HOT TOPICS DEPARTMENT Column Editor: Deborah L. McBride, MSN, RN, CPN, CPON, CCRN
Deborah L. McBride, MSN, RN, CPN, CPON, CCRN
New Trends in Global Childhood Mortality Rates Deborah L. McBride PhD, RN ⁎
Kaiser Permanente Oakland Medical Center, Berkeley, CA Received 13 November 2014; accepted 17 November 2014
A NEW STUDY has reported a significant decline in global child mortality rates which has occurred since 2000 (Liu et al., 2014). According to the authors, a major transition in child survival is occurring, with an estimated 6.3 million children under the age of 5 dying in 2013, compared to 9.9 million in 2000, although high rates stubbornly persist in parts of African and South Asia. Nearly half of the 3.6 million fewer deaths annual childhood deaths in 2013 than in 2000 resulted from reductions in deaths from pneumonia, diarrhea, and measles. The report attributed the progress to broad healthcare interventions over the years against infectious diseases, including increased immunizations and the use of insecticide-treated mosquito nets, as well as improvements in health care for expectant mothers and success fighting the effects of diarrhea and other dehydrating illnesses. Leading causes of death varied by region of the world: infection in sub-Saharan African and preterm birth complications in southern Asia. India, Nigeria, Pakistan, Democratic Republic of Congo and China had the highest numbers of child deaths, together contributing to around half of all child and neonatal deaths in 2013. Two countries, India and Nigeria, accounted for nearly one-third of all deaths among children younger than 5. The report also reported that the gap in mortality rates between the richest and poorest families has fallen in all regions of the world, except for sub-Saharan African, which continues to be the riskiest region for a young child. According to the report, a child born in Angola, which has the world's highest rate—167 deaths per 1,000 live births—is 84 times more likely to die before he or she turns 5
⁎ Corresponding author: Deborah L. McBride, PhD, RN. E-mail addresses: [email protected], [email protected].
http://dx.doi.org/10.1016/j.pedn.2014.11.003 0882-5963/© 2015 Elsevier Inc. All rights reserved.
than a child born in Luxembourg, which is the lowest rate of two per 1,000. The researchers used the latest “Nearly half of the available data and modeling methods to examine what caused 3.6 million fewer deaths in children under the age of deaths annual child5. They collected vital registration hood deaths in 2013 databases and verbal autopsy data than in 2000 resulted worldwide and compared mortality from reductions in rates in neonates and children under deaths from pneuthe age of 5 between 2000 and 2013. In countries with inadequate monia, diarrhea, vital registration, an updated autopand measles.” sy-based multi-cause model was used to derive numbers of deaths by causes. The report projects that, if current trends continue, in 2030 4.4 million children under 5 years will die and 60% of these will occur in sub-Saharan Africa. However, the authors note that with increased commitment to preventing the most important causes of child deaths, this number could be nearly halved, to just 2.8 million deaths. The authors identified the challenges that need to be overcome. Foremost, there is a need for more resources for vaccines and to pay for more health workers and clinics. In addition, instead of spending the money that is available to pay for large hospitals and intensive care units in the capital city, more money needs to be spent addressing the needs of the rural poor, where most of the child deaths are. Developing interventions to prevent prematurity should to be a top priority going forward because of the large number of deaths that occur in the first month of life. The authors noted that delaying pregnancy until a girl is 17 or 18 increases the chance of a child surviving fivefold. In
New Trends in Global Childhood Mortality Rates addition, being sure that the mother is well nourished before becoming pregnant and avoid getting malaria, HIV or syphilis increases the chance of survival. Also, encouraging “kangaroo mother care,” or skin-to-skin care, which can replace the need for incubators for premature babies who have difficulty keeping their body temperature up will reduce newborn mortality. Finally, the report notes the importance of other types of investments that indirectly affect health, primarily increasing girl's education because of the close relationship between girls that are educated and the fact that their children are less likely to die of diseases. In addition, the report noted the importance of increasing the number of community health workers who are able to reach out, diagnose and treat common illnesses which is particularly important in the poorest countries where health systems are not fully established. According to the authors under-5 mortality rates are important because they are barometers of other problems and
415 are considered to be an indicator of a country's quality of life. In addition, the under-5 mortality rates are sometimes seen as a measure of civilization because newborns, premature babies and children under-5 are the most vulnerable members of society who rely completely on the values and care that society provides its members. The report provides needed data to track progress, inform priority setting, assist in the creation of appropriate interventions and rally the global health community to reduce the number of child deaths.
Reference Liu, L., et al. (2014). Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: An updated systematic analysis. Lancet, http://dx.doi.org/10.1016/S0140-6736(14) 61698-6.
