By Joy Portella, Minerva Strategies—
My family has a saying: Everything’s better in baby.
Usually we’re talking about animals and the idea is that people are much more fond of puppies and kittens than grown dogs and cats. But the idea certainly extends to humans and the concept that people are much more easily engaged around children’s issues—tragedies and triumphs alike—than adults’ challenges.
So it shouldn’t be surprising that a recent study from our friends at the Institute for Health Metrics and Evaluation (IHME) about deaths of children under five years old captured so much attention. Headlines in places ranging from the UK to Nigeria to Nepal blared the mixed news of child health, even though the study came hot on the heels of big global health newsmakers like the Bill & Melinda Gates Foundation’s Goalkeepers report and UNICEF’s annual State of the World’s Children report.
The study, published in the journal Nature, touts some very good news: A child born today in almost any corner of the world has a better chance of living past their fifth birthday than a child born 20 years ago. But there’s a catch.
Before we get to the bad news, let’s bask in the glow of our global accomplishments. According to the study, 9.7 million children under five died in 2000 compared to 5.4 million in 2017—even with significant population growth. Across almost all 99 low- and middle-income countries in the study, mortality rates and numbers have dropped. That’s a huge accomplishment.
The trouble is that these gains haven’t been made equally. Mortality rates varied as much as 10-fold between districts within a country. Across all countries studied, the likelihood of a child dying before age five varied more than 40-fold at the district level.
Inequities are stubborn. Despite major reductions in child deaths over the past 20 years, the highest rates of death in 2017 were still largely concentrated where rates were highest in 2000.
Indonesia is a good example of how this inequality persists. This opinion piece by the former Indonesian Health Minister Dr. Nafsiah Mboi underscores the progress the country has made in driving down the death rate of children under five—from 86 deaths per 1,000 live births in 1990 to 26 in 2017. In one part of the island Sumatra, the mortality rate of young children is less than 15 deaths per 1,000 live births but on another part of the island, the rate is more than 3.4 times higher.
That kind of disparity is replicated all over Indonesia, and across the world. IHME’s study reveals just how much work we have to do to ensure that all young children can survive and thrive.
As always, IHME has a cool data visualization you can play with. This excellent interactive map allows you to see progress from year to year in specific countries and focus in on different regions and districts to see how inequities play out.
