Infant mortality in RP declines: Unicef


Posted at Sep 11 2009 05:20 PM | Updated as of Sep 12 2009 01:20 AM

MANILA - Infant mortality in the Philippines continues to decline thanks in part to improved immunization drives and a government campaign to address dehydration of infants, the United Nations Children's Fund (Unicef) said Friday.

A Unicef report said the Philippines compares well with other developing countries, with a rate of 32 deaths per 1000 live births, down from 40 in 2000. Most of the deaths occur in the neonatal period, or the first few weeks of life, and the primary causes of death are diarrhea and pneumonia or acute respiratory infections.

"Thanks to improved immunization drives and better use of oral rehydration salts to treat dehydration in infants, the Philippines is on track to meet the Millennium Development Goal. But there are still too many children dying before their fifth birthday from preventable diseases. By encouraging simple interventions such as exclusive breastfeeding for six months, and early detection of under nutrition in infants, many more lives could be saved," said Colin Davis, Deputy Representative of UNICEF Philippines, said in a statement.

A National Statistics Office report earlier said 25 out of every 1,000 live births in the Philippines end in death before they turn one, totalling 62,000 infant deaths every year. The 2008 National Demographic and Health Survey also showed that 34 babies out of every 1,000 born in the Philippines die before they reach the age of five.

NSO Administrator Carmelita Ericta said that while the numbers are lower than the ones recorded five years ago, Ericta said it is still a far cry from the United Nations Millennium Development Goal for the Philippines of 18 infant deaths for every 1,000 live births by the year 2015.

“A lot of these deaths are caused by such preventable problems such as diarrhea and respiratory problems. We need to reduce under-five mortality rate by half in six years, which means we have to work double-time to achieve it,” the country’s census chief told reporters.

Unicef said there was a 28 per cent decline in the under-five mortality rate worldwide, from 90 deaths per 1000 live births in 1990, to 65 deaths per 1000 live births in 2008. According to these estimates, the absolute number of child deaths in 2008 declined to an estimated 8.8 million from 12.5 million in 1990, the base line year for the MDGs.

"Compared to 1990, 10,000 fewer children are dying every day," said Unicef Executive Director Ann M. Veneman. "While progress is being made, it is unacceptable that each year 8.8 million children die before their fifth birthday."

The new estimates are the result of collection and analysis of a range of data sources by demographers and health experts from Unicef, the World Health Organization, the World Bank and the United Nations Population Division, guided by technical advisors from a number of major academic institutions.

The data shows global under-five mortality has decreased steadily over the past two decades, and that the rate of the decline in the under-five mortality rates has increased since the 1990s. The average rate of decline from 2000 to 2008 is 2.3 per cent, compared to a 1.4 per cent average decline from 1990 to 2000.  

Public health experts attribute the continuing decline to increased use of key health interventions, such as immunizations, including measles vaccinations, the use of insecticide-treated bednets to prevent malaria and Vitamin A supplementation. Where these interventions have increased, positive results have followed.

The new data also shows that seven of the 67 high mortality countries (those with under-five mortality rates of 40 per thousand live births or higher) have consistently achieved annual rates of reduction of under-five mortality of 4.5 per cent or higher. These are Nepal, Bangladesh, Eritrea, Lao People's Democratic Republic, Mongolia, Bolivia and Malawi.

Impressive gains have also been made in countries that are not fully on track to meet the Millennium goal. Niger, Mozambique and Ethiopia have all reduced under-five mortality by more than 100 per 1000 live births since 1990.
While progress has been made in many countries, the global rate of improvement is still insufficient to reach the MDG, and Africa and Asia combined still account for 93 per cent of all under-five deaths that occur each year in the developing world.

"A handful of countries with large populations bear a disproportionate burden of under-five deaths, with forty per cent of the world's under-five deaths occurring in just three countries: India, Nigeria, and the Democratic Republic of Congo," said Veneman. "Unless mortality in these countries can be significantly reduced, the MDG targets will not be met." 

In some countries, progress is slow or non-existent. In South Africa the under-five mortality rate has actually gone up since 1990. The health of the child is inextricably linked to the health of the mother and South Africa has the highest number of women living with HIV in the world. Recent commitments by the government to scale up interventions to prevent mother-to-child transmission of HIV/AIDS should help improve the situation. 

The survey data incorporated in these estimates generally reflects mortality over the preceding 3 to 5 years. This means that major improvements in provision of nets for malaria prevention, of vaccines against meningitis (HiB) and of vitamin A supplementation, improved prevention of mother-to-child transmission of HIV and of pediatric HIV, and further progress on protecting against measles and tetanus may not yet be fully reflected in the data.

Progress can be accelerated even in the poorest environments, through integrated, evidence-driven, community-based health programs that focus on addressing the major causes of death -- pneumonia, diarrhea, newborn disorders, malaria, HIV and under-nutrition.

The two leading causes of under-five mortality are pneumonia and diarrhea. New tools, such as vaccines against pneumococcal pneumonia and rotaviral diarrhea, could provide additional momentum.

"Achieving the Millennium Development Goal target of a two-thirds reduction in under-five mortality by 2015 will require a strong sense of urgency with targeted resources for greater progress," said Veneman.  With a report from David Dizon,