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[Washington, D.C.], World Bank, 2012 Jun. 4 p. (en breve No. 177)The Latin America and Caribbean (LAC) region fares well on achievement of the MDG targets when compared with other regions, but the region has great disparities between and within countries on these goals. The region is also performing better than the rest of the developing world in relation to child mortality, having achieved more than 70% of the progress needed to reduce under-five mortality by two-thirds. However, LAC still faces serious challenges regarding maternal mortality, achieving good public and individual health and alleviating poverty. For LAC, the MDGs are a historic opportunity to address all forms of inequality and attain the political will needed to achieve these goals. (excerpt)
BMJ. British Medical Journal. 2012; 345:e6229.New figures show that the number of children dying before the age of five has significantly fallen since 2000, but this progress needs to accelerate if the United Nationsâ€™ millennium development goal of reducing child mortality is to be reached. A report released by the UNâ€™s Childrenâ€™s Fund (Unicef), the World Health Organization, the World Bank and the UN Population Division provides statistical analyses of annual child mortality and its global concentrations; the highest rates of child mortality are still in sub-Saharan Africa. The report warns that securing accurate estimates of child mortality is a considerable challenge because many developing countries lack a registration system. It also warns that the decline in neonatal mortality rates has been slower than the decline in mortality rates among children overall.
New York, New York, UNICEF, 2012.  p.Across the world, the number of deaths among children under 5 has been on a continuous decline for over two decades, says the 2012 Progress Report on Committing to Child Survival: A Promise Renewed. Data released today by UNICEF and the United Nations Inter-agency Group for Child Mortality Estimation show that the number of children under the age of 5 dying globally has dropped from nearly 12 million in 1990 to an estimated 6.9 million in 2011. The report combines mortality estimates with insights into the top killers of children under 5 and the high-impact strategies that are needed to accelerate progress. The report shows that all regions of the world have seen a marked decline in under-5 mortality since 1990. Neither a country’s regional affiliation nor economic status need be a barrier to reducing child deaths; low-, medium- and high- income countries all have made tremendous progress in lowering their under-5 mortality rates. But under-5 deaths are increasingly concentrated in sub-Saharan Africa and South Asia. One in every nine children in sub-Saharan Africa dies before reaching the age of 5. And progress in lowering child mortality rates lags behind among disadvantaged and marginalized people, around the world. Undernutrition is a factor in one third of all under-5 child deaths. If disease and undernutrition are to be tackled successfully, broader issues such as water supply, sanitation and hygiene and education will also have to be addressed. The report provides further impetus for a renewed global movement to end preventable child deaths.
Child mortality estimation: Methods used to adjust for bias due to AIDS in estimating trends in under-five mortality.
PLOS Medicine. 2012 Aug; 9(8):e1001298.In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.
PLOS Medicine. 2012 Aug; 9(8):e1001303.Monitoring development indicators has become a central interest of international agencies and countries for tracking progress towards the Millennium Development Goals. In this review, which also provides an introduction to a collection of articles, we describe the methodology used by the United Nations Inter-agency Group for Child Mortality Estimation to track country-specific changes in the key indicator for Millennium Development Goal 4 (MDG 4), the decline of the underfive mortality rate (the probability of dying between birth and age five, also denoted in the literature as U5MR and 5q0). We review how relevant data from civil registration, sample registration, population censuses, and household surveys are compiled and assessed for United Nations member states, and how time series regression models are fitted to all points of acceptable quality to establish the trends in U5MR from which infant and neonatal mortality rates are generally derived. The application of this methodology indicates that, between 1990 and 2010, the global U5MR fell from 88 to 57 deaths per 1,000 live births, and the annual number of under-five deaths fell from 12.0 to 7.6 million. Although the annual rate of reduction in the U5MR accelerated from 1.9% for the period 1990-2000 to 2.5% for the period 2000-2010, it remains well below the 4.4% annual rate of reduction required to achieve the MDG 4 goal of a two-thirds reduction in U5MR from its 1990 value by 2015. Thus, despite progress in reducing child mortality worldwide, and an encouraging increase in the pace of decline over the last two decades, MDG 4 will not be met without greatly increasing efforts to reduce child deaths.