Child mortality rate declines

Ellanie Smit

WINDHOEK

The under-five child mortality rate in Namibia fell to 39 deaths per 1 000 live births in 2021, while under-five deaths dropped to an estimated 3 000 children.

In 2000, the under-five mortality rate stood at 77 deaths per 1 000 live births.

This is according to the latest estimates in two reports released by the United Nations (UN), which found that more than five million children under age five, including 2.3 million newborns, as well as 2.1 million children and youth aged five to 24 years - 43% of whom are adolescents – died in 2021.

It was also found that 1.9 million babies were stillborn during the same period, while in Namibia, out of an estimated 71 000 births, about 2 000 were stillbirths.

According to the UN, access to and availability of quality healthcare continues to be a matter of life or death for children globally. Most child deaths occur in the first five years, of which half are within the very first month of life.

“For these youngest babies, premature birth and complications during labour are the leading causes of death. Similarly, more than 40% of stillbirths occur during labour – most of which are preventable when women have access to quality care throughout pregnancy and birth.

“For children who survive past their first 28 days, infectious diseases like pneumonia, diarrhoea and malaria pose the biggest threat.”

Heaviest burden

Children continue to face wildly differentiating chances of survival based on where they are born, with sub-Saharan Africa and Southern Asia shouldering the heaviest burden, the reports showed. Though sub-Saharan Africa had just 29% of global live births, the region accounted for 56% of all under-five deaths in 2021, and Southern Asia for 26% of the total.

Children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world – 15 times higher than the risk for children in Europe and Northern America.

Mothers in these two regions also endure the painful loss of babies to stillbirth at an exceptional rate, with 77% of all stillbirths in 2021 occurring in sub-Saharan Africa and South Asia.

Nearly half of all stillbirths happened in sub-Saharan Africa. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times more likely than in Europe and North America.

Positive outcomes

The reports showed some positive outcomes, with a lower risk of death across all ages globally since 2000. The global under-five mortality rate fell by 50% since the start of the century, while mortality rates in older children and youth dropped by 36%, and the stillbirth rate decreased by 35%.

This can be attributed to more investments in strengthening primary health systems to benefit women, children and young people.

However, gains have reduced significantly since 2010, and 54 countries will fall short of meeting the Sustainable Development Goals target for under-five mortality.

The UN warned that if swift action is not taken to improve health services, almost 59 million children and youth will die before 2030, and nearly 16 million babies will be lost to stillbirth.

Covid impact

The reports further noted that while Covid-19 has not directly increased childhood mortality – with children facing a lower likelihood of dying from the disease than adults – the pandemic may have increased future risks to their survival. In particular, the reports highlighted concerns around disruptions to vaccination campaigns, nutrition services and access to primary healthcare, which could jeopardise their health and well-being for many years to come.

In addition, the pandemic has fuelled the largest continued backslide in vaccinations in three decades, putting the most vulnerable newborns and children at greater risk of dying from preventable diseases.