Child, infant, and neonatal mortality has become an international issue over the years. According to WHO in 2016 5.6 million children under 5 died, 15 000 children under 5 die everyday. The neonatal period is very crucial and fragile and most under 5 deaths are prevalent.
Child mortality is the number of under 5 deaths per 1 000 live births. NB: child ranges may differ
Infant mortality is the number of under 1 year deaths per 1 000 live births (they are in the under 5 genre formula)
Neonatal / Postnatal mortality is the number of children who die just after birth or usually within a month but before a year per 1 000 live births.(they are in the infant and under 5 genre formula)
These types of mortality are mainly prevalent in Sub-Saharan countries including Zimbabwe. Zimbabwe is among the top countries with a high prevalence of child mortality. According to MIMS 2009, 86 out of 1 000 live births die before reaching their fifth birthday, 60 out of 1 000 die before a year and 24 out of 1 000 die within a month.
Although measures have been put in place over the past couple of years, child mortality has dropped very slowly and still remains Zimbabwe’s problem of concern.
Causes and Factors leading to child mortality
NB: causes apply to all mortalities (neonatal, infant & under 5) unless where specified. Diseases
⋄ HIV/AIDS
⋄ Pneumonia
⋄
- Diarrhoea
- BCG related diseases
- Malnutrition (lack of good protein and carbohydrates)
- Asphyxia which is lack of oxygen, usually occurs in neonates due to poor incubators or poor delivery environments.
Social and Economic causes
- Unhealthy delivery environment which causes birth complications, diseases and possible death
- Poor antenatal and postnatal care which can lead to birth complications, diseases such as anoxia and possible death.
- Long distances to health facilities which lead to things like home deliveries and cures.(rural areas)
- Unaffordable health services which lead to the engagement of the above aforementioned.
- Shortage or unskilled staff.
- Poor technology, e.g. poor incubators
- Religious beliefs, for example some Apostolics does not recommend things like BCG injections.
- Home cures and remedies.
- Ignorance (having “What’s the worst that could happen” perception )
- Antenatal smoking which can cause birth complications and or death.
- Alternatives to breastfeeding e.g. bottle milk which is unrecommended for infants between 0-18 months.
- Early pregnancies
Home Injuries (mostly 1 year and above)
- Burns and cuts
- Suffocation e.g. from plastics
- Electric shocks
- Drowning
Most of the above aforementioned causes and factors occurs in LEDCs where factors such as expenses, long distance, poor technology and ignorance lead to the engagement of some undesirable health practices. Diseases such as HIV/AIDS, pneumonia and diarrhoea are curable only if there’s commitment and people follow recommended health practices.
However, in MEDCs child mortality is low and usually caused by home injuries such as burns or drowning. Most people in the developed world follow good and recommended health practices which reduce child mortality.
Mitigation and Prevention
Prevention is better than cure. Most child mortality can be prevented by following the recommended ways e.g. antenatal checks, BCG injections among others.
This is usually done mostly in developed countries; however, in LEDCs particularly Sub-Saharan Africa, different barriers restrict people to follow ethical and recommended ways to reduce child mortality.
Child mortality in urban areas is low compared to rural areas with barriers such as affordability, distance to health centers, poor technology and religious beliefs playing a pivotal role in child mortality.
Some mitigatory measures
♦ Encourage breastfeeding.
♦Encourage antenatal(before birth) HIV/AIDS testing and treatment to reduce mother to child infections.
♦ Improving and encourage antenatal and postnatal care especially in rural areas.
♦ Investing more in child protection and welfare eg Zimbabwe’s PHC initiative launched in 1980.
♦ Building more hospitals to increase accessibility especially in rural areas.
♦ Offering free child deliveries e.g. in Zimbabwe child delivery is now free of charge.
♦ Offering free child health services eg free BCG injections