The gap in child mortality rates between the poorest and wealthiest households has narrowed in many developing countries, a study from the Stanford University School of Medicine finds.
Based on survey data from nearly a million families in fifty-four low- and middle-income countries, the study, Changes in Child Mortality Over Time Across the Wealth Gradient in Less-Developed Countries, compared mortality rates for children under the age of 5 in 2002-07 and 2008-12 and found that rates declined fastest among the poorest families. With child mortality rates falling an average of 4.36 deaths a year per 1,000 live births among the poorest families, compared to 3.36 deaths a year among mid-range families and 2.06 deaths a year among the wealthiest families, the child mortality gap between the rich and poor was found to be narrowing in about three-quarters of the countries studied.
Eran Bendavid, assistant professor of medicine and the study's author, said the evidence in the study is consistent with progress made in controlling communicable diseases such as malaria, measles, diarrhea, and respiratory illnesses that disproportionately affect the poorest and for which international aid groups have funded significant interventions over the past decade.
Moreover, in countries where the gap in child mortality rates between the rich and poor widened, the study found a common element — poor governance, as characterized by low levels of government effectiveness, rule of law, regulatory quality, and control of corruption. Funded by the Doris Duke Charitable Foundation, the Dr. George Rosenkranz Prize for Health Care Research in Developing Countries, and the National Institute of Allergy and Infectious Diseases and published online in Pediatrics, the report raises questions about the effectiveness of foreign aid organizations in low- and middle-income countries that lack effective governance.
"We have the technologies, we have the means, we have the know-how to reduce child mortality dramatically," said Bendavid. "Even for such low-hanging fruit, however, implementation is not always easy. You have to have government that enables basic safety, and the ability to reach poor and rural communities that benefit from these kinds of programs."