Improving Child Survival in Developing Countries: The Need for an Integrated and Targeted Approach to Programming

Childhood mortality is a key indicator of population health and the level of social and economic development in a country. In spite of myriad efforts to reduce it in developing countries many children continue to die of causes that are preventable. In the year 2004, 10.5 million children died before their fifth birthday. The recent past has however witnessed mixed trends in childhood mortality, with the rate of decline decelerating in many countries, while reversing in others.

The objectives of this study are twofold: to explore the individual-levels factors that are associated with the recent patterns of childhood mortality in developing countries; and to recommend policy actions that will bring about faster improvement in child survival in developing countries.

Maternity history data from the Kenyan and Indian Demography Health Surveys are used, in conjunction with proportional hazards models that incorporate the age at death and the vector of covariates. In particular, the piecewise exponential hazards model is used to take into account the changes in the determinants of childhood mortality as the child ages.

The results show that the recent patterns of childhood mortality are associated with a variety of factors including use of maternal and child health services, mother's nutrition and socio-economic circumstances, and HIV/AIDS prevalence. In addition, specific stages of childhood and sub-groups bear the brunt of these risks. Therefore, it is recommended that improving child survival in developing countries requires integrated and targeted maternal and child welfare programs.