South Africa's child mortality reduction deemed 'a successful failure'

December 22, 2015

As the 25-year period for the UN Millennium Development Goals concludes on Dec. 31. 2015, to be replaced by the Sustainable Development Goals, a deeper analysis of factors outside defined goals is necessary to learn why some countries failed. This is an argument presented by researchers at Umeå University in an article published today in the scientific journal PLOS Medicine.

The case of South Africa, which failed to meet the MDG4 child mortality goal due to the simultaneous onset of the HIV epidemic, suggests that success is partly determined by how the goal was formulated. In South Africa, under-five mortality was already low in 1990, but increased as the HIV epidemic emerged. Thus, despite considerable mortality reduction in the last 10 years, South Africa saw no appreciable change between 2015 and the beginning of the MDG period (see graph).

"Whether or not a country achieved MDG4 also depends on how narrowly that goal was defined," says Peter Byass, epidemiologist at Umeå University and lead author of the article. "Our statistical research shows that it is possible to be successful in terms of controlling the HIV epidemic and lowering child mortality, as has been the case in South Africa, but at the same time spectacularly failing to meet MDG4. Although South Africa was never likely to meet the arbitrarily defined goal of reducing under-five child mortality by two thirds, the country is nevertheless back to the child mortality level it had before the HIV epidemic, which objectively should be considered a huge success."

Drawing conclusions from national child mortality data is difficult because it requires access to detailed, consistent and reliable data for the entire MDG period from 1990-2015. However, a unique set of health data from the population of the Agincourt sub-district, in northeastern South Africa, offers a rare exhaustive glimpse of a population through the MDG period. The data is based on annual household visits, which included verbal autopsies to determine the number and causes of deaths in each household.
-end-
The findings are described in an article titled 'A successful failure: Missing the MDG4 target for under-five mortality in South Africa', published today in the journal PLOS Medicine.

"Even though South Africa in the last 10 years has successfully reduced the number of childhood deaths associated with HIV, bringing overall child mortality levels down, the country's progress as measured against MDG4 is deemed a failure. As MDG outcomes are now evaluated and successful cases highlighted, we can learn from these findings. Countries such as South Africa, that failed to meet MDG4 as it was defined, should be evaluated more deeply and in ways that factor in disruptive factors such as HIV," says Peter Byass.

In the United Nations' Sustainable Development Goals, which will supersede the MDGs from Jan. 1, 2016, the new child mortality goal is based on absolute numbers instead of a percentage reduction from the baseline rate. The new goal calls for less than 25 deaths per 1,000 live births by 2030 in all countries.

Umea University

Related Mortality Articles from Brightsurf:

Being in treatment with statins reduces COVID-19 mortality by 22% to 25%
A research by the Universitat Rovira i Virgili (URV) and Pere Virgili Institut (IISPV) led by LluĂ­s Masana has found that people who are being treated with statins have a 22% to 25% lower risk of dying from COVID-19.

Mortality rate higher for US rural residents
A recent study by Syracuse University sociology professor Shannon Monnat shows that mortality rates are higher for U.S. working-age residents who live in rural areas instead of metro areas, and the gap is getting wider.

COVID-19, excess all-cause mortality in US, 18 comparison countries
COVID-19 deaths and excess all-cause mortality in the U.S. are compared with 18 countries with diverse COVID-19 responses in this study.

New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin
A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality.

Hydroxychloroquine reduces in-hospital COVID-19 mortality
An Italian observational study contributes to the ongoing debate regarding the use of hydroxychloroquine in the current pandemic.

What's the best way to estimate and track COVID-19 mortality?
When used correctly, the symptomatic case fatality ratio (sCFR) and the infection fatality ratio (IFR) are better measures by which to monitor COVID-19 epidemics than the commonly reported case fatality ratio (CFR), according to a new study published this week in PLOS Medicine by Anthony Hauser of the University of Bern, Switzerland, and colleagues.

COVID-19: Bacteriophage could decrease mortality
Bacteriophage can reduce bacterial growth in the lungs, limiting fluid build-up.

COPD and smoking associated with higher COVID-19 mortality
Current smokers and people with chronic obstructive pulmonary disease (COPD) have an increased risk of severe complications and higher mortality with COVID-19 infection, according to a new study published May 11, 2020 in the open-access journal PLOS ONE by Jaber Alqahtani of University College London, UK, and colleagues.

Highest mortality risks for poor and unemployed
Large dataset shows that income, work status and education have a clear influence on mortality in Germany.

Addressing causes of mortality in Zambia
Despite the fact that people in sub-Saharan Africa are now living longer than they did two decades ago, their average life expectancy remains below that of the rest of the world population.

Read More: Mortality News and Mortality Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.