Abstract

PIP: The findings of a World Fertility Survey of infant and early childhood mortality trends in 29 countries in Africa, the Americas, and Asia are reported. The national surveys, carried out in 1974-79, utilized the synthetic cohort method. Analysis of the infant and child mortality 0-4 years before the data of each survey revealed wide variation. A moderate percentage (4-8%) of children died before reaching age 5 in 10 of the 29 countries studied: Costa Rica, Fiji, Guyana, Jamaica, Jordan, Korea, Malaysia, Panama, Trinidad and Tobago, and Venezuela. A moderate to high percentage (8-12%) of infant and child deaths was noted in Colombia, Mexico, Paraguay, Philippines, Sri Lanka, Syria, and Thailand. Mortality in this age group was high (12-15%) in Dominican Republic, Indonesia, Kenya, Peru, and Sudan; very high (16-20%) in Haiti, Lesotho, and Turkey; and extremely high (20% or more) in Bangladesh, Nepal, Pakistan, and Senegal. Even the countries with the lowest mortality levels have more than twice the mortality of developed countries. The neonatal death rate has been the most difficult to control. To determine time trends, children born to women ages 20-29 at time of the survey were further analyzed. Mortality has declined over time in all countries studied. There was an average of 43 fewer deaths under the age of 5 years per 1000 births in the period 0-4 years before the surveys than 15-19 years earlier, for an overall 28% decrease. Per 1000 births, 20 infant, 10 toddler, and 13 preschooler deaths were averted. However, the declines have not been equal or consistent across countries. When the countries were grouped by region, Western Asia recorded the greatest decline, with an average of 93 fewer infant and early childhood deaths in the period 0-4 years before survey than 15-19 years earlier. With 26 fewer deaths per 1000 births, the countries of Africa demonstrated the least fall. Asia (excluding Western Asia) and the Americas showed average declines of 34 and 45 deaths, respectively. There is some indication of a slowdown in the rate of decline of mortality, and 4 countries have shown increases in the recent period. This finding must be interpreted with caution, however, since recently born children may have been better reported.