World health: childhood illness
Worldwide, half of the deaths in children aged <5yrs are due to:
Under-nutrition is a major factor contributing to these deaths. Two-thirds could be prevented by interventions already available and feasible today for implementation in low-income countries. In fact, we have the knowl-edge and instruments to reduce child mortality, but children continue to die because effective interventions are not reaching them. For example, Haemophilus influenzae type b vaccine coverage is universally low and, with few exceptions, insecticide-treated net coverage rates in malarial areas are well below 5%.
There are also clear indications in the developed world of health ine-qualities. Infant mortality rates show an excess associated with social dep-rivation and ethnic minorities.
The infant mortality rate in England and Wales of 4.7 deaths per 1000 live births in 2009 was the lowest ever recorded in England and Wales and has fallen by 64% since 1978 In sub-Saharan Africa the equivalent rate in children under 1yr was 81 deaths per 1000 live births, 39 in Asia and 19 in Latin America and the Caribbean. In the UK, the rate varies by socio-economic status, being 69% higher in the ‘routine and manual’ group com-pared with the ‘managerial and professional group’.
In 2003, data showed also that:
·Excess infant mortality also occurs in children of Asian parents—8.3 per 1000 live births born to mothers whose country of birth was Bangladesh, India, or Pakistan died.
·Babies born to mothers whose country of birth was Pakistan had an infant mortality rate of 10.5 per 1000 live births.
The factors associated with excess infant mortality include low birth weight, ethnicity, poverty, maternal cigarette smoking, the delivery of health care, and consanguinity