Under-5 Mortality in sub-Saharan Africa

We often hear the number of children dying from a certain cause of death in, say, sub-Saharan Africa. I always wonder where such information comes from.

I learned that since the 1990s, there has been an effort to estimate the number of deaths by cause for different age categories across different regions of the world. It's called the Global Burdern of Disease project. Estimates for year 1990 were published in The Global Burden of Disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020 edited by Christopher J. L. Murray and Alan D. Lopez (Harvard University Press, 1996). Follow-up estimates for years 2000 to 2002 (for 2002 estimate, country-by-country statistics as well) are provided by the WHO website.

Regional categorization for the 2002 estimates is different from the 1990 estimates. However, this page of the WHO website offers a comparable data for the 2002 estimates.

Comparaing these two sets of estimates for sub-Saharan Africa, an interesting picture emerges. Of course, the issue of data reliability is a significant concern given that most countries in sub-Saharan Africa lacks vital event registration. Still, it's worth taking note of.

Under-5 mortality (here I simply divide the number of deaths for children under age of five by the population of such children) has declined from 42.87 deaths per 1,000 in 1990 to 39.54 in 2002. Given that the population of under-5 children went up from 94 million to 115.4 million, this should have been something. Major causes of death for children under five in 1990 were, in a descending order of importance, diarrhoea, lower respiratory infections (mainly pneumonia), malaria, measles, and perinatal conditions (e.g. low birth weight, birth asphyxia). These five causes account for nearly 80 percent of deaths of children in sub-Saharan Africa. By 2002, the order of importance has changed: malaria, lower respiratory infections, diarrhoea, perinatal conditions, HIV/AIDS, and measles. These six factors still account for nearly 80 percent of child deaths. Under-5 mortality by cause has increased only for malaria and HIV/AIDS. Diarrhoea and measles have seen a sizable decline. Mortality from lower respiratory infections and perinatal conditions has moved sideways.

People keep talking about corrupt governments and dismal conditions for well-being in sub-Saharan Africa. It seems, however, that some changes were under way during the 1990s.