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UK has highest death rate for under-5s in Western Europe

UK death rate in under-5s cannot be explained by population size

OnMedica Staff

Wednesday, 12 May 2010

More children under the age of five die in the UK than in any other country in Western Europe, according to a major international study.

The study, funded by WHO, UNICEF, and the Bill & Melinda Gates Foundation through a grant to the US Fund for UNICEF, concluded that this difference could not be solely accounted for by population size.

The UK, with a population of around 61 million, had 4,324 deaths in children under 5 in 2008, way ahead of France (population 64 million, deaths 3,090), Germany (population 82 million, deaths 2,943), and Italy (population 60 million, deaths 2,350). 

And while the UK total under-5 deaths total is very small in the global context, even in this high-income setting many deaths are preventable. 55% of under-5 deaths in the UK were in neonates. 147 deaths (3%) were due to pneumonia, and 74 (2%) to meningitis. Preterm birth complications (1549 deaths/36%) congenital abnormalities (1109 deaths/26%), and birth asphyxia (306 deaths/7%), and injuries (175 deaths/4%) were the leading single causes of death in children under-5 in the UK in 2008.

Despite this, the Department of Health claims that infant mortality in the UK is at 'its lowest ever level' and noted that definitions and registration systems vary from country to country 'making it difficult to make valid international comparisons'.

Worldwide, according to the global analysis, reported in an Article published Online First and in an upcoming Lancet, written by Professor Robert E Black and colleagues of Johns Hopkins Bloomberg School of Public Health, Baltimore, there are 8.8 million deaths in children under-5.

More than two thirds of these are caused by infectious diseases such as pneumonia, diarrhoea, malaria, and sepsis. Preterm birth complications, birth asphyxia, and congenital abnormalities are also important causes of death.

High-income countries make up a very small (around 1%) proportion of the total deaths, while almost half of all under-5 deaths occur in just five countries — India, Nigeria, Democratic Republic of the Congo, Pakistan, and China.

The authors concluded: "The concentration of all-cause child deaths and deaths due to some specific causes, such as diarrhoea, pneumonia, malaria, and AIDS, in a small set of countries is striking. This result is partly related to the large populations of children younger than 5 years in these countries, but also some diseases are concentrated because of epidemiological and social conditions. Success in disease control efforts in these countries is essential if Millennium Development Goal 4 targets are to be achieved. However, nearly all countries still face the challenge to reduce child deaths from preventable conditions, irrespective of their number or cause. These national estimates of the causes of child death in 2008 should help to identify priority interventions for child survival, and how to allocate national and international resources.”

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