Monday, June 3, 2013

Millennium Development Goal 4 - Countdown to 2015

Millennium Development Goal 4, or simply MDG 4, set an ambitious target of reducing child infant mortality by two thirds between 1990 and 2015. Reducing this was identified as one of the keys to development. Since 2000, governments around the world have taken a raft of measures to meet the targets laid out under MDG 4.

Progress to Date

Great strides have been made in moving towards the attainment of MDG 4. In a number of countries, this has gradually fallen and all time lows are now being recorded. The biggest improvements have come from South and East Asia as well as North Africa. However, the Indian sub-continent and Sub-Saharan Africa still record the highest infant mortality though progress has been made. To date, there are still 3.6 million infant deaths around the world with the bulk being recorded in Sub-Saharan Africa and India.

What is causing Infant Mortality?

There are three main causes of infant mortality that cut across borders. These are:

• Neonatal infections, the main being sepsis and pneumonia
• Birth Asphyxia or deaths related to intrapartum events
• Complications related to premature delivery

The above three causes account for about 90% of all child mortality cases.

What are the Impediments to Reducing Infant Mortality?

The main impediments to meeting MDG 4 have nothing to do with lack of resources as many people might think. The problem lies in lack of strategic investment, poor resource allocation, gaps in research and inaccuracy of data recording for later use in policy formulation.

What needs to be done?

In order to meet MDG 4 by 2015, a number of measures need to be instituted:

• Coming up with better methods of recording pregnancy outcomes accurately.
• Including stillbirths in policy dialogue because failure to acknowledge stillbirth data distorts the intelligence on this. The numbers of stillbirths and newborns must be linked in order to improve the overall understanding of infant mortality.
• Reducing infant mortality needs to be made a political priority in most nations around the world.
• Improving antenatal care
• Improving availability of skilled medical personnel at the delivery stage
• Improving access to emergency obstetrical care
• Implementing new methods known to reduce infant mortality at the neonatal level such as Kangaroo Mother Care
• Address the gaps in early postnatal care

Given that 2015 is not far off, national authorities must move with speed to implement the above points. Many of the interventions noted above do not require intensive capital investments as mentioned earlier. In fact, in the case of Kangaroo Mother Care, medical care personnel need only be taken through a short two-hour training session. In countries where Kangaroo Mother Care has been effectively implemented, it has reduced deaths arising from complications of pre-term delivery by over 50%.

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