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In low- and middle-income countries (LMICs), economic downturns can lead to increased child mortality by affecting dietary, environmental, and care-seeking factors. This study estimates the potential loss of life in children under five years old attributable to economic downturns in 2020. We used a multi-level, mixed effects model to estimate the relationship between gross domestic product (GDP) per capita and under-5 mortality rates (U5MRs) specific to each of 129 LMICs. Public data were retrieved from the World Bank World Development Indicators database and the United Nations World Populations Prospects estimates for the years 1990-2020. Country-specific regression coefficients on the relationship between child mortality and GDP were used to estimate the impact on U5MR of reductions in GDP per capita of 5%, 10%, and 15%. A 5% reduction in GDP per capita in 2020 was estimated to cause an additional 282,996 deaths in children under 5 in 2020. At 10% and 15%, recessions led to higher losses of under-5 lives, increasing to 585,802 and 911,026 additional deaths, respectively. Nearly half of all the potential under-5 lives lost in LMICs were estimated to occur in Sub-Saharan Africa. Because most of these deaths will likely be due to nutrition and environmental factors amenable to intervention, countries should ensure continued investments in food supplementation, growth monitoring, and comprehensive primary health care to mitigate potential burdens. [ABSTRACT FROM AUTHOR]

Child death and mothers who suffer from child death are a public health concern in Sub-Saharan Africa. The location and associated factors of child death and mothers who suffer child death were not identified. To monitor and prioritize effective interventions, it is important to identify hotspots areas and associated factors. Data from nationally representative demographic and health survey and Multiple Indicator Cluster administrated in 42 Sub-Sahara Africa countries, which comprised a total of 398,574 mothers with 1,521,312 children. Spatial heterogeneity conducted hotspot regions identified. A mixed-effect regression model was run, and the adjusted ratio with corresponding 95% confidence intervals was estimated. The prevalence of mothers who suffer child death 27% and 45–49 year of age mother 48%. In Niger, 47% of mothers were suffering child death. Women being without HIV knowledge, stunted, wasted, uneducated, not household head, poor, from rural, and from subtropical significantly increased the odds of the case (P < 0.05). The spatial analysis can support the design and prioritization of interventions. Multispectral interventions for mothers who suffer from child death are urgently needed, improve maternal health and it will reduce the future risk of cases. [ABSTRACT FROM AUTHOR]

We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics. [ABSTRACT FROM AUTHOR]

Sickle cell anemia (SCA) is the commonest life-threatening genetic disorder in tropical regions, particularly in sub-Saharan Africa. It has been estimated that between 50–90% of SCA children will die in Africa before the age of 5, corresponding to a number of 150,000–300,000 annual SCA child deaths, which represents 5–10% of total child mortality. Transfusion support remains an essential component in the management of patients with SCA and has made a significant contribution to improving patient morbidity and mortality. In Africa where the majority of patients with SCA reside, many blood transfusion challenges remains, including shortage of blood supplies, risks related to infectious and immunologic potential side effects and limitation on the diagnosis and management of post-transfusion iron overload. The proportion of transfused SCA patients varies from different studies, between 30% and 90%. This variation can be related to environmental factors, disease genetic factors and other factors including the low availability of blood, difficulties in accessing to health care and inadequacies of the transfusion system. Because blood transfusion therapy is an integral component of the management of SCA, improved efforts and strategies to overcome these challenges and optimize blood transfusion practices are needed in African countries. [ABSTRACT FROM AUTHOR]

Preterm birth is a live birth that occurs before 37 completed weeks of pregnancy. Approximately 15 million babies are born preterm annually worldwide, indicating a global preterm birth rate of about 11%. With 1 million children dying due to preterm birth before the age of 5 years, preterm birth is the leading cause of death among children, accounting for 18% of all deaths among children aged under 5 years and as much as 35% of all deaths among newborns (aged <28 days). There are significant variations in preterm birth rates and mortality between countries and within countries. However, the burden of preterm birth is particularly high in low- and middle-income countries, especially those in Southeast Asia and sub-Saharan Africa. Preterm birth rates are rising in many countries. The issue of preterm birth is of paramount significance for achieving United Nations Sustainable Development Goal 3 target #3.2, which aims to end all preventable deaths of newborns and children aged under 5 years by 2030. [ABSTRACT FROM AUTHOR]

The article discusses the decline in substantial progress in reducing child deaths which was made between 1990 and 2015 across the world and mentions how analyses will be foundational in global efforts towards Sustainable Development Goals (SDGs) for child mortality. Topics include variations to be highlighted in under-5 and neonatal mortality rates, scarcity of summary birth history data from some regions and precision public health across Africa.

This study applies multilevel logistic regression to Demographic and Health Survey data from 22 sub-Saharan African countries to examine whether the relationship between child mortality and family structure, with a specific emphasis on polygyny, varies cross-nationally and over time. Hypotheses were developed on the basis of competing theories on the relationship between child health and family structure. Although children of mothers in polygynous marriages are more likely to die than those of mothers in monogamous unions, the relationship is constant across time. Familial factors including education, socioeconomic status (SES), and urban residence accounted for most of the observed cross-national variation associated with polygyny. Consequently, improving maternal education and household SES would greatly benefit child health in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

• Integrated models can address interlinkages between health and environment factors. • The SDG target on child mortality is not achieved in any of the scenarios analysed. • Environmental health risk factors remain prominent in 2030 • Achieving environment-related SDG targets can avoid 733.000 child deaths in 2030. • Integrated and intersectoral approaches to environmental health are needed. An estimated 26% of current global child deaths can be attributed to various and modifiable environmental factors, which are addressed under multiple Sustainable Development Goals (SDGs). This study assesses future reductions in child mortality in relation to the achievement of environment-related SDG targets. It uses projections of health risk factors from the IMAGE 3.0 Integrated Assessment Model, based on the Shared Socioeconomic Pathways (SSPs), linked to a standard multi-state health model (GISMO), distinguishing risk factors, disease occurrence and cause-specific death. The study concludes that, on a global level, the SDG target on child mortality will not be achieved in any of the three SSP scenarios analysed, mainly due to persistent high mortality rates in Sub-Saharan Africa and South Asia. By 2030, environmental health risk factors – including childhood undernutrition, no access to improved drinking water and sanitation, no access to modern fuels and exposure to malaria – will still be responsible for 14% to 16% of total global child deaths (8% to 10% when excluding nutrition-related mortality). Under the middle-of-the-road SSP2 baseline scenario, achievement of the SDG targets on hunger, drinking water and sanitation and modern energy services, would avoid 433 thousand child deaths by 2030. If, in addition, also higher standards would be achieved for access to water and energy, as well as universal secondary female education and advanced malaria control, a total of 733 thousand child deaths is projected to be avoided by 2030 (444 thousand child deaths, when excluding nutrition-related mortality), which would reduce projected global child mortality by 13%. Overall, more than 25% of the child mortality reduction that is needed to achieve the SDG target in Sub-Saharan Africa can be achieved through SDG-related policies on food, water and energy. This requires integrated and intersectoral approaches to environmental health. [ABSTRACT FROM AUTHOR]

Spectacular progress in reducing under 5 mortality achieved in the last few decades is projected to continue. There were about 11 million such deaths in 1997 compared to 21 million in 1955. The under-5 mortality rates per 1000 live births was 210 in 1955 and is projected to be 37 in 2025. Today about 29,000 children under the age of five -- 21 each minute -- die every day of the 10.5 million deaths in children under five a year. Two-thirds of deaths occur in just 10 countries and almost half of them occur in sub-Saharan Africa, where progress has slowed due to lack of preventive care and treatment, fragile health systems, and socio-economic stagnation due to conflicts, instability and AIDS. According to the 2005 World Health's report near by 90 % of the less than 5 years old children's deaths are related to six major diseases: acute newborn's problem (mainly prematurity, apparent neonatal death, infections (37%)), lower respiratory tract infections mainly pneumonia (19%), diarrhoea (18%), paludism (8%), measles (4% ) and HIV/AIDS (3%). About 50% of deaths among children under 5 are associated with malnutrition. But disease isn't inevitable, nor do children with these diseases need to die. Research and experience show that six million of the almost 10.5 million children who die each year could be saved by low-tech, evidence-based, cost-effective measures such as vaccines, antibiotics, micronutrient supplementation, insecticide-treated bed nets and improved family care and breastfeeding practices. In 2000, the millennium goals where defined by WHO. The goal number 4 is to reduce child mortality by two-thirds, from 93 children of every 1,000 dying before age five in 1990 to 31 of every 1,000 in 2015. Are we on the way to succeed? [ABSTRACT FROM AUTHOR]