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Reassessing infant mortality figures

[Kazakhstan] A Kazakh mother and her child.
A new UNICEF report says more accurate methods of recording child and infant deaths are needed ( UNICEF Kazakhstan/Vladimir Starygin)

While Kazakh official statistics continue to record a drop in infant and child mortality figures, such figures may not be an accurate portrayal of the real situation. "It’s too early to say, given the contradictory nature of the two sources of data being used," Phillippe Heffinck, area representative for the UN children's agency, UNICEF, told IRIN in the Kazakh commercial capital, Almaty, on Wednesday.

Like other Central Asian countries, the oil and gas-rich nation has maintained the former Soviet definition of live birth, which is considerably looser than the World Health Organisation (WHO)-recommended global definition. A new UNICEF report issued on Tuesday calls for countries in Central Asia and elsewhere to reassess how they compile infant mortality figures so a more accurate picture of child health can be established.

Since child and infant mortality is calculated as a percentage of live births, it is conceivable that child mortality rates in Kazakhstan could be significantly higher if the international definition were used.

Under the locally adopted definition, the Ministry of Health has reported that since 1990, the number of deaths of children under the age of one per 1,000 live births has dropped from 26.4 to 19.4. However, according to the Demographic and Health Survey (DHS), undertaken by the USAID-contracted company Macro International, and conducted every five years in collaboration
with national institutions, using the WHO definition that figure now stands at 61.9 (DHS 1999).

"There is a big difference between the official rate and the survey-based rate," Heffinck said, noting it would be very difficult to make a clear statement on child mortality given such discrepancies. And while the government, as part of its millennium development goals, hopes to reduce the under-five mortality rates by two-thirds between 1990 and 2015, this objective appears doubtful. "It’s unlikely to be achieved even if we use the government’s data at the current rate," the UNICEF official said.

The problem of inaccurate child and infant mortality figures is apparent across the region. "We believe that in Central Asia infant deaths are of particular concern for two reasons: the rate of infant mortality is very high, and secondly, official figures hide the gravity of the true situation," UNICEF's Jerry Redmond, editor of Social Monitoring 2003 - an annual regional report examining the wellbeing of children in transition countries - told IRIN from Florence, Italy.

The report shows that in Tajikistan a more realistic figure would be around 90 infant deaths per 1,000 live births. "In all these countries the official figure [of infant deaths] is considerably lower," Redmond said, noting that in Tajikistan the official figure in 1993 was just 47 deaths per 1,000.

UNICEF explains the difference by pointing out that the definition of live birth in several countries in the region doesn't conform with the minimum of international standards. "This means in practice that several baby deaths may go unrecorded simply because they were never considered officially to be alive, and in particular very premature infants who are born alive are very often classified as stillbirths or miscarriages," he said.

On top of that, he said, the number of infant deaths was misreported as miscarriages or stillbirths, which was a part of Soviet legacy. With deteriorating conditions in health services it has been a difficult legacy to overcome. "Governments need to acknowledge that infant mortality is high and urgent action is needed to reduce it," Redmond said, adding that poverty, leading to malnutrition and bad health, was one of the primary causes of the problem.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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