Beruflich Dokumente
Kultur Dokumente
Lawn, Kerber et al. BJOG 2009, updated with data from the most recent IGME and IHME release (Lozano, etc, Lancet 2011)
Global Progress to MDG 4
Lawn, Kerber et al. BJOG 2009, updated with data from IGME and IHME (Rajaratnam J Lancet 2010)
Child Mortality Rate: IGME 2011
Release
80
73 71 69 68
70 66 64 62 61 59 58
60 57
50 45 44 43 41 40 39 NMR
40 38 36 35 34 34 PNMR
28 28 27 26 U5MR
30 26 25 25 24 24 23 23
20
10
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2008 and 2010 Envelopes by IGME and
IHME
10
0-59m 1-59m 0-1m
9 8.8
7.9 8.0
8 7.6 7.6 7.7
7.3
7
6
5.2
5 4.7 4.7 4.6 4.5 4.6 4.4
4 3.6
3.2 3.2 3.0 3.1 3.1 2.9
3
0
IGME_2010 IGME_2011 IHME_2010 IHME_2011 IGME_2011 IHME_2010 IHME_2011
2008 2010
Mortality “Envelope (total number of
deaths)” and Causes of Child Death
Vital
Registration
Cause distribution
Proportional Mortality Among Under Fives in the Year
2000 - Afro
ARI
Diarrhoea
Measles
Malaria
HIV
Perinatal
Other
Use of Vital Registration (VR) Data from
WHO Mortality Database
Vital
Registration
Cause distribution
Proportional Mortality Among Under Fives in the Year
Multi-cause 2000 - Afro
on VR
Diarrhoea
Measles
Malaria
HIV
Perinatal
Other
VR data based multi-cause model
(VRMCM) for Neonatal and Post-neonatal
Causes if No Usable VR and U5MR<=35
Vital
Registration
Cause distribution
Proportional Mortality Among Under Fives in the Year
Multi-cause 2000 - Afro
on VR
Diarrhoea
Measles
Malaria
HIV
Perinatal
Other
Multi-cause
models based on
verbal autopsy
(VA) data
VA Data based multi-cause model
(VAMCM) for Neonatal Causes if No
Usable VR Data and U5MR>35
Vital Subnational
Registration multi-cause
Cause distribution
Proportional Mortality Among Under Fives in the Year model-India
Multi-cause 2000 - Afro
Multi-cause
models based
on VA
India and China
Vital Subnational
Registration multi-cause
Cause distribution
Proportional Mortality Among Under Fives in the Year model-India
Multi-cause 2000 - Afro
• AIDS: UNAIDS
Estimation of Uncertainty
• Major causes:
– pneumonia
– prematurity
– diarrhea
China
• 58% of neonatal
deaths
• Major causes
– Pneumonia
– Birth asphyxia
– Prematurity
Children Under 5 Years Old
0.2 0.2
0.1 0.1 0.2 0.2
0.1 0.1 0.2 0.2
0.3 0.3 0.1 0.1 0.2 0.2
0.3 0.3 0.1 0.2 0.2
3
1.3 1.3 1.2 1.2 1.2 1.2 1.1 1.1 1.1 1.1 1.1
1
0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4
0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1
0.4 0.4 0.4 0.3 0.4 0.4 0.4 0.4 0.3 0.3 0.3
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
AFRO, 0-1m
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
1
0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4
0.4
.4
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
1.5 SEARO, 0-1m
0.1 0.1
0.0 0.0 0.1
0.1 0.1 0.0 0.1
0.0 0.1
0.1 0.1 0.0 0.0
0.0 0.0
0.1 0.1 0.0 0.0
0.0 0.0
0.3 0.1 0.1 0.0 0.0
0.0 0.0
0.3 0.3 0.1 0.0
0.1
1
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
.5 EMRO, 0-1m
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
.4
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1
.3
.2
0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2
0.2
.1
0.0 0.0 0.0 0.0 0.1 0.0 0.1 0.0 0.1 0.1 0.1
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.1 0.1 0.1 0.1 0.0 0.1 0.1 0.1 0.0 0.0 0.0
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
.4 WPRO, 0-1m
0.1
0.1
0.0 0.1
0.0 0.0 0.1
0.0 0.0 0.1
.3
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
.2 AMRO, 0-1m
0.0
0.0
0.0 0.0
0.0 0.0
0.0 0.0 0.0
0.0 0.0 0.0
.15
0.0
0.0 0.0 0.0 0.0 0.0
0.1 0.1 0.1 0.1 0.1 0.1
.05
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
EURO, 0-1m
0.0
.1
0.0 0.0
0.0
0.0 0.0
0.0 0.0 0.0 0.0
0.0
.08
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
.02
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
sepsis preterm
intrapartum congenital
tetanus other
World, 1-59m
6
1.4 1.4
1.4 1.4
1.4 1.3
0.3 0.3 1.3
0.3 0.3 1.3 1.4
4
1.5 1.4 1.4 1.3 1.3 1.2 1.2 1.2 1.1 1.1 1.1
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
AFRO, 1-59m
3
0.1
0.6 0.6 0.7 0.1 0.1
0.6 0.7 0.7 0.1 0.1
0.1 0.7 0.6
0.1 0.1 0.6
0.1 0.1 0.6 0.5
0.3 0.3 0.2 0.3 0.1
0.1 0.2 0.1
0.0 0.1
0.0 0.1 0.1 0.1
0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.0 0.0 0.0
0.2
1
0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
1.5 SEARO, 1-59m
0.4
0.4
0.4
0.4 0.4
0.1 0.1 0.3 0.3
0.0 0.0
0.1 0.1 0.1
1
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
.8
.6 EMRO, 1-59m
0.2 0.2
0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2
0.0 0.0
0.0 0.0 0.0
.4
0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
.5
.4 WPRO, 1-59m
0.1
0.1
0.1
.3
0.1 0.1
0.0 0.1
0.0 0.1
0.0 0.0 0.1 0.1
0.0 0.0
0.0
0.0 0.0 0.0 0.1
.2
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
AMRO, 1-59m
.25
.2
0.1
0.1
.15
0.1
0.1
0.1
0.1
0.1 0.1
0.1
0.0 0.1
.1
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
.8
.6 EMRO, 1-59m
0.2 0.2
0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2
0.0 0.0
0.0 0.0 0.0
.4
0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
pneumonia diarrhea
hiv measles
meningitis malaria
injury other
10
8
6
4
2
0 World, 0-1m
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
10
0
2
-10
-20
0
0
-10
-20
2
-30
-40
0
10
2
0
-10
-20
-30
0
15
10
5
2
0
-5
-10
0
0 10 20 30 40 50
0 50
Neonatal 100in 2000 (per 1,000
mortality rate 150 live births) 200
mr_u5d
10
0
2
-10
-20
0
0 10 20 30 40 50
0 50
Neonatal 100in 2000 (per 1,000
mortality rate 150 live births) 200
mr_u5d
0.7 R2009
R2011
0.6
0.5
0.4
0.3
0.2
0.1
0
1980-1989 1990-1999 2000-2009
Distribution of Diarrhea Fractions by Year,
studies included in the last vs. this round
• Child mortality has declined by 35% globally from 1990 to 2010 and by more than
50% in many world regions
• High rates of child mortality persist, especially in Southern Asia and sub-Saharan
Africa, regions that now have 82% of child deaths
• Deaths in the first month of life now constitute 40% of all child deaths, with
complications of premature births and intrapartum-related events as the major causes
• Comparing 2000 with 2010 the number of child deaths decreased by 2 million to 7.6
million with 50% of the decline due to reductions in diarrhea, pneumonia and measles
• The annual rate of change in child deaths has not been sufficient to achieve the
MDG4 but for all major causes of death some countries have exceeded this 4.4% rate
and achieved rates of 5-10% or even higher
Additional Details Available in Liu et al,
2012
References for Estimates