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Urgent action needed to further improve child survival in Ethiopia: study

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New global research on child mortality rates in Ethiopia shows while there has been a significant decline in these rates in past three decades, too many children under the age of five are still dying.

The analysis found the mortality rate in the under-five demographic decreased by almost 4.5 per cent every year between 1990 and 2019.

However, despite the progress, it’s still one of the highest rates in the world with an estimated 190,000 under 5 deaths in 2019 at the rate of 52 deaths per 1000 livebirths. The country’s neonatal mortality rate is 26.6 deaths per 1000 livebirths.

Lead author Dr Gizachew Tessema from the Curtin School of Population Health said in 2019, almost three quarters (74 per cent) of these deaths occurred before a child’s first birthday and over half (52 per cent) in the first 28 days.

“While a baby born in Ethiopia today is three times less likely to die before age five than one born in 1990, this reduction is not enough,” Dr Tessema said.

“We are still losing unacceptably too many young lives from preventable causes, such as neonatal disorders, diarrhoeal diseases and respiratory infections.”

Dr Tessema called for a concerted effort to improve the standard of care across Ethiopia, particularly in regions with predominantly rural and pastoralist communities, where both services and reporting mechanisms are sub-standard.

“We need a global investment and more domestic financing in strengthening essential obstetric, neonatal care and other child-focused services to ensure the hard-won gains in fighting child mortality and supporting Ethiopia’s most vulnerable families are not lost.”

The United Nation’s Sustainable Development Goals set targets to reduce the death rate for under-five-year-olds to 25 per 1000 livebirths and reduce neonatal death rate to 12 per 1000 by 2030. With Ethiopia’s mortality rates two and three times those figures, the country is unlikely to reach those targets.

Given the study uses data prior to the COVID-19 pandemic and the recent civil war in the country, Dr Tessema warned the current figures could be higher, suggesting the need for urgent study.

“Ethiopia is yet establishing vital registration system and has a historical lack of reporting due to cultural and other reasons, particularly in its predominantly pastoralist communities regions,” Dr Tessema said.

“This study highlights the urgent need to improve the accuracy of regional estimates, so accurate data can be used to guide both support and policy decisions.”

Curtin University, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine, the Ethiopian Public Health Institute, and Ethiopia Child Mortality Collaborators worked together as part of the Global Burden of Disease (GBD) 2019 Study. They examined data across nine administrative regions and two chartered cities in Ethiopia.

Published in PLOS Global Public Health, the research ‘National and subnational burden of under-5, infant, and neonatal mortality in Ethiopia, 1990–2019’ is available online here:

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