The gap in the childhood mortality rate between poor and wealthy households in developing countries has narrowed, according to a recent study by the Stanford University School of Medicine. The study suggests that the reconciliation is due in most part to a reduction of child mortality in poorer households, stating that there has been a dramatic decrease in the under-five mortality rate in the poorest households in developing regions since 2002. The average was a decline of 4.36 deaths per 1000 live births.

Reducing child mortality rates is part of the Millennium Development Goals that were presented in the UN Millennium Declaration in 2000. Childhood mortality in developing regions is caused by a number of factors, including pneumonia, malaria, sepsis and prematurity.

The study at Stanford, published in Pediatrics, shows a correlation between the countries that had a narrowing gap between poor and wealthy child mortality rates and the quality of governance of the country. It states that countries that were governed poorly often saw a widening gap, while countries with good governance saw a narrowing gap. Governance was measured by government effectiveness, rule of law, control of corruption and regulatory quality.

The study compared almost one million households in 54 developing countries. Households were classified based on a holistic, not monetary, approach to more accurately portray the gap. The categories for households were poorest, middle and wealthiest.

One particular finding of this study could have repercussions for foreign aid in developing regions. It shows that aid is effective in reducing the under-five mortality rate for countries with good governance and that the aid is reaching the right people; according to Davidson Gwatkin, “[The study] makes a persuasive case that these improvements [in child health] have often begun to benefit the poor even more than the better-off.”

However, in countries with poor governance, aid has not made the necessary impact. Eran Bendavid, the researcher on the study, says that even with the development of technology and infrastructure that helps reduce under-five mortality, bad governance can create too high a barrier for foreign aid to jump.

The study might also have implications for policy makers in public health. Health equality could become a priority and stipulation for foreign aid going towards public health efforts in developing regions. Bendavid says that an increase in health inequality as countries grow has “been a signature of our time” and is of concern to nations of all levels of development.

– Caitlin Huber

Sources: World Bank, Stanford University, Medical News Toda
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