December 19, 2016
China’s rapidly declining child mortality rate largely due to reductions in deaths caused by infectious diseases and injuries
National and subnational all-cause and cause-specific child mortality in China, 1996–2015, The Lancet Global Health
A new study found that China’s under-5 child mortality declined by 80% over the past two decades. Nationally, mortality rates declined from 50.8 per 1,000 livebirths to 10.7 per 1,000 livebirths between 1996 and 2015. The study, published today in The Lancet Global Health, was led jointly by researchers from the Johns Hopkins Bloomberg School of Public Health and the China National Office of Maternal and Child Health Surveillance.
The decline in under-5 deaths could be attributed largely to reductions in deaths caused by injuries and infectious diseases, including pneumonia and diarrhea. Declines in mortality rates were seen across regions, age groups, and cause-of-death categories. Great disparities, however, still exist. The Western region and rural areas lag far behind other regions and urban areas. They, therefore, should receive more attention to improving child survival through enhanced policy and programs. Furthermore, continued investment in primary and secondary prevention of deaths is crucial for reducing deaths due to congenital abnormalities and preterm birth complications, the two leading causes of deaths among children under-5 in China.
- At the national level, the under-5 mortality rate fell by nearly 80% during the past two decades, from 50.8 deaths per 1,000 livebirths in 1996 to 10.7 per 1,000 livebirths in 2015–with an annual rate of reduction at 8.2% per year.
- In 2015, 181,600 children died before the age of 5 in China, with 93,400 (51.5%) occurring in the neonatal period.
- In 2015, the leading causes of death for children under-5 years old were complications due to congenital abnormalities (19.7%, 35,700 deaths), preterm birth complications (17.0%, 30,900 deaths) and injuries (14.6%, 26,600 deaths).
- From 1996 to 2015, major infectious diseases, such as pneumonia and diarrhea, accounted for a rapidly declining proportion of under-5 mortality, with an annual rate of reduction of greater than 10% at the national level and across regions. The proportion of deaths caused by congenital abnormalities showed the steepest increase, from 9% to 20%.
- The cause-of-death composition varied across age groups. The contribution of preterm birth complications to mortality decreased after the neonatal period; congenital abnormalities remained an important cause of mortality throughout infancy, whereas the contribution of injuries to mortality increased after the first year of life.
- The rural area of the Western region is the only region-residency stratum with an infectious disease (pneumonia) as the leading cause of death.
National and subnational all-cause and cause-specific child mortality in China, 1996-2015: a systematic analysis with implications for the Sustainable Development Goals, was written by Chunhua He, Li Liu, Yue Chu, Jamie Perin, Li Dai, Xiaohong Li, Leni Kang, Qi Li, Robert Scherpbier, Sufang Guo, Igor Rudan, Peige Song, Kit Yee Chan, Yan Guo, Robert E Black, Yanping Wang and Jun Zhu, and was published online on The Lancet Global Health, November 19, 2016. doi: 10.1016/ S2214-109X(16)30334-5
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