Poverty and child mortality in different contexts: can Mozambique learn from the decline in mortality at the turn of the 19th century in Stockholm?
Child mortality has declined in many low-income countries. However, in Sub-Saharan Africa, childhood mortality is still a major public health problem, which is worsening with some countries experiencing new increases in mortality due to HIV /AIDS. This lack of success in reducing child mortality is not only due to HIV /AIDS, but also to high numbers of deaths in other causes of death such as diarrhoea, pneumonia and neonatal causes, for which there are effective curative and preventative interventions. One problem seems to be in the access, coverage and implementation of these interventions, particularly among the poorer sections of the population. A related problem is the interventions that sometimes, when implemented, take place in environments in which they can only be expected to have limited effects. On the other hand in many developed countries infant and child mortality declined as social and economic changes of modernisation took place. However, the mechanisms that did bring about the decline are still not well understood. This paper discuss whether analyses of the historical decline of mortality in industrialised countries could contribute to knowledge in reducing the high child mortality in poor countries today, based on studies of child mortality in different social contexts in Mozambique 1973-1997 and Stockholm 1878-1925.
Macassa
Gloria
G
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, SE 171 76 Stockholm, Sweden. Gloria.Macassa@phs.ki.se
Burström
Bo
B
D046688:Child Mortality; D002675:Child, Preschool; D006285:Health Planning; D019456:Health Transition; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009073:Mozambique / Q000453:epidemiology; D011203:Poverty; D011634:Public Health / Q000266:history; D012922:Social Change / Q000266:history; D013548:Sweden / Q000453:epidemiology