title: Counting the cost of child mortality in the World Health Organization African region.
abstract: BACKGROUND
  Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is "by 2030, end preventable deaths of new-borns and children under 5 years of age". There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all the basic needs for a healthy population. The specific objective of this study was to estimate expected/future productivity losses from child deaths in the WHO African Region in 2013 for use in advocacy for increased investments in child health services and other basic services that address children's welfare.
  
  
  METHODS
  A cost-of-illness method was used to estimate future non-health GDP losses related to child deaths. Future non-health GDP losses were discounted at 3 %. The analysis was undertaken with the countries categorized under three income groups: Group 1 consisted of nine high and upper middle income countries, Group 2 of 13 lower middle income countries, and Group 3 of 25 low income countries. One-way sensitivity analysis at 5 % and 10 % discount rates assessed the impact of the expected non-health GDP loss.
  
  
  RESULTS
  The discounted value of future non-health GDP loss due to the deaths of children under 5 years old in 2013 will be in the order of Int$ 150.3 billion. Approximately 27.3 % of the loss will be borne by Group 1 countries, 47.1 % by Group 2 and 25.7 % by Group 3. The average non-health GDP lost per child death will be Int$ 174 310 for Group 1, Int$ 57 584 for Group 2 and Int$ 25 508 for Group 3.
  
  
  CONCLUSIONS
  It is estimated that the African Region will incur a loss of approximately 6 % of its non-health GDP from the future years of life lost among the 2 976 000 child deaths that occurred in 2013. Therefore, countries and development partners should in solidarity sustainably provide the resources essential to build resilient national health systems and systems to address the determinants of health and meet the other basic needs such as for clothing, education, food, shelter, sanitation and clean water to end preventable child morbidity and mortality.
authors.affiliation: Research, Publications and Library Services Programme, Health Systems and Services Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo. kirigiaj@who.int.
authors.forename: Joses M
authors.initials: JM
authors.lastname: Kirigia
authors.affiliation: Department of Psychology, United States International University (USIU), Nairobi, Kenya. karimimuthuri@ymail.com.
authors.forename: Rosenabi Deborah Karimi
authors.initials: RD
authors.lastname: Muthuri
authors.affiliation: Health Systems and Services Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo. nabyongaj@who.int.
authors.forename: Juliet
authors.initials: J
authors.lastname: Nabyonga-Orem
authors.affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya. dkirigia@kemri-wellcome.org.
authors.forename: Doris Gatwiri
authors.initials: DG
authors.lastname: Kirigia
mesh_terms: D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D002648:Child; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D003247:Conservation of Natural Resources / Q000191:economics* / Q000639:trends; D017281:Cost of Illness; D005260:Female; D005544:Forecasting; D014943:Global Health / Q000191:economics*; D006801:Humans; D007223:Infant; D008297:Male; D009017:Morbidity; D011203:Poverty; D014944:World Health Organization