Successes and challenges of under-five child mortality reduction in West Africa

Abstract

Background: Under-five mortality rate is an important index for assessing achievements by countries and thus its targeted reduction is adopted as benchmark towards realizing the Millennium Development Goal number
4 by 2015. With less than 24 months to the deadline, West Africa still contributes significantly to the global burden of child mortality, with over half of the deaths caused by infections.

Objective: To review the successes and challenges of reducing
under-five mortality in West Africa.

Sources: A search was made in Pub Med and Google Scholar using the key words: Under-five, Children, Mortality, West Africa, Successes, Progress, Achievements and Challenges. Relevant publications and reports available
at WHO, UNICEF and UN websites were also consulted. Tables and charts were drawn from relevant data for West African Countries obtained from these sources using Microsoft® Excel® for Mac 2011 Version 14.1.0
(110310).

Results: Although significant under-five death reductions have been  recorded in countries of West Africa between 1990 and 2012, the reduction falls far short of the expected targets and infections still remain the leading causes of death. In spite of a fivefold rise of average annual rate of reduction of under-five deaths compared to a 3-fold rise of the global average and a 49.7% reduction in under-five mortality rate, the sub-region trails behind other parts of Africa. While only Liberia achieved the MDG 4 target, Niger, Cape Verde, Gambia, Guinea and Burkina Faso are on track. Nigeria’s huge child population, high under-five mortality burden and slow reduction, weighs down the sub-region’s averages. Neonatal death  proportions are rising, with four countries ranking amongst the world’s top ten. With less than 24 months left, the likelihood of achieving the reduction targets for under-five mortality in most of the countries in the sub-region by the end of 2015 remains a mirage.

Conclusion: Numerous daunting challenges have contributed to slow the pace of under-five death reduction in West Africa. Countries in the sub-region need to address their challenges while scaling up proven interventions to accelerate progress towards further reductions of under-five deaths.

Key words: Children, under-five, mortality, West Africa, progress, successes, achievements, challenges