The Drop in Child Mortality Over the Past 200 Years Has Been Amazing

Yesterday I blogged about the work being done by the Bill and Melinda Gates Foundation to reduce child mortality and increase contraceptive use in developing countries. In their letter, they used a graph from The Economist showing the drop in child mortality over time. Perhaps not coincidentally, Max Roser of Oxford recently also produced a graph of the amazing drop in child mortality occurring over the past 200 years.

In 1800, more than 400 out of every 1000 children born alive in the world died before reaching their fifth birthday. Now it about 40 out of 1000. The drop has been especially noticeable since the end of WWII as death control technology spread to developing countries. Melinda Gates noted in her separate commentary in Fortune yesterday that she had been particularly moved by the women she met in her travels who were happy that their children were surviving, but were now wondering how they could cope financially with more children. They needed help, and the Gates Foundation is working to provide assistance. 

I had a similar experience back in 1984 when I went to Zimbabwe as part of a USAID funded project to help the newly organized Zimbabwe National Family Planning Council (ZNFPC) create a computerized database to track its activities in rural areas of that country. The child mortality rate had dropped to about 100 deaths per 1000 babies born, but the total fertility rate was still nearly 7 children per woman. The director of the ZNFPC was Esther Bohene, twin sister of the wife of Robert Mugabe, who at the time was in the early years of his presidency after Zimbabwe had gained its independence. She was Ghanaian (because Mugabe had been in exile in Ghana prior to the country's independence) and she and her sister were very popular. I spent a considerable amount of time at the main family planning clinic in Harare, hearing the stories of women who wanted to know how to avoid an unwanted pregnancy, as well as the stories of women who wanted to know how to have another child in order to keep their husband happy. Gender inequality was, and still is, a big issue, as I learned from my meetings with Dr. Marvelous Mhloyi, Professor of Sociology at the University of Zimbabwe, who had recently obtained her PhD in Demography from the University of Pennsylvania. She is still active in the pursuit of women's rights in Africa. And, of course, a key right relates to access to reproductive health care. The child mortality rate in Zimbabwe is now down to 70 per thousand (compared to 6 in the U.S.), but the birth rate remains stubbornly high at 4 children per woman. There is still a lot of work to do...