Key challenges in meeting MDG 4: Reduction of child mortality

Abstract

Most of the articles in this issue are related to child, infant and neonatal health which are embodied in the Millennium Development Goal (MDG)4 (reducing under –five mortality rate by two-thirds, between 1990 and 2015). MDG4 is measured using three important indicators: under-five mortality rate, infant mortality rate and proportion of infants immunized against measles (1). The inclusion of the latter indicator shows the strong correlation between immunization coverage and child survival and the fact that vaccinating children through increasing access to services contributes to reductions in infant mortality rate. As this indicator measures measles coverage, it can serve as a proxy indicator of other immunization services as well as of how well primary health care services are available and functioning in developing country set up (2, 3). Strength in this intervention
indicates programmatic contributions to reductions in under-five mortality which often is disproportionately high among lower age groups. When an immunization program is not strong and coverage is low, thenumber of susceptible children under five
accumulates favoring conditions for the occurrence ofmeasles outbreak. One of the papers in this issue has reported a high case fatality rate (13.4%) among children under five in a district in Ethiopia due to measles outbreak where the case fatality rate was even higher among infants (33.3%) (4).