Child Mortality Basing on Argentina - Essay Example

? MDG 4: Argentina Case Study Introduction In 2000, the sometimes maligned United Nations established eight noble goals to address the most pertinent issues facing the contemporary world. These Millennium Development Goals (MDGs) following the resolutions of 191 UN member states committing to address extreme poverty, disease, hunger, illiteracy, degradation of the environment and gender discrimination with the details provided by the 18 targets spread among the eight MDGs to be achieved by 2015 (UN 2012). The MDGs have helped govern local, national and global efforts to meet the needs of the world’s poorest. However, with only three years to go for most of the targets, crucial questions about the achievability of the MDGs arise. Importantly, there is a need for appraisal on what has already been achieved, the successes and challenges and what remains to be done (Hulme and Scott, 2010, p. 293). One of the ways of establishing this is through focusing on one of the MDGs and a given case study. This study selects one of the most important indicators of achievement: child mortality addressed by MDG 4, basing on Argentina. This paper holds a strong position that despite a variety of challenges, Argentina can achieve and surpass the targets of MDG 4. Definition of Key Terms and Concepts The following are the key terms and concepts which understanding is of importance for a meaningful discussion: Infant Mortality Rate: This is the probability of death between the time of birth and the age of one year per 1000 of children born alive. This also serves as an important indicator of socioeconomic conditions in a given country besides relating with important health considerations such as maternal health and malnutrition (Steiner, 2006, p. 41). Millennium Development Goals: These are a framework to plan and implement global development, including time-bound targets and goal-oriented indicators by which development progress is measured over the period from 1990 until 2015 (CEPAL Organisation, 2008, p. 3). Under-five Mortality Rate: This is the number of children per 1,000 children born alive who will die before reaching five years old. It is an important indicator of the socioeconomic development in a country as it refers to the probability per 1,000 that a newly born will die- if subject to current age-specific mortality rates before age five (CEPAL Organisation, 2008, p. 1). Background: An Overview of the MDGs UN member countries, after lengthy considerations, signed the eight MDGs in 2000 (UN 2012). The first goal addresses the eradication of extreme poverty and hunger through seeking to halve the proportion of people earning less than a dollar a day and halve the proportion of people suffering from hunger between 1990 and 2015. The second goal is concerned with the achievement of universal primary education by 2015. The third goal seeks to promote gender equality and empower women in the society. MDG 4, the focus of this study, aims to reduce under-five child mortality by two-thirds between 1990 and 2015. MDG 5 concerns the improvement of maternal health indicated by reduction in the maternal mortality ratio (UNFPA, 2006, p. 249). Goal 6 addresses the combating of HIV/AIDS, malaria and other major diseases. The seventh goal addresses the problem of environment degradation. Lastly, the eight MDG seeks to promote global partnership for development. The eight MDGs, thus, effectively cover probably the most important considerations in people’s livelihoods in the modern society. MDG 4 in Argentina MDG 4 Overview MDG 4 is concerned with the reduction of child mortality in the world. The timeline for the goal is achievement by 2015 like all other MDGs, with the target being a reduction by two-thirds, between 1990 and 2015 of the under five mortality rate; the infant mortality rate; and the proportion of one year old children targeted for immunisation against measles. This is well captured in the table below: Table 1: MDG 4 and its targets (Source: Alliance Organization, 2009). According to UNICEF (2007), MDG 4 is an important goal as millions of children pay the price when it is not achieved. The UNICEF findings established that by 2007, only 82 out of the 147 member states of the UN categorised as developing countries were on track to achieve MDG 4. Out of the remaining, 27 countries had made no progress at all, with some instead retrogressing on infant mortality rate indicators. The UN (2010) confirms the shortfall, observing that the progress made so far in reducing infant mortality is a drop from 99/1000 in 1990 to 72/1000 in 2008. This represents only a 28% reduction, clearly off the two-thirds target. The UNICEF (2007) report also establishes that the root cause of high infant mortality rates is poverty, thereby showing the link between the MDGs. The explanation behind this is that children in poorer countries are more likely to be exposed to contaminated water, poor housing, infectious diseases and malnourishment. According to the report, the major causes of infant mortality are pneumonia, diarrhoea and malaria (malaria is more profound in sub-Saharan Africa). Pneumonia and diarrhoea, however, are global causes of child mortality including in places such as Argentina. The Situation in Argentina The most recent data on the national average for the under five mortality rate is 13.80 per 1000 births as of 2010 (Index Mundi-Argentina, 2012). There has been a gradual drop in terms of under five mortality rates in Argentina from the high of 74/1000 to the 13.80/1000 reported above. The following graph shows the decline in under five mortality rates since 2000, the year the MDGs were instituted: Table 2: The gradual decline in Under-Five Mortality Rate in Argentina Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Under Five Mortality Rate 20.7 19.8 19 18.2 17.4 16.7 16 15.3 14.7 14.1 (Source: Index Mundi-Argentina 2012). However, concern about regional disparity on the child mortality rates exist in Argentina, with Help Argentina (2007) observing that the Northern Provinces of Argentina bear higher child mortality rates; Formosa, Catamarca, Chaco and Tucuman have rates of 25.1%, 22%, 21.3% and 20.5% respectively. In terms of the second criterion for MDG 4, Argentina has an infant mortality rate of 10.52 deaths per 1000 live births, of which males have 11.76/1000 and females have 9.22/1000 as of 2011 (CIA World Factbook 2012). The table below presents the gradual decline per five years since 1990, the base year for MDG 4: Table 3: Gradual decline in Infant Mortality Rates in Argentina since 1990 Year 1990 1995 2000 2005 2010 Infant Mortality Rate 25 23 19 15 12.30 (Source: Index Mundi-Argentina 2012). The main causes of child mortality in Argentina include malnutrition which Help Argentina (2007) cites at 8% in 2005 basing on UNICEF reports. Valente (2009) reports lack of clean water and environmental pollution resulting from industrial wastes and use of agricultural pesticides. The lack of water results in deadly diseases for children, with Galiani, Gertler and Schargrodsky (2003, p. 2) noting that diarrhoea, gastrointestinal infections and septicaemia associated with clean water scarcity are among the top ten causes of under-five child mortality in Argentina. Augustovski, Garcia, Pichon-Riviere and Debbag (2009, pp. 423-430) present their findings from a study that shows that childhood pneumococcal disease (PD) is one of the heaviest burdens in Argentina. The next consideration is in terms of the proportion of 1 year old children immunised against measles. Here, Argentina has achieved and even surpassed the target set among the Latin America and Caribbean countries of 90% by 2010 coverage against measles. Argentina had about97% coverage as of 2006 as shown in the figure below: Proportion of 1 year old children immunised against measles in the LAC (Latin and Caribbean Countries) region (Source: CEPAL Organisation, 2008, p. 6). Progress made in Argentina in terms of MDG 4 Despite various challenges, Argentina has made commendable progress in MDG 4 as summarised by the following graph: Under-five Mortality Rates in Argentina since 1960 (Source: World Bank, 2012). As the graph above indicates, Argentina has a history of high under-five mortality rates realised with the first set of reliable data collected. The country experienced declines in under-five mortality rates form the 1970s, falling steeply through the 1980s. The decline since 1990, the base year for MDGs considerations has been gradual, seeing a fall in 26.9/1000 in 1990 to 13.8/1000 in 2010. In terms of achievement of the reduction of in child mortality, the UNDP (2010) classifies Argentina as having achieved this overall target in MDG 4. As shown in the figure below, MDG 4 is one of only two MDGs that Argentina had as of 2010 achieved: Figure 1: Achievement of MDG goals in Argentina (Source: UNDP, 2010, p. 1). Upon breaking down MDG 4 into its component targets, the following considerations are realised; the overall goal of reducing child mortality has been achieved; reduction of the under five mortality rate is being achieved at a fast pace; the reduction in infant mortality rate is being achieved at the first rate; the proportion of 1 year old children immunised against measles has been achieved; and lastly, other considerations determining child mortality rates have been achieved (UNDP, 2010, p. 3). This information is represented in the figure below: Indicators of Success and Challenges in the Achievement of MDG 4 The achievement of an infant mortality rate of 10.52 deaths per 1000 live births in Argentina is a mark of significant success in MDG 4. This is as a result of implementation of high impact and low cost primary care; oral-rehydration therapies; encouraging breastfeeding and monitoring of healthy children; increased level of education and heightened coverage of basic services (CEPAL Organisation, 2008, p. 4; Etchegoyen and Paganini, 2007, pp. 223-230). These observations are also true for the rest of the LAC region. Hence, the level of success achieved in terms of MDG 4 entails overall progress made towards the other MDGs (Schneider et al., 2002, p. 538). The success achieved in terms of the proportion of one year old under measles immunisation can also not be ignored. Argentina has experienced several challenges in progress towards MDG 4. First, the country has not been able to eradicate or significantly reduce child under-nutrition (CEPAL Organisation, 2005, p. 255). This is one of the probable reasons behind the failure to have achieved the two targets of two-thirds reduction in under-five and infant mortality rates. The regional disparities reported in progress towards reduction of childhood mortality in the country (where the Northern provinces lag behind by 6-11 percentage points) are also another challenge derailing the achievement of MDG 4 (Help Argentina, 2007). A further challenge is to keep up with emerging economies when the country’s achievement of MDG 4 is benchmarked to other countries. Whereas the country’s difference between Argentina and developed nations may be expected, Lopez (2010) reports that the mortality rate of Argentina is three times that of Singapore; 89% over Cuba and 35% over Chile. Implications and Critical Analysis The highlight findings of the discussion include the achievement of Argentina in terms of MDG 4. The study shows that Argentina is well on its way to achieve reduction by two thirds of under-five and infant child mortality. Argentina has already achieved the target proportion of 1 year olds under measles immunisation. Overall, the country will have achieved and, at this rate, surpassed MDG 4 by 2015. A look at the strategies that have enabled these results for achievement reveals improvement in primary care, proactive monitoring and penetration of basic services in the society. This implies that MDG 4 is within rich for countries in the developing world upon setting the right policies, improving professional practice and committing towards set targets. Another key establishment is the disparity between Argentina and emerging economies in the world. Here, a number of possible explanations are discerned, including under-nutrition and regional disparities. Thus, countries may avoid such drawbacks and benchmark with other countries in a bid to improve healthcare achievements. This also shows that there is always room for improvement in terms of healthcare provision beyond set targets. Overall, MDG 4 provides an important approach towards addressing health inequities in the world. The achievement of Argentina alongside other members of the Latin and Caribbean region is proof enough that commitment towards MDGs bears desirable results. The findings of this study are reliable due to strengths in data collection; various perspectives and sources of data on the given issues have been used, making the results significantly reliable. The source of weakness in this study is the failure to adequately link MDG 4 in Argentina with the other MDGs – the attempts made are not deemed sufficient. Future research efforts may be directed at investigating the sources of disparity between MDG 4 achievements in a country such as Argentina and in the emerging economies. Conclusion Since their establishment in 2000, MDGs have helped chart the way for countries to tackle the pertinent issues of poverty reduction, disease, hunger, illiteracy, degradation of the environment and gender discrimination. However, the achievement of these MDGs is not automatic as the timeline of 2015 approaches fast. A case study of Argentina’s experience with MDG 4 helps determine the achievement, successes and challenges regarding MDGs. Extensive data is collected from various sources on Argentina’s efforts towards reducing under-five and infant mortality rates by two thirds and proportion of 1 year olds under measles immunisation. After analysis of this data, the position that Argentina can achieve and surpass the targets of MDG 4 is reaffirmed. References Alliance Organization. (2009). Millennium Development Goals (MDGs). Retrieved 4 April 2012 from http://www.alliance2015.org/fileadmin/user_upload/MDGs.pdf Augustovski, F. A., Garcia, M. S., Pichon-Riviere, A., & Debbag, R. (2009). Childhood pneumococcal disease burden in Argentina. Pan American Journal of Public Health, 25(5), 423-30. CEPAL Organisation. (2008). Goal 4: Reduce child mortality. 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