Child survival in East Africa: The impact of preventive health care

Abstract

Since the mid-1980s or earlier, several East African countries have experienced constant or rising child mortality rates concurrent with social and biomedical improvements of the “Child Survival Revolution”. This study examines whether preventive primary health care enhanced early child survival in the late 1980s and early 1990s in five East African countries. Child mortality rates were considerably lower than they would have been in the absence of specific immunizations, access to safe drinking water, fertility regulation, and frequent antenatal care visits. There was, however, substantial missed opportunity for mortality decline as a result of insufficient use of preventive measures. In particular, universal immunization across these countries could have reduced rates of mortality under age two by as much as one-third. Continued pursuit of the goals of the World Summit for Children appears essential to offset macroeconomic and growing epidemiological constraints to child survival in the region.