African Future, 13 November - A new study looking into Uganda's high child mortality rate concludes that the "vast majority" of under-five children deaths are easily preventable, only needing relatively low-expense prevention programmes.

The "2007 Uganda Child Verbal Autopsy Study", just released by the US agency Measure DHS and the Uganda Bureau of Statistics, documents grave failures by the Ugandan health sector to address the country's high child mortality rates. Most could have been saved by easy, low-cost means.

"The large majority of deaths to children under age 5 in Uganda are caused by diseases that are easily prevented," the study concludes. The leading causes of death in children under-five years in Uganda were found to be malaria, perinatal and early neonatal conditions, meningitis, pneumonia, and HIV/AIDS.

The overwhelming majority - 77 percent - of deaths in the first month of life are due to perinatal and early neonatal conditions, while most deaths to older children are due to malaria. Malaria accounts for 41 percent of deaths in the age group from 29 days to five years. Meningitis (11 percent) and pneumonia (10 percent) were found to be the second and third main causes of death in the same age group.

Half of children under-five who died, had died at home; only 39 percent died in health facilities, the study found. Especially in Uganda's rural areas, most children die at home.

Four out of five children who died had received some form of treatment or care for the illness that led to death. Almost all of these children received care from the formal health sector, including government and private hospitals and health centres. It is a paradox that the resources spent on failing to save the lives of these already ill children probably would have reached a long way in preventing the diseases they died from.

The report also concludes that, "the vast majority of deaths to children under five are caused by diseases that are addressable through cost-effective prevention programmes, such as use of insecticide-treated bed nets or childhood vaccinations." Experiences from other African countries demonstrate these prevention measures to be both cheap and effective.

John Male-Mukasa, Executive Director of the Uganda Bureau of Statistics, underlines that the findings of the study "are very important for measuring the impact of malaria on child death" and expressed hope that the study would be "widely disseminated at the various levels of administration within the country."

Mr Male-Mukasa, in addition to emphasise the study's importance to Ugandan decision-makers, noted that ground-breaking work had been done in the country.

"Since the vast majority of children in Uganda do not die in health facilities, information on causes of death established by health professionals is generally not available," Uganda's chief statistician noted. "Death certificates are almost nonexistent and those that are available are not representative of the entire population. It was therefore deemed necessary to conduct the Uganda Child Verbal Autopsy Study to meet this objective," he added.

Uganda's infant mortality rate remains at a high 66 deaths for each 1,000 live births. Around 130 out of 1,000 children die before reaching the age of five years.

By staff writer

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