MDG 4: Reduce Child Mortality

Nationally, Lao PDR’s child mortality indicators are improving satisfactorily. The under-5 mortality rate declined from 170 to 98, and the infant mortality rate from 104 to 70 per 1000 live births between 1995 and 2005. At this rate the 2015 MDG mortality targets seem within reach, though mortality rates are much higher in rural areas, particularly in the most remote districts, than in urban areas.

The progress in mortality indicators is not matched by equally steady progress in immunization of 1-year old children against measles. Until 2007, the proportion of children immunized remained more or less constant, at around the low proportion of 69%. While the recent measles immunization campaign reached over 95% of the target group due to a concerted mobilization of high-level political support and resources, the challenge is now to make necessary institutional changes to sustain this success over coming years.

A cause of concern is the child malnutrition figure, which has remained around the 40% mark over the past decade. Insufficient nutrition makes children more vulnerable to communicable diseases such as malaria and dengue fever, acute respiratory infections, diarrhoea and vaccine-preventable diseases such as measles and meningitis, for those children that are not reached by immunisation campaigns. In turn, children who are not reached by essential child health care services are more vulnerable to malnutrition. The fact that child mortality has declined at the same time may be because of increased access to primary health care services such as village drug kits, village health volunteers, medical and preventive outreach services and easy access to antibiotics.

To get an overall perspective of the state of child health in the Lao PDR, it is important to view the progress in overall child mortality against progress in inter-related indicators such as immunization, nutrition, and access to health services. This will help to devise suitable interventions in order to stabilise the positive trend.

Meeting the targets: Most child deaths are caused by neonatal conditions and communicable diseases, in particular malaria, acute respiratory infections, diarrhoea and epidemics such as dengue fever, measles or meningitis. To address this, the government has to tackle some of the more difficult problems, such as ensuring universal access to quality health care and particularly skilled birth attendants, combating malnutrition, and increasing and sustaining immunisation coverage. This, again, needs to be done in a way that benefits all people regardless of their location, gender, ethnic background or wealth.

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