The growing pains of South Asia’s children

Under-5 mortality rate

Seven Million South Asian r children under the age of five died in 1990. In 2000 the figure had declined to about 3 million. However, the overall improvement in the statistical aggregate for South Asia conceals wide geographical disparities, with the gains made being lagely confined to some areas. The trends suggest that the gap between countries has narrowed considerably over the last 40 years. As the graph indicates, Afghanistan has shown no significant progress, which is perhaps inevitable in a country that has seen sustained civil and military conflict for the last 20 years. Sri Lanka on the other hand has posted very encouraging results.

Sandwiched between the two, the other South Asian countries occupy a narrow band, registering on average between 90 and 130 under-5 deaths per 1000 live births. But the average, like the aggregate, is deceptive. Central, western and south-western Pakistan and parts of central India account for the high intra-country variations in the magnitude of incidence. Mortality figures here are at par with the levels in Afghanistan, where mortality exceeds 130 children for every 1000 live births. The regions with high under-5 mortality also have high fertility rates. Women in these areas tend to bear, on average, more than four children per head, going as high as six children in some areas. This geographical coincidence of high mortality and high fertility has serious policy implications. Institutional intervention in these areas must target both mortality and fertility simultaneously if adverse demographic consequences are to be avoided.