Declining child mortality in northern Malawi despite high rates of infection with HIV

This brief paper investigates whether the decrease in Malawi’s under-5 mortality rates in recent years was tangible or was it that previous surveys underestimated these rates. Furthermore, the paper focuses on HIV infection, seeking to determine its exact role in Malawian children’s mortality.

The document states that under-5 mortality rate in Malawi was one of the highest rates in southern Africa, and was 85 per 1000 births during the period from 2002 to 2006, according to statistics from the  Demographic Surveillance System (DSS). However, this figure is considerably lower than estimates from the 2004 Demographic and Health Surveys (DHS). In this context, the authors think that the relatively low mortality rates measured in the DSS are likely to be accurate, and suggest that the 2004 DHS estimates were probably influenced by misclassification.

Moreover, in terms of HIV infection, the paper points out the following findings:

• HIV infection had a considerable impact on child mortality, with approximately 11, 15 and 20 out of every 1000 children born dying from AIDS by age 2, 5 and 15 years respectively
  
• yet, the relative impact of HIV infection on child mortality depends on the background level of mortality from other causes
• given the high stable prevalence of HIV infection since the late 1990s in Malawi, the sustained decrease in mortality can only be explained by an accelerated decline in mortality from other causes.
  

The authors conclude that the relatively low rates of mortality, as DDS statistics indicate, are encouraging. Nevertheless, it is clear that this area of Malawi still needs to achieve further reductions in child mortality in order to meet its MDGs target.