Country-level causes of child mortality

Only a small fraction of child deaths occur in countries with complete civil registration of deaths and their causes, and, despite efforts by the Health Metrics Network and others, complete and accurate civil registration of deaths will not be available in many countries for years to come. Some countries have partial civil registration, e.g., in some urban areas or in selected surveillance sites, sometimes even a nationally representative sample. In addition, many countries have information on causes of child deaths in hospitals, in demographic surveillance areas, or in study populations. This activity seeks to develop a methodology to link health-facility information with community-based data from the same catchment area, to expand estimates of cause-specific mortality at a national level, as well as to improve global and regional estimates of the causes of child mortality. 

Methods and Expected Products

This activity will be carried out by country teams assisted by CHERG, in coordination with others. At the global level, a CHERG working group, in consultation with The Bill & Melinda Gates Foundation, WHO, UNICEF and others, will select countries for the work based on certain criteria, including national interest and expertise, opportunity to obtain or collect data, and potential contribution of the results to national initiatives and to regional or global evidence on causes of child mortality, including recent trends. This work is being conducted in India, especially the five high-mortality northern states, because of its very large contribution to global child deaths, as well as up to six countries in sub-Saharan Africa where child survival interventions are being accelerated such as Ethiopia, Mozambique or Malawi. Several of these countries also offer opportunities for additional data collection on causes of death because they will be employing new techniques for monitoring child mortality and for program impact evaluation. The country working groups, in collaboration with CHERG, will develop national estimates of the causes of child mortality and make these widely available in reports and peer-reviewed publications both in country and outside. These results will also be used by CHERG to improve and make more timely estimates of sub-regional and global causes of child deaths. It is expected that national estimates will be developed by December 2010.

Related Publications

Hsiao M, Morris SK, Bassani DG, Montgomery AL, Thakur JS, Jha P. Factors associated with physician agreement on verbal autopsy of over 11,500 injury deaths in India. PLoS One. 2012;7(1):e30336.

Jagnoor J, Suraweera W, Keay L, Ivers RQ, Thakur J, Jha P. Unintentional injury mortality in India, 2005: Nationally representative mortality survey of 1.1 million homes. BMC Public Health. 2012 Jun 28;12(1):487. 

Montgomery AL, Morris SK, Bassani DG, Kumar R, Jotkar R, Jha P. Factors associated with physician agreement and coding choices of cause of death using verbal autopsies for 1130 maternal deaths in India. PLoS One. 2012;7(3):e33075. 

Morris SK, Bassani DG, Kumar R, Awasthi S, Paul VK, Jha P. Factors associated with physician agreement on verbal autopsy of over 27000 childhood deaths in India. PLoS One. 2010 Mar 8;5(3):e9583. 

Waiswa P, Kalter HD, Jakob R, Black RE for the Social Autopsy Working Group.Increased use of social autopsy is needed to improve maternal, neoantal and child health programmes in low-income countries. Bull World Health Organ (editorial) 2012;90:403-403A.

Zhang JSF. Efficacy and effectiveness of 20 child health interventions in China: systematic review of Chinese literature. J Global Health 2011. 1(1): 87-95.

Social, economic, political and health system and program determinants of child mortality reduction in China between 1990 and 2006: A systematic analysis. Feng XL, Theodoratou E, Liu L, Chan KY, Hipgrave D, Scherpbier R, Brixi H, Guo S, Chunmei W, Chopra M, Black RE, Campbell H, Rudan I, Guo Y. (2012). J Glob Health. 2 (1): 010405.

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. Edmond KM, Kortsalioudaki C, Scott S, Schrag SJ, Zaidi AK, Cousens S, Heath PT. Lancet. 2012 Feb 11;379(9815):547-56. Epub 2012 Jan 4.

Hipgrave, David (2011). Communicable disease control in China: From Mao to now. J Glob Health. 1 (2): 224–238.

Capturing the context of maternal deaths from verbal autopsies: a reliability study of the maternal data extraction tool (M-DET). Montgomery, Ann L, Shaun K Morris, Rajesh Kumar, Raju Jotkar, Prem Mony, Diego G Bassani, Prabhat Jha (2011).  PLoS One. 6(2): e14637. 

Diarrhea, Pneumonia, and Infectious Disease Mortality in Children Aged 5 to 14 Years in India. Morris, Shaun K, Diego G Bassani, Shally Awasthi, Rajesh Kumar, Anita Shet, Wilson Suraweera, Prabhat Jha, for the MDS Collaborators (2011). PLoS ONE 6(5): e20119.

Unintentional injury deaths among children younger than 5 Years of age in India: a nationally representative study. Jagnoor, Jagnoor, Diego G Bassani, Lisa Keay, Rebecca Q Ivers, JS Thakur, G Gururaj, Prabhat Jha, for the Million Death Study Collaborators (2011). Inj Prev. 17(3): 151-155.

Causes of neonatal and child mortality in India: a nationally representative mortality survey. (2010). The Million Death Study Collaborators. The Lancet, 376(9755): 1853-1860.  

Estimating the distribution of causes of death among children age 1–59 months in high-mortality countries with incomplete death certification. Hope L Johnson, Li Liu, Christa Fischer-Walker and Robert E Black International Journal of Epidemiology, Advanced Access: doi:10.1093/ije/dyq074.

Global, regional, and national causes of child mortality in 2008: a systematic analysis.The Lancet (online), 12 May 2010. Robert E Black, Simon Cousens, Hope L Johnson, Joy E Lawn, Igor Rudan, Diego G Bassani, Prabhat Jha, Harry Campbell, Christa Fischer Walker, Richard Cibulskis, Thomas Eisele, Li Liu, Colin Mathers, for the Child Health Epidemiology Reference Group of WHO and UNICEF.

Causes of deaths in children younger than 5 years in China in 2008. Rudan I, Chan KY, Zhang JS, Theodoratou E, Feng XL, Salomon JA, Lawn JE, Cousens S, Black RE, Guo Y, Campbell H; on behalf of WHO/UNICEF's CHERG.  The Lancet. 2010 Mar 27;375(9720):1083-9.
«Supplemental Information: List of Studies»  

Julia Kaufmann
Julia is 34 years old and has studied nutritional sciences. She specializes in nutrition, health and fitness. To this end, she passionately analyzes the new trends in nutritional supplements, evaluates them under the strictest regulations and does her best to help other people feel better about life.


Please enter your comment!
Please enter your name here