The development route for the countries of Africa, Asia and Latin America used to be unquestioned concentration on economic growth. It assumed a healthy labour force enthusiastically committed to meeting the planners’ targets. Ignored were life expectancy figures showing the ill health of so much of the population - see below.
In the last few years, the emphasis has been less on growth and more on a fairer sharing of national wealth, a provision of education for all children, and thebuildingof communities based on the active participation of all the inhabitants.
Such development presumes, even more than the old pattern, a physically healthy and mentally energetic people. It demands a pool of human energy that is no more than a mirage in countries where life expectancy is short and illness common.
Life expectancy figures have to be regarded with care, particularly when they are low. For the largest cause of such low figures would be the large number of deaths in infancy (0-12 months old) and early childhood (1 year to 4 years old). Although Ethiopia and the Yemen have an average life expectancy of 35-39 years, the life expectancy of a youth who has survived to 15 years of age is much longer.
Mothers and small children are the most threatened by ill health. The World Health Organisation has pointed out’ that of the world’s population of 4,219 million in 1978, 24% were women of reproductive age and 36% were children. National investment in preventative health measures to protect these vulnerable groups-providing adequate clean water, better sanitation, thorough immunization campaigns and adequate nutrition - would bring the most dramatic rises in life expectancy. Indirectly it would also boost national development efforts.
The improvement in lifeexpectancy in nearly all the developing countries in the last twenty years is one of the great success stories of development. It has been primarily due to sweeping immunization campaigns and some improvements in nutrition. Nevertheless, of the 122 million infants born in 1979, more than 10% will die before they are one year old and another 4% before they are five. The risk of dying before reaching adolescence is unevenly distributed, being about 1 in 40 in developed countries increasing to 1 in 4 in Africa.
*Maternal and Child Health - Report by the Director General’World Health Organization 1979
Mother and child
The biggest cause of death in this most vulnerable group is poverty. There are striking differences in the infant mortality figures according to the means, or lack of them, of the parents. Even in the industrialised world, unequal distribution of wealth means there are pockets of high infant mortality in the poorer regions and amongst the most deprived. Between count ries,contrast in mortality figures is stark (see panel ‘Survival of the Richest’).
The same figures also underline the 1980 State of the World Population Report (UNFPA) which points out that the ‘lower the death rate, the greater the likelihood of the population growth rate falling’. This seeming paradox is explained by parents who - where infant mortality rates are high - will have many children to make sure some will survive to adulthood. Where the death rate for infants is low then the birth rate will drop, parents being confident that their children will survive.
The strict cause of infant deaths in the Third World is usually unspecific. It can be an infection. Generally this is the final straw for an infant already weakened by malnutrition. Such weakness presently affects more than 100 million children under five years old - 10 million are affected severely and probably fatally.
The most powerful medicine for a reduction in infant mortality figures and in turn birth rates, would be better nutrition. And more food is only possible when there is the means to buy or grow it.
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