Lao PDR

Millennium Development Goal 4

Reduce Child Mortality

Nationally, Lao PDR's child mortality indicators are improving satisfactorily. The under-five mortality rate declined from 170 to 98 per 1,000 live births, and the infant mortality rate from 104 to 70 between 1995 and 2005. At this rate, the 2015 MDG mortality targets seem within reach, although mortality rates are much higher in rural areas, particularly in the most remote districts.

However, the progress in mortality indicators is not matched by equally steady progress in immunisation of one-year-old children against measles. Until 2007, the proportion of children immunised remained more or less constant, at around the low proportion of 69 percent.

While the recent measles immunisation campaign reached more than 95 percent of the target group following a concerted mobilisation of high-level political support and resources, the challenge now is to make necessary institutional changes to sustain this success.

A cause of concern is found in the child malnutrition figure, which has remained around the 40 percent 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 who 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 obtain an overall perspective on the state of child health in Lao PDR, it is important to view the progress in overall child mortality against progress in inter-related indicators such as immunisation, 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 must 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. Again, this needs to be done in a way that benefits all people regardless of their geographic location, gender or wealth.

See the indicators for MDG 4

Update from the 2010 UNDP report Beyond the Midpoint: Achieving the Millennium Development Goals:

Infant and child mortality rates have declined significantly, but immunization coverage needs to be increased, particularly in rural areas. A lack of awareness, information and infrastructure present significant barriers, but the government is committed to maintaining progress.