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TOO MANY BABIES DYING

Unicef: T&T infant and child mortality rates rising

By Anna Ramdass anna.ramdass@trinidadexpress.com

More babies are dying in Trinidad and Tobago despite this country's economic progress and prosperity, according to statistics provided by the United Nations Children's Fund (Unicef).

Unicef's representative for the Eastern Caribbean, Khin Sandi Lwin, in an exclusive interview with the Express at the Carlton Savannah hotel in Cascade, yesterday, said this country needed to determine why babies were dying more than they were some five decades ago.

Unicef, she said, supported the University of the West Indies (UWI) to prepare a situation analysis of children and women in Trinidad and Tobago and the findings of that document confirmed what Unicef had known for a while—that infant and child mortality rates in this country have not improved.

Lwin pointed the Express to a graph in the UWI document which shows that the infant death rate per 1,000 live births was approximately 13 up to 2009.

Noting that data provided by the Central Statistical Office (CSO) on infant mortality rates was not up to date, Lwin pointed to the findings of the Child Mortality Estimates Info (CMO Info)—which is a database containing the latest child mortality estimates based on the research of the UN Inter Agency Group for Child Mortality estimation.

These figures show that Trinidad and Tobago is lagging behind other Caribbean islands with respect to its reduction in child mortality rates.

According to the data contained in a discussion paper "Child Mortality in Trinidad and Tobago" prepared by Unicef this year, this country showed progress in reducing its under-five mortality and infant mortality from 1960 to 1990 but since then there has not been further progress.

"The current under-five and infant mortality rates are 27 and 24 in 2010 respectively. These are higher than the average under-five infant and mortality rate in the Latin and the Caribbean region ie 23 and 18 respectively," stated the discussion paper.

"The country (Trinidad and Tobago) is showing slow progress rate towards further reducing under-five mortality and the portability (sic) that a newborn will die before his fifth birthday since the 1990s," stated the Unicef paper.

In 1960, Lwin noted, this country had the lowest mortality rate in babies under five among all the countries.

However, while other countries have showed a significant reduction in this rate since the 1980s, Trinidad and Tobago stands as the country with the highest under-five mortality rates.

"Trinidad and Tobago is economically performing well, developing well but this is not commensurate with reduction in the level of infant morality," said Lwin.

According to the UNICEF discussion paper, "The comparison analysis of child mortality in Trinidad and Tobago with other countries in Latin America and the Caribbean, especially countries with substantially smaller per capita incomes and lower per capita health spending shows that Trinidad and Tobago is falling behind its regional countries."

"Also globally, Trinidad and Tobago falls within the lower half in terms of under-five mortality rates and ranks 72nd in the world along with Guyana from the Caribbean region. This despite the country's Human Development Index (HDI) ranking of 62," the paper added.

"Unicef calls attention to the worrying situation of child mortality in Trinidad and Tobago for urgent action to cut the rates in half by 2015," Unicef stated further.

The People's Partnership Government, said Lwin, recognises this problem in the mid-term policy document of the Planning Ministry which has set a goal to reduce the under-five mortality rate to five per 1,000 by 2015.

Asked how Unicef has proposed to help Government deal with this challenge, Lwin replied, "What we are proposing is first you got to understand why is this happening."

Lwin said Unicef proposed to partner with the Health Ministry to conduct a study as to why babies were dying in this country and whether the health system or public practices were root causes.

She said this country's data from the CSO also needs to be re-examined.

"These are the things we have to find out and then determine the intervention that are best suited," she said.

"The Cabinet has formed a working group to look at the maternal mortality rate which is also not improving and it is not improving at the pace it should. So, we are suggesting that the same committee look at the infant mortality rate," said Lwin.

She said in this region, other countries such as Guyana and Suriname are in a worse off position than Trinidad and Tobago "but their level of development is incomparable".

Unicef's discussion paper noted that this country's Health Ministry data and reports analysed in UWI's Situation Analysis of Children and Women in Trinidad and Tobago 2010 identified the leading causes of death among newborns as pre-term birth, severe infections, birth asphyxia and congenital anomalies for the period 1998-2005.

The Express yesterday questioned Health Minister Dr Fuad Khan on Unicef's concerns on the child mortality rate.

Khan acknowledged that this country is seen to have a high mortality rate when compared to the rest of the region, but he questioned the methodology used to compile the figures.

He said this country does not have a high child mortality rate and it has in fact decreased over the past five years.

According to Khan, if the deaths of pre-term babies that are 28 to 36 weeks are added then the figures would be higher.

"When you try to save a baby 28 weeks and you have poor lung function and the baby isn't fully mature, you run the risk of infection, metabolic disorders...with a full term baby which is about 36 to 39 weeks you don't have these kind of problems," said Khan.

Khan admitted that this country has a problem with maternal mortality—more so in the South regions. He said Dr Lackram Bodoe is in the progress of compiling a report on maternal mortality.

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