Editorial | Infant mortality benchmark of progress and prosperity
The recent Independence celebration was the backdrop for much reflection about growth and prosperity in Jamaica. While some of our leaders waxed glowingly about prosperity, lingering questions remain: How much progress have we made since 1962? How much will living standards improve in the future? How do we measure real progress?
Jamaicans over 50 years old can point to improvements in physical and housing infrastructure, social amenities, and industrial developments since Independence. On the other hand, for many young Jamaicans, the rate of progress appears frighteningly slow. Many are concerned about the future and being able to live even at the same level as their parents.
A significant proportion view migration as the only real option to improve their life chances. They, like their parents and grandparents, worry about the high rate of crime and violence and the very poor social conditions for many in inner-city and rural communities.
This negative mindset needs to be reversed by real achievements in development goals.
The infant mortality rate is a social indicator that could offer an explanation as to why older and younger Jamaicans perceive the post-Independence world so differently. Infant mortality measures deaths per 1,000 live births in the age group zero to one year. It is an important pointer of the overall well-being of a community. The frequent debates about the deaths of premature babies in our hospitals is part of this wider development issue.
In 1960, the infant mortality rate in Jamaica was 60 deaths per 1,000 live births. The significant growth and development during the post-Independence period facilitated a fall in the rate to 15 per 1,000 by 1997 - a significant improvement.
This reduction required attention to many vital areas - control of infectious diseases, sanitation, water availability and quality, nutritional status of mothers and infants, prenatal and medical care, access to reproductive health, better education for women and girls, reduction in gender-based violence, and increased income. This one measure, therefore, tells a significant story about Jamaica's post-Independence development.
SLOWING INFANT MORTALITY REDUCTION RATE
Unfortunately, since the 2000s, there has been a slowing of the reduction of the infant mortality rate. The rate in 2017, at 12.8 per 1,000 live births, is identical to the rate in 2004, according to Government of Jamaica and World Bank figures. While this rate is in line with the average for upper middle-income countries globally, much more can be achieved. In Costa Rica, another upper middle-income country, the rate currently is eight per 1,000.
The very slow annual rate of economic growth over the last 20 years, along with the very high levels of public debt and subsequent strenuous fiscal consolidation measures to deal with it, has combined to constrain resources for investment in the vital areas that would improve the overall quality of life and thus reduce the infant mortality rate further.
The perception of the young that overall progress has stalled may, therefore, be more in line with reality.
The Government, as it implements Jamaica's Vision 2030 in alignment with the global Sustainable Development Goals and the bewildering 169 targets covering 17 broad goals, would do well to focus national attention around the target of reducing infant mortality to eight per 1,000 live births in Jamaica by 2030. This is a challenging but achievable target that Jamaicans can rally around. This would show real national ambition.
The country has to grapple with its woeful record in recent years of implementing projects to reduce child mortality. A 2013 European Union-funded, four-year, J$3-billion grant programme to reduce maternal and child mortality (PROMAC), has been delayed by the usual bureaucratic bungling, lack of urgency, and inefficiencies. The programme was given a reprieve in 2018 and extended to 48 months to, inter alia, improve newborn and emergency obstetrics by establishing 11 high dependency units in six hospitals.
The Ministry of Health and all relevant agencies associated with this programme should move with alacrity to achieve effective and efficient implementation of this and all other projects aimed at improving child and maternal mortality. Delay means that Jamaica risks losing the grant funding.
Our leaders would do well to pay closer attention to how we treat the most vulnerable human beings in our population, those completely dependent on others to survive. The payback to the nation would be immeasurable.