Summary

Global deaths among children under age five have fallen from more than 12 million per year in 1990, to 7.6 million in 2010 and 6.9 million in 2011. The decline in deaths has accelerated in the past decade, from 1.9% a year on average in the 1990s to 2.5% a year from 2000 to 2011. Despite this progress, however, most developing countries − particularly those in sub-Saharan Africa − will not achieve Millennium Development Goal 4 (to reduce the under-five mortality rate by two thirds globally between 1990 and 2015).

As the sixth largest country by population in sub-Saharan Africa, Kenya is important for the achievement of global under-five mortality targets. Kenya achieved a 24% reduction in under-five mortality between 1990 and 2008, from 98 to 74 for every 1,000 live births. Kenya’s under-five mortality rate rose in the 1990s, while it was falling amongst its neighbours and in sub-Saharan Africa as a whole. Reasons for this include malaria drug resistance, falling levels of women’s education and immunisation, reduced use of maternity services, increased malnutrition, inter-ethnic violence and the spread of HIV. These trends, however, have been reversed with a 34% reduction in under-five mortality in the decade prior to 2008.

This review assesses the Department for International Development’s (DFID) contribution to the reduction of under-five child mortality in Kenya, where donors spend more than £500 million each year on the health sector. Overall, we awarded a rating of green-amber and made three recommendations.

Blog following country visit to Kenya

Commissioner Mark Foster writes about his visit to Kenya as part of the report into child mortality reduction.