Skip to main content

01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Counting the cost of child mortality in the World Health Organization African region

BMC Public Health > Ausgabe 1/2015
Joses M. Kirigia, Rosenabi Deborah Karimi Muthuri, Juliet Nabyonga-Orem, Doris Gatwiri Kirigia
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JMK, RDKM, JNO and DGK participated in the study design, analysis of data and writing of the paper. All the authors read and approved the final version of the manuscript.

Authors’ information

Joses M. Kirigia (JMK) holds a PhD in economics, specializing in health economics, from the University of York, UK. He did his PhD studies with a training grant from TDR. He has worked with the WHO Regional Office for Africa over the last 16 years in various capacities. He is currently the Programme Manager for Research, Publications and Library Services. Prior to joining WHO, he was a senior lecturer and coordinator of master’s in health economics programme at the University of Cape Town, South Africa. He has published widely in peer reviewed journals, and two books with the University of Nairobi, entitled Economic evaluation of public health problems in sub-Saharan Africa and Efficiency of health system units in Africa: a data envelopment analysis.
Rosenabi D.K. Muthuri (RDKM) is currently pursuing her degree in psychology at the United States International University, Nairobi, Kenya. RDKM has worked as a research assistant with a number of JMK research projects.
Juliet N. Orem holds MD and MSc degrees in health economics from the University of York, UK, and a PhD in public health from the Catholic University of Louvain, Belgium. She is currently the Regional Adviser on health systems partnerships, monitoring and evaluation at the WHO Regional Office for Africa. Prior to this, she worked with WHO for over 10 years at the country level in Uganda and supporting other countries in the WHO African Region on health systems strengthening. She also undertook research in health economics and health financing. Over the years, she has published on health systems performance assessment, health financing, health and poverty, economic evaluation and knowledge translation.
Doris G. Kirigia (DGK) holds a PhD in health economics and public health from the University of New South Wales, Australia, and a master’s in public health from the London School of Hygiene and Tropical Medicine, United Kingdom. DGK joined KEMRI-Wellcome Trust Research Programme in 2011 as a postdoctoral researcher. Her research interests include health equity, health systems research, use of technology to deliver health care (e-Health) interventions, social determinants of health, Health in All Policies, health care financing, and economic evaluation of health related interventions. She is a member of several public health and health economics professional organizations. Over the years she has published on equity and social determinants of health, health financing, fiscal space, health facility efficiency, economic evaluation and health governance.



Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is “by 2030, end preventable deaths of new-borns and children under 5 years of age”. There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all the basic needs for a healthy population. The specific objective of this study was to estimate expected/future productivity losses from child deaths in the WHO African Region in 2013 for use in advocacy for increased investments in child health services and other basic services that address children’s welfare.


A cost-of-illness method was used to estimate future non-health GDP losses related to child deaths. Future non-health GDP losses were discounted at 3 %. The analysis was undertaken with the countries categorized under three income groups: Group 1 consisted of nine high and upper middle income countries, Group 2 of 13 lower middle income countries, and Group 3 of 25 low income countries. One-way sensitivity analysis at 5 % and 10 % discount rates assessed the impact of the expected non-health GDP loss.


The discounted value of future non-health GDP loss due to the deaths of children under 5 years old in 2013 will be in the order of Int$ 150.3 billion. Approximately 27.3 % of the loss will be borne by Group 1 countries, 47.1 % by Group 2 and 25.7 % by Group 3. The average non-health GDP lost per child death will be Int$ 174 310 for Group 1, Int$ 57 584 for Group 2 and Int$ 25 508 for Group 3.


It is estimated that the African Region will incur a loss of approximately 6 % of its non-health GDP from the future years of life lost among the 2 976 000 child deaths that occurred in 2013. Therefore, countries and development partners should in solidarity sustainably provide the resources essential to build resilient national health systems and systems to address the determinants of health and meet the other basic needs such as for clothing, education, food, shelter, sanitation and clean water to end preventable child morbidity and mortality.
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2015

BMC Public Health 1/2015 Zur Ausgabe