By Marielba Núñez
[CARACAS] The progress made by Venezuela in reducing child mortality rates has been lost over the past decade, leaving the country facing rates at a level not seen since the late 1990s.
Child mortality had been steadily declining since the 1940s. According to official data reported in an article published in The Lancet, in 2009 there was an average of 16 deaths of children under one year of age for every 1000 live births. But since then, “the rate began to increase with a rapid growth from 2011,” write the authors.
Venezuela’s economy and health system have collapsed in recent years, and the country is currently in the midst of a political crisis.
To come up with the child mortality estimates, the researchers took into account the latest figures, which were released in 2014 by official Venezuelan institutions such as the Ministry of Health and the National Institute of Statistics. They supplemented these with data from other sources, including a national survey on living conditions in 2017.
“We are facing a problem of infrastructure, of nutrition, of services, that sums up and that has produced this collapse,”
Julio Castro, Central University of Venezuela
The research is the result of an effort to address the lack of public information in the country, according to lead author Jenny García from the National Institute for Demographic Studies in France.
“We think that the figures may be higher than the estimates we have made because the assumptions we are using for the application of statistical models are conservative,” García tells SciDev.Net.
“Our findings are until 2016, and we know that in 2017 and 2018 the figures are going to be worse than what we are projecting, because the conditions in the country have worsened,” she warns.
One of the assumptions on which García and her collaborators based their calculation is that the country has maintained the same level of underreporting of deaths and births that occurred up to 2012.
“But we know that in times of economic and institutional crisis, such as the ones Venezuela is having, this can vary and the number of deaths outside the hospital can be much greater than those registered by the historical pattern,” says García.
Venezuela is currently facing a humanitarian emergency due to the collapse of its health system and the re-emergence of communicable diseases such as malaria, measles and diphtheria, according to the Pan American Health Organization (PAHO). The shortage of medicines prevents the treatment of chronic diseases, such as HIV.
An article due to be published in April in Emerging Infectious Diseases collects data for vaccine-preventable diseases re-emerging in Venezuela. It reports that up to October of last year, 5,525 cases of measles had been reported in the country, including 73 deaths. Almost 1250 cases of diphtheria were also confirmed.
Health system in ruins
The deterioration of public policies is behind the erosion of Venezuela’s achievements in the health sector, according to the study in The Lancet.
“For instance, between 2007 and 2009, the Ministry of Health of Venezuela did not provide vaccines against polio, diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae type b to children under 5, and they did not vaccinate almost 20 per cent of children in 2010,” it states.
Together with PAHO, it has implemented a national plan to respond to outbreaks of these diseases. Through this plan it claims to have provided vaccines against measles to eight million children between six months and 15 years of age, and against diphtheria to 4.8 million children between seven and 15 years of age old against diphtheria.
But the recent figures on child mortality reveal the “major deterioration of the Venezuelan health system,” says Julio Castro, an infectious disease physician and researcher at the Central University of Venezuela, who did not participate in the study.
Along with the Venezuelan Society of Infectology, and the Venezuelan Network ‘Let’s defend the Epidemiology’, Castro has publicly denounced the lack of official data. “We are facing a problem of infrastructure, of nutrition, of services, that sums up and that has produced this collapse,” he says.
García hopes that the research will put pressure on the Venezuelan government to reveal official data on health indicators. “That data is needed because the country is plunged in a crisis and there are many versions of reality, depending on the political position.
“That is very dangerous,” he adds, “because decisions are made according to personal criteria, and it is necessary to take them based on objective data”.