Child mortality, also known as child death, refers to the death of children under the age of 14 and encompasses national mortality, under-5 mortality, and mortality of children aged 5–14. Many child deaths go unreported for a variety of reasons, including lack of death registration and lack of data on child migrants. Without accurate data on child deaths, we cannot fully discover and combat the greatest risks to a child's life.
Reduction of child mortality is reflected in several of the United Nations' Sustainable Development Goals. Rapid progress has resulted in a significant decline in preventable child deaths since 1990, with the global under-5 mortality rate declining by over half between 1990 and 2016. While in 1990, 12.6 million children under age five died, in 2016 that number fell to 5.6 million children. However, despite advances, there are still 15,000 under-five deaths per day from largely preventable causes. About 80 per cent of these occur in sub-Saharan Africa and South Asia, and just 6 countries account for half of all under-five deaths: India, Nigeria, Pakistan, the Democratic Republic of the Congo, Ethiopia and China. 45% of these children died during the first 28 days of life.
Child mortality refers to number of child deaths under the age of 5 per 1000 live births. However, the child mortality could be simplified into more specific terms such as prenatal, perinatal, Neonatal, infancy and under 5. Prenatal: child death before the birth, Perinatal: child death before one week of birth, Neonatal: child death before 28 days of birth, Infancy: child death before 1st birthday, and child mortality under 5 refer to any deaths from birth to the 5th birthday.
Perinatal mortality rate: Number of child deaths within first week of birth/ total number of birth
Neonatal mortality rate: number of child deaths within first 28 days of life/ total number of birth
Infancy mortality rate: number of child deaths within first 12 months of life/ total number of birth
Under 5 mortality rates: number of child deaths within 5th birthday/ total number of birth
The leading causes of death of children under five include:
There is variation of child mortality around the world; countries that are in the second or third stage of the Demographic Transition Mode (DTM) have higher rates of child mortality than countries in the fourth or fifth state of the DTM. Chad infant mortality is about 96 per 1,000 live births. And developed country such as Japan infant mortality is about 2.2 per 1,000 live births. In 2010, there were estimated to 7.6 million child deaths around the world and most of it occurred in less developed countries and 4.7 million died from infection and disorder. Child mortality isn’t only caused by infection and disorder, it is also caused by premature birth, birth defect, new born infection, birth complication, and disease like malaria, sepsis, and diarrhea. In less developed countries, malnutrition is the main source of child mortality. Pneumonia, diarrhea and malaria together are the cause of 1 out of every 3 child deaths before the age of 5 and nearly half of under-five deaths globally are attributable to under nutrition.
Child survival is a field of public health concerned with reducing child mortality. Child survival interventions are designed to address the most common causes of child deaths that occur, which include diarrhea, pneumonia, malaria, and neonatal conditions. Of the portion of children under the age of 5 alone, an estimated 5.6 million children die each year mostly from such preventable causes.
The child survival strategies and interventions are in line with the fourth Millennium Development Goals (MDGs) which focused on reducing child mortality by 2/3 of children under five before the year 2015. In 2015, the MDGs were replaced with the Sustainable Development Goals (SDGs), which aim to end these deaths by 2030. In order to achieve SDG targets, progress must be accelerated in more than 1/4 of all countries (most of which are in sub-Saharan Africa) in order to achieve targets for under-5 mortality, and in 60 countries (many in sub-Saharan Africa and South Asia) to achieve targets for neonatal mortality. Without accelerated progress, 60 million children under age 5 will die between 2017 and 2030, about half of which would be newborns.
Two-thirds of child deaths are preventable. Most of the children who die each year could be saved by low-tech, evidence-based, cost-effective measures such as vaccines, antibiotics, micronutrient supplementation, insecticide-treated bed nets, improved family care and breastfeeding practices, and oral rehydration therapy. Empowering women, removing financial and social barriers to accessing basic services, developing innovations that make the supply of critical services more available to the poor and increasing local accountability of health systems are policy interventions that have allowed health systems to improve equity and reduce mortality.
In developing countries, child mortality rates related to respiratory and diarrheal diseases can be reduced by introducing simple behavioral changes, such as handwashing with soap. This simple action can reduce the rate of mortality from these diseases by almost 50 per cent.
Proven, cost-effective interventions can save the lives of millions of children per year. The UN Vaccine division as of 2014 supported 36% of the world's children in order to best improve their survival chances, yet still, low-cost immunization interventions do not reach 30 million children despite success in reducing polio, tetanus, and measles. Measles and tetanus still kill more than 1 million children under 5 each year. Vitamin A supplementation costs only $0.02 for each capsule and given 2–3 times a year will prevent blindness and death. Although vitamin A supplementation has been shown to reduce all-cause mortality by 12 to 24 per cent, only 70 per cent of targeted children were reached in 2015. Between 250,000 and 500,000 children become blind every year, with 70 percent of them dying within 12 months. Oral rehydration therapy (ORT) is an effective treatment for lost liquids through diarrhea; yet only 4 in 10 (44 per cent) of children ill with diarrhea are treated with ORT.
Essential newborn care - including immunizing mothers against tetanus, ensuring clean delivery practices in a hygienic birthing environment, drying and wrapping the baby immediately after birth, providing necessary warmth, and promoting immediate and continued breastfeeding, immunization, and treatment of infections with antibiotics - could save the lives of 3 million newborns annually. Improved sanitation and access to clean drinking water can reduce childhood infections and diarrhea. Over 30% of the world's population does not have access to basic sanitation, and 844 million people use unsafe sources of drinking water.
Agencies promoting and implementing child survival activities worldwide include UNICEF and non-governmental organizations; major child survival donors worldwide include the World Bank, the British Government's Department for International Development, the Canadian International Development Agency and the United States Agency for International Development. In the United States, most non-governmental child survival agencies belong to the CORE Group, a coalition working, through collaborative action, to save the lives of young children in the world's poorest countries.
Child mortality has been dropping as each country reaches a high stage of DTM. From 2000 to 2010, child mortality has dropped from 9.6 million to 7.6 million. In order to reduce child mortality rates, there needs to be better education, higher standards of healthcare and more caution in childbearing. Child mortality could be reduced by attendance of professionals at birth and by breastfeeding and through access to clean water, sanitation, and immunization. In 2016, the world average was 41 (4.1%), down from 93 (9.3%) in 1990. This is equivalent to 5.6 million children less than five years old dying in 2016.
Huge disparities in under-5 mortality rates exist. Globally, the risk of a child dying in the country with the highest under-5 mortality rate is about 60 times higher than in the country with the lowest under-5 mortality rate. Sub-Saharan Africa remains the region with the highest under-5 mortality rates in the world: All six countries with rates above 100 deaths per 1,000 live births are in sub-Saharan Africa.
Furthermore, approximately 80% of under-5 deaths occur in only two regions: sub-Saharan Africa and South Asia. 6 countries account for half of the global under-5 deaths, namely, India, Nigeria, Pakistan, the Democratic Republic of the Congo, Ethiopia and China. India and Nigeria alone account for almost a third (32 per cent) of the global under-five deaths. Within countries in Africa, there is also substantial variation in child mortality rates across administrative divisions.
Likewise, there are disparities between wealthy and poor households in developing countries. According to a Save the Children paper, children from the poorest households in India are three times more likely to die before their fifth birthday than those from the richest households.
The child survival rate of nations varies with factors such as fertility rate and income distribution; the change in distribution shows a strong correlation between child survival and income distribution as well as fertility rate, where increasing child survival allows the average income to increase as well as the average fertility rate to decrease.
Centre-Est is one of Burkina Faso's 13 administrative regions. The population of Centre-Est was 1,132,023 in 2006. The region's capital is Tenkodogo. Three provinces—Boulgou, Koulpélogo, and Kouritenga, make up the region.
As of 2010, the population of the region was 2,043,943 with 49.78 per cent females. The population in the region was 12.99 per cent of the total population of the country. The child mortality rate was 39, infant mortality rate was 56 and the mortality of children under five was 93. As of 2007, the literacy rate in the region was 16.6 per cent, compared with a national average of 28.3 per cent.Centre-Nord Region
Centre-Nord is one of thirteen administrative regions of Burkina Faso, a landlocked country in Africa. The population of Centre-Nord in 2006 was 1,203,073. The region's capital is Kaya. Three provinces—Bam, Namentenga, and Sanmatenga, make up the region.
As of 2010, the population of the region was 1,334,860 with 52.97 per cent females. The population in the region was 8.49 per cent of the total population of the country. The child mortality rate was 55, infant mortality rate was 64 and the mortality of children under five was 116. As of 2007, the literacy rate in the region was 16.6 per cent, compared to a national average of 28.3 per cent. The coverage of cereal need compared to the total production of the region was 70.00 per cent.Centre-Ouest Region
Centre-Ouest is one of Burkina Faso's 13 administrative regions. The population of Centre-Ouest was 1,348,784 in 2011. The region's capital is Koudougou. Four provinces (Boulkiemdé, Sanguié, Sissili, and Ziro) make up the region.
As of 2010, the population of the region was 1,310,644 with 53.92 per cent females. The population in the region was 8.33 per cent of the total population of the country. The child mortality rate was 61, infant mortality rate was 87 and the mortality of children under five was 142. As of 2007, the literacy rate in the region was 28.8 per cent, compared to a national average of 28.3 per cent. The coverage of cereal need compared to the total production of the region was 135.00 per cent.Centre-Sud Region
Centre-Sud is one of Burkina Faso's 13 administrative regions. The population of Centre-Sud was 638,379 in 2006 and was estimated at 722,631 in 2011. The region's capital is Manga. Three provinces-Bazèga, Nahouri, and Zoundwéogo, make up the region.
As of 2010, the population of the region was 703,358 with 52.90 per cent females. The population in the region was 4.47 per cent of the total population of the country. The child mortality rate was 61, infant mortality rate was 70 and the mortality of children under five was 127. As of 2007, the literacy rate in the region was 15.9 per cent, compared to a national average of 28.3 per cent. The coverage of cereal need compared to the total production of the region was 69.00 per cent.Child
Biologically, a child (plural: children) is a human being between the stages of birth and puberty, or between the developmental period of infancy and puberty. The legal definition of child generally refers to a minor, otherwise known as a person younger than the age of majority.Child may also describe a relationship with a parent (such as sons and daughters of any age) or, metaphorically, an authority figure, or signify group membership in a clan, tribe, or religion; it can also signify being strongly affected by a specific time, place, or circumstance, as in "a child of nature" or "a child of the Sixties".Est Region (Burkina Faso)
Est is one of Burkina Faso's 13 administrative regions. It was created on 2 July 2001. The region's capital is Fada N'gourma. Five provinces make up the region—Gnagna, Gourma, Komondjari, Kompienga, and Tapoa.
As of 2010, the population of the region was 1,369,233 with 50.97 per cent females. The population in the region was 8.70 per cent of the total population of the country. The child mortality rate was 98, infant mortality rate was 98 and the mortality of children under five was 186. As of 2007, the literacy rate in the region was 28.5 per cent, compared with a national average of 28.3 per cent. The coverage of cereal need compared with the total production of the region was 108.00 per cent.Global health
Global health is the health of populations in the global context; it has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement (including mental health), reduction of disparities, and protection against global threats that disregard national borders. Global health is not to be confused with international health, which is defined as the branch of public health focusing on developing nations and foreign aid efforts by industrialized countries. Global health can be measured as a function of various global diseases and their prevalence in the world and threat to decrease life in the present day.
The predominant agency associated with global health (and international health) is the World Health Organization (WHO). Other important agencies impacting global health include UNICEF and World Food Programme. The United Nations system has also played a part with cross-sectoral actions to address global health and its underlying socioeconomic determinants with the declaration of the Millennium Development Goals and the more recent Sustainable Development Goals.Health in China
See also Healthcare in China.Health in Kenya
Tropical diseases, especially malaria and tuberculosis, have long been a public health problem in Kenya. In recent years, infection with the human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), also has become a severe problem. Estimates of the incidence of infection differ widely.
The life expectancy in Kenya in 2016 was 69.0 for females and 64.7 for males. This has been an increment from the year 1990 when the life expectancy was 62.6 and 59.0 respectively.The leading cause of mortality in kenya in the year 2016 included diarrhoea diseases 18.5%, HIV/AIDs 15.56%, lower respiratory infections 8.62%, tuberculosis 3.69%, ischemic heart disease 3.99%, road injuries 1.47%, interpersonal violence 1.36%. The leading causes of DALYs in Kenya in 2016 included HIV/AIDs 14.65%, diarrhoea diseases 12.45%, lower back and neck pain 2.05%, skin and subcutaneous diseases 2.47%, depression 1.33%, interpersonal violence 1.32%, road injuries 1.3%. The burden of disease in Kenya has mainly been from communicable diseases but it is now shifting to also include the noncommunicable diseases and injuries. As of 2016, the 3 leading causes of death globally were ischemic heart disease 17.33%, stroke 10.11% and chronic obstructive pulmonary disease 5.36%.Health in Mongolia
Since 1990, key health indicators in Mongolia like life expectancy and infant and child mortality have steadily improved, both due to social changes and to improvement in the health sector. Echinococcosis was one of the commonest surgical diagnoses in the 1960s, but now has been greatly reduced. Yet, adult health deteriorated during the 1990s and the first decade of the 21st century and mortality rates increased significantly. Smallpox, typhus, plague, poliomyelitis, and diphtheria were eradicated by 1981. The Mongolian Red Cross Society focusses on preventative work. The Confederation of Mongolian Trade Unions established a network of sanatoriums.Serious problems remain, especially in the countryside. According to a 2011 study by the World Health Organization, Mongolia's capital city of Ulaanbaatar has the second-most fine particle pollution of any city in the world. Poor air quality is also the largest occupational hazard, as over two-thirds of occupational disease in Mongolia is dust induced chronic bronchitis or pneumoconiosis.Average childbirth (fertility rate) is around 2.25–1.87 per woman (2007) and average life expectancy is 68.5 years (2011). Infant mortality is at 1.9% to 4% and child mortality is at 4.3%.Mongolia has the highest rate of liver cancer in the world by a significant margin.Health in Tanzania
The 2010 maternal mortality rate per 100,000 births for Tanzania was 790. This is compared with 449 in 2008 and 610.2 in 1990. The UN Child Mortality Report 2011 reports a decrease in under-five mortality from 155 per 1,000 live births in 1990 to 76 per 1,000 live births in 2010, and in neonatal mortality from 40 per 1,000 live births to 26 per 1,000 live births. The aim of the report The State of the World's Midwifery is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal health. In Tanzania there are only two midwives per 1,000 live births; and the lifetime risk of death during delivery for women is one in 23.Infant mortality
Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the number of deaths of children under one year of age per 1000 live births. The under-five mortality rate, which is referred to as the child mortality rate, is also an important statistic, considering the infant mortality rate focuses only on children under one year of age.Premature birth is the biggest contributor to the IMR. Other leading causes of infant mortality are birth asphyxia, pneumonia, congenital malformations, term birth complications such as abnormal presentation of the foetus umbilical cord prolapse, or prolonged labor, neonatal infection, diarrhoea, malaria, measles and malnutrition. One of the most common preventable causes of infant mortality is smoking during pregnancy. Many factors contribute to infant mortality, such as the mother's level of education, environmental conditions, and political and medical infrastructure. Improving sanitation, access to clean drinking water, immunization against infectious diseases, and other public health measures can help reduce high rates of infant mortality.
In 1990 9 million infants younger than 1 year died globally. Until 2015 this number has almost halved to 4.6 million infant deaths. Over the same period, the infant mortality rate declined from 65 deaths per 1,000 live births to 29 deaths per 1,000.Child mortality is the death of a child before the child's fifth birthday, measured as the under-5 child mortality rate (U5MR). National statistics sometimes group these two mortality rates together. Globally, 5.4 million children die each year before their fifth birthday in 2017. In 1990 the number of child deaths was 12.6 million. More than 60% of these deaths are seen as being avoidable with low-cost measures such as continuous breast-feeding, vaccinations and improved nutrition.The child mortality rate, but not the infant mortality rate, was an indicator used to monitor progress towards the Fourth Goal of the Millennium Development Goals of the United Nations for the year 2015. A reduction of the child mortality is now a target in the Sustainable Development Goals for Goal Number 3 ("Ensure healthy lives and promote well-being for all at all ages").Throughout the world, infant mortality rate (IMR) fluctuates drastically, and according to Biotechnology and Health Sciences, education and life expectancy in the country is the leading indicator of IMR. This study was conducted across 135 countries over the course of 11 years, with the continent of Africa having the highest infant mortality rate of any other region studied with 68 deaths per 1,000 live births.International Conference on Population and Development
The United Nations coordinated an International Conference on Population and Development (ICPD) in Cairo, Egypt, on 5–13 September 1994. Its resulting Programme of Action is the steering document for the United Nations Population Fund (UNFPA).
Some 20,000 delegates from various governments, UN agencies, NGOs, and the media gathered for a discussion of a variety of population issues, including immigration, infant mortality, birth control, family planning, the education of women, and protection for women from unsafe abortion services.
The conference received considerable media attention due to disputes regarding the assertion of reproductive rights. The Holy See and several predominantly Islamic nations were staunch critics, and U.S. President Bill Clinton received considerable criticism from conservatives for his participation, considering the fact that president Ronald Reagan did not attend or fund the previous conference held in Mexico City in 1984. The official spokesman for the Holy See was archbishop Renato Martino.
According to the official ICPD release, the conference delegates achieved consensus on the following four qualitative and quantitative goals:
Universal education: Universal primary education in all countries by 2015. Urge countries to provide wider access to women for secondary and higher level education as well as vocational and technical training.
Reduction of infant and child mortality: Countries should strive to reduce infant and under-5 child mortality rates by one-third or to 50–70 deaths per 1000 by the year 2000. By 2015 all countries should aim to achieve a rate below 35 per 1,000 live births and under-five mortality rate below 45 per 1,000.
Reduction of maternal mortality: A reduction by 1/2 the 1990 levels by 2000 and 1/2 of that by 2015. Disparities in maternal mortality within countries and between geographical regions, socio-economic and ethnic groups should be narrowed.
Access to reproductive and sexual health services including family planning: Family-planning counseling, pre-natal care, safe delivery and post-natal care, prevention and appropriate treatment of infertility, prevention of abortion and the management of the consequences of abortion, treatment of reproductive tract infections, sexually transmitted diseases and other reproductive health conditions; and education, counseling, as appropriate, on human sexuality, reproductive health and responsible parenthood. Services regarding HIV/AIDS, breast cancer, infertility, and delivery should be made available. Active discouragement of female genital mutilation (FGM).Mastoiditis
Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear. Specifically, it is an inflammation of the mucosal lining of the mastoid antrum and mastoid air cell system inside the mastoid process. The mastoid process is the portion of the temporal bone of the skull that is behind the ear. The mastoid process contains open, air-containing spaces. Mastoiditis is usually caused by untreated acute otitis media (middle ear infection) and used to be a leading cause of child mortality. With the development of antibiotics, however, mastoiditis has become quite rare in developed countries where surgical treatment is now much less frequent and more conservative, unlike former times. Additionally, there is no evidence that the drop in antibiotic prescribing for otitis media has increased the incidence of mastoiditis, raising the possibility that the drop in reported cases is due to a confounding factor such as childhood immunizations against Haemophilus and Streptococcus. Untreated, the infection can spread to surrounding structures, including the brain, causing serious complications.Millennium Development Goals
The Millennium Development Goals (MDGs) were eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration. All 191 United Nations member states at that time, and at least 22 international organizations, committed to help achieve the following Millennium Development Goals by 2015:
To eradicate extreme poverty and hunger
To achieve universal primary education
To promote gender equality and empower women
To reduce child mortality
To improve maternal health
To combat HIV/AIDS, malaria, and other diseases
To ensure environmental sustainability
To develop a global partnership for development
Each goal had specific targets, and dates for achieving those targets. The 8 goals were measured by 18 targets. To accelerate progress, the G8 finance ministers agreed in June 2005 to provide enough funds to the World Bank, the International Monetary Fund (IMF) and the African Development Bank (AfDB) to cancel $40 to $55 billion in debt owed by members of the heavily indebted poor countries (HIPC) to allow them to redirect resources to programs for improving health and education and for alleviating poverty.
Interventions evaluated include (1) improvements required to meet the millennium development goals (MDG) for water supply (by halving by 2015 the proportion of those without access to safe drinking water), (2) meet the water MDG plus halving by 2015 the proportion of those without access to adequate sanitation, (3) increasing access to improved water and sanitation for everyone, (4) providing disinfection at point-of-use over and above increasing access to improved water supply and sanitation (5) providing regulated piped water supply in house and sewage connection with partial sewerage for everyone (Hutton, G. Evaluation of the Cost and Benefits of Water and Sanitation Improvements at the Global Level, 2004 WHO-Geneva)
Critics of the MDGs complained of a lack of analysis and justification behind the chosen objectives, and the difficulty or lack of measurements for some goals and uneven progress, among others. Although developed countries' aid for achieving the MDGs rose during the challenge period, more than half went for debt relief and much of the remainder going towards natural disaster relief and military aid, rather than further development.
As of 2013, progress towards the goals was uneven. Some countries achieved many goals, while others were not on track to realize any. A UN conference in September 2010 reviewed progress to date and adopted a global plan to achieve the eight goals by their target date. New commitments targeted women's and children's health, and new initiatives in the worldwide battle against poverty, hunger and disease.
Among the non-governmental organizations assisting were the United Nations Millennium Campaign, the Millennium Promise Alliance, Inc., the Global Poverty Project, the Micah Challenge, The Youth in Action EU Programme, "Cartoons in Action" video project and the 8 Visions of Hope global art project.
The Sustainable Development Goals (SDGs) replaced the MDGs in 2016.Plateau-Central Region
Plateau-Central is one of Burkina Faso's 13 administrative regions. It was created on 2 July 2001 and had an estimated population of 693,137 in 2006. The region's capital is Ziniaré. Three provinces make up the region—Ganzourgou, Kourwéogo, and Oubritenga.
As of 2010, the population of the region was 764,574 with 53.48 per cent females. The population in the region was 4.86 per cent of the total population of the country. The child mortality rate was 83, infant mortality rate was 59 and the mortality of children under five was 138. As of 2007, the literacy rate in the region was 21.1 per cent, compared to a national average of 28.3 per cent. The coverage of cereal need compared to the total production of the region was 111.00 per cent.Sanctions against Iraq
The sanctions against Iraq were a near-total financial and trade embargo imposed by the United Nations Security Council on Ba'athist Iraq. They began August 6, 1990, four days after Iraq's invasion of Kuwait, stayed largely in force until May 22, 2003 (after Saddam Hussein's being forced from power), and persisted in part, including reparations to Kuwait, through the present. The original stated purposes of the sanctions were to compel Iraq to withdraw from Kuwait, to pay reparations, and to disclose and eliminate any weapons of mass destruction.
Initially the UN Security Council imposed stringent economic sanctions on Iraq by adopting and enforcing United Nations Security Council Resolution 661. After the end of the 1991 Persian Gulf War, those sanctions were extended and elaborated on, including linkage to removal of weapons of mass destruction, by Resolution 687. The sanctions banned all trade and financial resources except for medicine and "in humanitarian circumstances" foodstuffs, the import of which into Iraq was tightly regulated.The effects of the sanctions on the civilian population of Iraq have been disputed. Whereas it was widely believed that the sanctions caused a major rise in child mortality, research following the 2003 invasion of Iraq has shown that commonly cited data were doctored by the Saddam Hussein regime and that "there was no major rise in child mortality in Iraq after 1990 and during the period of the sanctions".Sud-Ouest Region (Burkina Faso)
Sud-Ouest is one of Burkina Faso's 13 administrative regions. It was created on July 2, 2001 and had a population of 624,056 in 2006. It covers an area of 16 202 km2. The region's capital is Gaoua. Four provinces make up the region—Bougouriba, Ioba, Noumbiel, and Poni.
As of 2010, the population of the region was 687,826 with 51.99 per cent females. The population in the region was 4.37 per cent of the total population of the country. The child mortality rate was 98, infant mortality rate was 107 and the mortality of children under five was 195. As of 2007, the literacy rate in the region was 18.1 per cent, compared to a national average of 28.3 per cent. The coverage of cereal need compared to the total production of the region was 156.00 per cent.Water supply and sanitation in Argentina
Drinking water supply and sanitation in Argentina is characterized by relatively low tariffs, mostly reasonable service quality, low levels of metering and high levels of consumption for those with access to services. At the same time, according to the WHO, 21% of the total population remains without access to house connections and 52% of the urban population do not have access to sewerage. The responsibility for operating and maintaining water and sanitation services rests with 19 provincial water and sewer companies, more than 100 municipalities and more than 950 cooperatives, the latter operating primarily in small towns. Among the largest water and sewer companies are Agua y Saneamientos Argentinos (AYSA) and Aguas Bonarenses S.A. (ABSA), both operating in Greater Buenos Aires, Aguas Provinciales de Santa Fe, and Aguas Cordobesas SA, all of them now publicly owned. In 2008 there were still a few private concessions, such as Aguas de Salta SA, which is majority-owned by Argentine investors, and Obras Sanitarias de Mendoza (OSM).
Most service providers barely recover operation and maintenance costs and have no capacity to self-finance investments. While private operators were able to achieve higher levels of cost recovery, since the Argentine financial crisis in 2002 tariffs have been frozen and the self-financing capacity of utilities has disappeared. Roughly two-thirds of provincial water and sanitation spending since 2002 has come from general transfers from the federal government, the remainder coming from various national programs directed specifically to the sector.
Services are regulated by the 23 Provinces, in the case of 14 through regulatory agencies that have some limited autonomy from the government. Overall, however, responsibilities are not always clearly defined, and institutions are often weak, subject to political interference and lacking enforcement powers. The various national institutions with policy-setting responsibilities in the sector are not always well coordinated. There is no coherent national policy in terms of sector financing, subsidies, tariffs and service standards. The federal structure of the country and the dispersion of sector responsibilities between and within various levels of government make the development of a coherent sector policy all the more difficult.
Between 1991 and 1999, as part of one of the world's largest privatization programs covering a range of sectors, water and sanitation concessions with the private sector were signed covering 28% of the country's municipalities and 60% of the population. The highest profile concession was signed in 1993 with a consortium led by the French firm Suez for the central parts of Greater Buenos Aires. After the 2001 economic crisis, many concessions were renegotiated. Many were terminated, as it was the case in Buenos Aires in 2006.The impact of private sector participation in water and sanitation is a controversial topic. While the public perception of the mostly international concessionaires is overwhelmingly negative in Argentina, some studies show positive impacts. For example, a 2002 study assessed the impact of privatization on child mortality based on household survey data, finding that child mortality fell 5 to 7 percent more in areas that privatized compared to those that remained under public or cooperative management. The authors estimate that the main reason is the massive expansion of access to water. According to Suez, the private concession in Buenos Aires extended access to water to 2 million people and access to sanitation to 1 million people, despite a freeze in tariffs imposed by the government in 2001 in violation of the concession agreement. The government argues that the concessionaire did not fully comply with its obligations concerning expansion and quality, saying that the supplied water had high levels of nitrate, pressure obligations were not kept and scheduled works were not carried out.
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