Child mortality trends show progress but concerns remain – CMO

The island’s top public health advisor has cautioned that while Barbados continues to record declining child and maternal mortality rates, emerging issues such as vaccine hesitancy could threaten these gains, Barbados TODAY can reveal.

“Fundamentals of family healthcare continue to be alive and well,” said Chief Medical Officer (CMO), Dr Kenneth George, on Tuesday as he assessed a comprehensive Barbados Country Profile on Health recently released by Our World in Data (OWID) – a scientific international online publication that focuses on large global problems such as poverty, disease, hunger, war, climate change, population growth, existential risks, and inequality.

The wide-ranging report on Barbados produced statistics on child and maternal healthcare, such as their mortality rates, child malnutrition, causes of death to children and their mothers, the share of births that are attended by skilled workers, life expectancy and stunting of children.

“The latest data, referring to 2023, shows that 1.2 per cent died before the age of 15 in Barbados. This is the youth mortality rate, which measures the share of newborns who die before reaching their 15th birthday,” the OWID report said. It also showed that the rate has been steadily declining, having dropped from 2.2 per cent in 1990.

It also examined the share of children under five who die in Barbados.

“One of the most-used indicators of child health is the child mortality rate, which measures the share of newborns who die before the age of five. In Barbados, one per cent of children under the age of five died in 2023, also demonstrating a steady decline from 1.8 per cent in 1990,” according to the report.

For children under five years of age, 66 per cent died from birth disorders, while 20 per cent died from non-communicable diseases including neonatal asphyxia or suffocation and trauma, respiratory diseases, cardiovascular diseases, genetic blood disorders and COVID-19, said the global online scientific publication.

Dr George told Barbados TODAY: “With respect to the indices of child mortality, we are doing well. Child mortality is death before five years of age, neonatal mortality is death within the first 28 days of life, and infant mortality is death within the first year of life. And Barbados is holding its own. If you look at the figures, there has been a significant decrease over the last five decades with respect to child mortality in Barbados.

“We realise that every death of a child is a concern. Although we are doing well, there is always room for improvement. With respect to neonatal mortality, the causes of death are usually prematurity. These are persons who died with the first 28 days of life. Other causes would include infection from various causes, and what we consider as congenital abnormalities…things that persons are born with. Those are the main causes of death, which mirrors a worldwide phenomenon. Preterm babies are usually at a disadvantage; hence the outcomes may not be what we expect.”

While stating that the report was generally acceptable and “fairly decent”, Dr George disagreed with its narrative on stunting of children in Barbados caused by chronic malnutrition.

The report stated: “Here, we look at stunting, which is when a child is deemed short for their age. It is often a sign of chronic malnutrition, and that their development has been hindered. Stunting is not just an issue during childhood: it affects both physical and cognitive development, and these impacts can persist into adulthood. In 2024, this share was 5.8 per cent.”

But the chief medical officer responded: “With respect to stunting, is the issue I have here, is we in Barbados do not have a problem with stunting, we have a problem with children being overweight or obese. So, I can’t support the report of malnourishment in Barbados. We would have one or two cases where a child is failing strive because of some chronic medical issue. But let me make it clear that Barbados has moved over the decades away from malnutrition, one in which our major problem is obesity.”

He also assured the country that the rate of maternal mortality was encouraging.

The report found that mothers who died during pregnancy, at childbirth, or in the following six weeks in Barbados stood at 39.1 per 100 000 live births, dropping from 48.4 in 2000.

“We have done fairly well with maternal mortality,” Dr George remarked. “We believe in public health that any woman who is pregnant and who dies in pregnancy, is an avoidable death. And we have mechanisms in Barbados that any maternal death is fully investigated. The ministry of health is notified of the outcome of the investigation, and there is a panel that looks to see if the issue is not occurring. But with respect to overall maternal mortality, we are doing fairly well.”

The chief medical officer noted a steady decline in these deaths as reflected in the report, acknowledging also that almost a hundred per cent of births are attended by skilled healthcare workers. “It is good, because it gives us an opportunity for early intervention.”

He also urged mothers to ensure they get the appropriate testing for HIV and hepatitis and other markers during pregnancy “because it is important to identify high-risk mothers who may have unfortunate outcomes.”

Dr George concluded: “So, it’s a fairly decent report. As I said, there is always room for improvement. We take these statistics very seriously. We are happy when this type of information is shared with the public, to let them know that the fundamentals of family healthcare continue to be alive and well. I must add that our child mortality rate may be at threat because of vaccine hesitancy; and we encourage the public to understand that vaccination is the most significant public health achievement globally, with the last number of years. So, I am happy that Barbados controls its situation, but that we are always looking for ways to improve. Ideally we would like some of these numbers to be zero; and that’s our ultimate goal.”

(EJ)