Measuring human development: An introduction to table 8
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8
If development is to assume a more human face, then there arises
a corresponding need for a means of measuring human as well
as economic progress. From UNICEF’s point of view, in particular,
there is a need for an agreed method of measuring the level
of child well-being and its rate of change.
The under-five mortality rate (U5MR) is used in table
8 as the principal indicator of such progress.
The U5MR has several advantages. First, it measures an end
result of the development process rather than an ‘input’
such as school enrolment level, per capita calorie availability,
or the number of doctors per thousand population — all
of which are means to an end.
Second, the U5MR is known to be the result of a wide variety
of inputs: the nutritional health and the health knowledge of
mothers; the level of immunization and ORT use; the availability
of maternal and child health services (including prenatal care);
income and food availability in the family; the availability
of clean water and safe sanitation; and the overall safety of
the child’s environment.
Third, the U5MR is less susceptible than, say, per capita GNI
to the fallacy of the average. This is because the natural scale
does not allow the children of the rich to be one thousand times
as likely to survive, even if the man-made scale does permit
them to have one thousand times as much income. In other words,
it is much more difficult for a wealthy minority to affect a
nation’s U5MR, and it therefore presents a more accurate,
if far from perfect, picture of the health status of the majority
of children (and of society as a whole).
For these reasons, the U5MR is chosen by UNICEF as its single
most important indicator of the state of a nation’s children.
That is why the tables rank the nations of the world not in
ascending order of their per capita GNI but in descending order
of their under-five mortality rates.
The speed of progress in reducing the U5MR can be measured
by calculating its average annual reduction rate (AARR). Unlike
the comparison of absolute changes, the AARR reflects the fact
that the lower limits to U5MR are approached only with increasing
difficulty. As lower levels of under-five mortality are reached,
for example, the same absolute reduction obviously represents
a greater percentage of reduction. The AARR therefore shows
a higher rate of progress for, say, a 10-point reduction if
that reduction happens at a lower level of under-five mortality.
(A fall in U5MR of 10 points from 100 to 90 represents a reduction
of 10 per cent, whereas the same 10-point fall from 20 to 10
represents a reduction of 50 per cent).
When used in conjunction with GDP growth rates, the U5MR and
its reduction rate can therefore give a picture of the progress
being made by any country or region, and over any period of
time, towards the satisfaction of some of the most essential
of human needs.
As table 8 shows, there is no fixed relationship between the
annual reduction rate of the U5MR and the annual rate of growth
in per capita GDP. Such comparisons help to throw the emphasis
on to the policies, priorities, and other factors which determine
the ratio between economic and social progress.
Finally, the table gives the total fertility rate for each
country and its average annual rate of reduction. It will be
seen that many of the nations that have achieved significant
reductions in their U5MR have also achieved significant reductions
in fertility.
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8
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