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Bolivia, Plurinational State of

Reducing child deaths: Geography and cultural barriers are the major obstacles

© UNICEF Bolivia/2004
Arminda shares information and experiences with other mothers about the health of their children.

LA PAZ, Bolivia, 8 October 2004 – Arminda has two boys and always longed to have a little girl. Now her daughter, Judith Mariels, is five months old. Judith, like her two brothers, was born at home. Arminda did not receive any prenatal care; she believed that, as an member of the indigenous Aymaras ethnic group, she would face mistreatment and discrimination at most health centres.

The Aymaras live mainly in the central Andes of Peru and Bolivia. In Bolivia, geographical and cultural barriers, rather than economic issues, remain the major obstacles to reducing the mortality rate among children under five.

Bolivia has recently experienced improvements in the health of pregnant women and children under 5, mainly due to an increase in government funding and improvements in providing access to basic services, especially in poor rural areas.

However, infant mortality is still very high in Bolivia, despite the fact that the country is on schedule to meet the Millennium Development Goal of reducing child mortality by two thirds. Neonatal mortality represents more than half of child deaths under five, and more than one third of all child deaths. More than 65 per cent of neonatal deaths are in rural areas. The main factors causing or contributing to child deaths are infectious diseases, low birth weight and premature birth.

In the last decade, overall progress in reducing under-five mortality rates in Latin America and the Caribbean has been substantial and steady, but particular groups have to some extent been left behind. Impoverished or indigenous communities typically have experienced much less progress in reducing mortality. Almost 110 million children in Latin America are living in poverty; every year, 400,000 children die before the age of 5 from preventable infections or from inadequate prenatal care.

Arminda is very fortunate in that she belongs to a community association in the district of El Alto, in the Bolivian capital of La Paz. The community associations are part of the project ‘Renacer’ (‘New start’), which is supported by UNICEF and other partners. The project’s aim is to promote good health practices.

At association meetings each week, Arminda has an opportunity to share information and experiences with other mothers about the health of their children and, in particular, about how to care for infants. At a recent meeting, Arminda proudly announced to her friends that her little Judith Mariels had just been immunized for the first time.




8 October 2004: Reducing child mortality in Latin America and the Caribbean – progress and challenges

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