Abstract
Infant mortality is considered to be one of the greatest expressions of social injustice. Thus, the Convention on the Rights of the Child (CRC) in 1989 urged adhering states to take the necessary steps to reduce it progressively and as a guarantee of equal opportunities. This objective was further supported by a series of subsequent international conferences, in which specific goals of reduction, both in the level as well as in the differences between social sectors, were laid down. Among them: The World Summit for Children in 1990, the International Conference on Population and Development in 1994, the Millennium Summit in 2000 and the Special Session on Children in 2002.
Argentina adheres to both the CRC and the subsequent conferences, adopting the goals concerning the levels of infant mortality as they were laid down internationally. However, in so far as the goals of inter-sector gaps reduction are concerned, it reduced their requirements. Results show that, from 1990, the country has managed to reduce the level of infant mortality, although it has not reached all the goals agreed upon with the international community. The situation regarding the fulfillment of the equality goals, however, is worse. According to the method and degree of disaggregation used results vary, showing, at times, that disparities, far from shrinking, have actually increased. This means non-compliance with the commitments agreed upon in the framework of children’s rights, a situation that is aggravated, in particular, when the topic of preventable deaths is addressed.
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Notes
- 1.
- 2.
Both the goals set in international conferences and the goal laid down at a national level in Argentina, will be conveniently stated explicitly in the following section.
- 3.
That is to say, the goals setting the magnitude of the reduction in a determined time frame.
- 4.
In the case of CRC, this is expressed in Article 2, when referring to equal opportunities to exercise the rights acknowledged in its text, although without setting specific goals in that respect.
- 5.
The territory of the Argentine Republic is divided in 24 political-administrative units called provinces. These are, in turn, grouped in regions: Center (consisting of: the Autonomous City of Buenos Aires and the Provinces of Buenos Aires, Córdoba, Santa Fe and Entre Ríos), Cuyo (Provinces of Mendoza, San Juan, San Luis and La Rioja), Northeast (Provinces of Corrientes, Misiones, Chaco and Formosa), Northwest (Provinces of Catamarca, Santiago del Estero, Tucumán, Salta and Jujuy) and South (Provinces of La Pampa, Neuquén, Chubut, Santa Cruz and Tierra del Fuego). To avoid confusion, all our analyses are based on the regional division used in the yearly publications by DEIS.
- 6.
Argentinan death records include information on the social group of the deceased (for instance, mother’s age and educational level, marital status and membership in medical insurance or health care plan). Nevertheless, we decided not to use these data for this research because they have (serious) quality problems regarding the completeness of the information.
- 7.
For more information, it is advisable see National Council for the Coordination of Social Policies, Presidency of the Argentine Republic (2007, p. 13 and p. 32).
- 8.
The choice of a classification designed in another country results from a series of trials based on different classifications for preventable deaths according to preventability criteria used in different Latin American countries, that is to say: Argentina, Chile and Brazil. Based on the results obtained, we decided to choose the classification used by SUS in Brazil, because it disaggregates child deaths to a greater extent according to the preventability criteria it takes into account; whereas the classification used in Argentina offers several preventability criteria, depending on whether the death occurred in the neonatal period or in the post-neonatal period, which, for example, does not allow for the association of a post-neonatal death to a criterion linked to the neonatal period. Likewise, the classification used in Chile places most deaths within the “preventable by means of mixed actions” criterion, which does not allow, per se, for inferring the exact combination of measures that would have prevented its occurrence.
- 9.
Population projections prepared by the National Institute of Statistics and Censuses (INDEC) of Argentina (in collaboration with the Latin American and Caribbean Demographic Center (CELADE)—Population Division of the Economic Commission for Latin America and the Caribbean (ECLAC)) show a declining trend in the level of infant mortality even in the decades before 1990. Indeed, infant mortality rate is 65.9 per thousand live births in 1950–55 and reaches 27.1 per thousand live births in 1985–90 (INDEC, CELADE/ECLAC 2004).
- 10.
Other information sources, such as the Latin American and Caribbean Demographic Centre (CELADE), offer future estimates regarding the infant mortality rate. Nonetheless, we decided not to use them for this research because our main interest is to show the capability of the information gathered in the country to monitor compliance with the commitments agreed upon concerning the reduction in the infant mortality level.
- 11.
They are: Absolute and relative differences, and Gini coefficient (see above).
- 12.
The gap becomes narrower decreasing by 20.3 % going from 12.3 to 9.8 per thousand live births.
- 13.
Which stipulates the elimination of the differences inside adhering countries by 2010.
- 14.
The gap becomes narrower decreasing by 44.7 % going from 12.3 to 6.8 per thousand live births.
- 15.
Needless to say that they would not reach the goal set by RAP.
- 16.
According to which, the differences must decrease by 95 % between the years analysed.
- 17.
In fact, according to this strategy, gaps should be reduced by 14.5 % for total deaths and by 15.9 % for preventable deaths.
- 18.
In this case, it is worth pointing out that despite a decrease in mortality in Formosa, there was a significant reduction to 1.1 in Tierra del Fuego.
- 19.
For which the reduction of differences shows a value close to 5.2 %.
- 20.
It should be remembered that its expected reduction, in that period, is 4.2 %.
- 21.
Which proposes a 60 % reduction in the differences.
- 22.
Although the causes mentioned before show a significant participation in the total preventable deaths, the mortality levels associated with them decrease between 1997 and 2009. In fact, the rate associated with shortness of breath in newborns decreases by 42.2 %, going from 20.6 to 11.9 per 10,000 live births; the rate linked to conditions related to short duration of gestation or low birth weight decreases by 17 % (going from 18.8 to 15.6 per 10,000 live births); and the rate linked to specific infections occurring during the perinatal period decreases by 38.9 % (from 12.6 to 7.7 per 10,000 live births).
- 23.
In fact, relative gap increase can only be seen in the first cause of death. For the rest of the causes, geographical differences observed are especially given that some provinces reach zero deaths in 1997 and 2009.
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Santillán Pizarro, M., Rojas Cabrera, E., Celton, D. (2014). Infant Mortality Measurement and the Rate of Progress on International Commitments: A Matter of Methods or of Guarantees of Rights? Some Evidence from Argentina. In: Anson, J., Luy, M. (eds) Mortality in an International Perspective. European Studies of Population, vol 18. Springer, Cham. https://doi.org/10.1007/978-3-319-03029-6_7
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