Causes of child death in China pinpointed

But the number of children in China who die before reaching the age of five has dropped by 70 per cent since 1990 -- from 6.5 per cent of live births to 1.9 per cent.

The team predicts that complications caused by premature birth will soon become the leading cause of childhood death in China as increased access to hospital treatment cuts the number of deaths from pneumonia.

The research, published in the Lancet journal, is the first to make detailed Chinese health information available in the English language.

The study, led by the University of Edinburgh, was made possible by the recent digitisation of Chinese health research reports. They are now available through searchable electronic databases, which make them accessible to international health research community.

The international team of researchers now hope to focus on the reasons behind the reduction in mortality rates and they will investigate the role of factors such as increased access to healthcare, public education, increased personal wealth and the one child per family policy.

China is home to 15 per cent of the world's children, but until recently information on child, infant and newborn mortality was not easily accessible to researchers outside the country and was not included in global estimates of childhood disease.

Doctors hope that by learning more about China and the impact of socio-economic factors such as income, education, infrastructure and health system development and breastfeeding practices, they may gain greater insight into the health needs of children worldwide.

They also hope it might shed light on a significant and unexplained drop in Western childhood mortality rates, which occurred between 1900 and 1930 in the absence of antibiotics and vaccinations. The data confirm that China has already met the fourth of United Nation's Millennium Development Goals, which aims to reduce under-five mortality by two-thirds between 1990 and 2015.

Harry Campbell, Professor of Genetic Epidemiology and Public Health at the University of Edinburgh, said: "Within international health community, China has been a "black box" for the past several decades regarding the information on health problems of its large population, particularly for children and infants. We welcome their immense efforts in recent years to digitalize their health research reports produced during the 20th century by Chinese researchers. We have now learned that health research conducted in China has been of a very high quality. Our study will also bring attention to some neglected causes of child death, such as accidents and congenital abnormalities, on which we had hardly any information from other low and middle income countries"

Professor Igor Rudan, Director of the Croatian Centre for Global Health and Senior Research Fellow at the University of Edinburgh, said: "Working with our Chinese, Australian and American colleagues, we have uncovered a mine of valuable health information that has remained inaccessible to international researchers for many decades. Thanks to Chinese data, we can now validate our knowledge on international health issues, which was based predominantly on studies published in the English language. We hope this will improve our approach to reducing global child mortality and help us to study the social and economic determinants of child survival."

The study was conducted by an international team of doctors from Peking University in China, the Nossal Institute for Global Health in Australia, Johns Hopkins University and Harvard University in the USA, "Saving Newborn Lives" from South Africa, the London School of Hygiene and Tropical Medicine in the UK, and Centre for Global Health in Croatia.