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The child mortality rates are improving in the majority of 54 developing nations, a team from Stanford University School of Medicine reported. The researchers found that these rates have fallen the greatest in the poorest families, narrowing the child mortality gap between poor and wealthy households.

"In many countries, national wealth has increased hand-in-hand with increasing health inequality. That's been a signature of our time," said study author, Eran Bendavid, MD, assistant professor of medicine. "It's a pressing concern for many societies, especially in wealthy countries, but it's also been an issue in low- and middle-income countries."

For this study, the researchers focused on analyzing the link between death in children younger than five and wealth inequality. For child mortality, they looked at data provided by 1.2 million women who were from 929,224 households in 54 developing nations. The women completed surveys regarding their children's survival rates. In terms of wealth in equality, the researchers categorized wealth into three groups, which were poorest, middle and wealthiest. They examined wealth trends during 2002-07 and 2008-12.

Overall, the researchers found that the child death rates fell the most in the poorest households at an average annual rate of 4.36 deaths per 1,000 live births. The mortality rate for middle-income households declined by an average of 3.36 deaths per 1,000 live births. In the wealthiest group, the rate decreased by an average of 2.06 deaths per 1,000 live births. The nations with the greatest drop in child mortality rate in the poorest families also had a smaller mortality gap between families of different wealth.

The countries whose child mortality rate narrowed between the poorest and the wealthiest households were more likely to have four factors, which were government effectiveness, rule of law, control of corruption and regulatory quality. Bendavid noted that not all nations had declines in their child mortality rate. The nations with an increasing gap were more likely to have poor governance.

"Dr. Bendavid's study is an important contribution to knowledge about child health improvements in the developing world," commented Davidson Gwatkin, a senior fellow at the Results for Development Institute and a senior associate at Johns Hopkins Bloomberg School of Public Health, who was not involved with the study. "It makes a persuasive case that these improvements have often begun to benefit the poor even more than the better-off."

Dr. Bendavid added according to the press release, "We have the technologies, we have the means, we have the know-how to reduce child mortality dramatically. Even for such low-hanging fruit, however, implementation is not always easy. You have to have government that enables basic safety, and the ability to reach poor and rural communities that benefit from these kinds of programs."

The study, "Changes in Child Mortality Over Time Across the Wealth Gradient in Less-Developed Countries," was published in the journal, Pediatrics.