In South Asia, the mortality rate of children under the age of five has decreased significantly in the last few decades. However, along with this positive progress, another worrying issue has come to the fore. The number of children with disabilities is gradually increasing.

A recently published study has shown that as child mortality has decreased, the number of children with disabilities has increased, which is creating a new and dual challenge for the health system.

The study, published in the journal ‘Developmental Medicine & Child Neurology’, was conducted by Dr. Md. Nuruzzaman Khan, Associate Professor of the Department of Population Science at Jatiya Kabi Kazi Nazrul Islam University, and a team of local and foreign researchers. The study analyzed data from various countries in South Asia from 1985 to 2023. Dr. Md. Nuruzzaman Khan is also associated as a Senior Research Fellow at the University of Melbourne.

The study used data from six countries—Bangladesh, India, Pakistan, Nepal, Sri Lanka, and Afghanistan. The researchers analyzed data from UNICEF, the World Health Organization (WHO), the World Bank, surveys, research articles, and international databases to find the relationship between child mortality and childhood disabilities.

The study found that the mortality rate of children under five years of age in Asia has decreased significantly over the past three decades. In 1990, 126 children died per 1,000 live births, but in 2022, it fell to 37. That is, the child mortality rate has decreased by about 70 percent during this period.

According to the researchers, improved public health systems, expanded immunization programs, improved maternal health, improved nutrition, access to clean water, and socio-economic development have played a significant role in this success.

The analysis showed that the average under-five mortality rate from 1985 to 2023 was 62.8 per 1,000 live births. On the other hand, an average of 47 children under the age of 18 are living with disabilities for every 1,000.

The study results show that although the child mortality rate has decreased, the number of disabled people has increased. Between 2005 and 2015, these two trends have surpassed each other. Since 2010, the number of children with disabilities has started increasing faster than the child mortality rate. This trend has been observed in all countries - Bangladesh, India, Pakistan, Nepal, Sri Lanka and Afghanistan, although there are some differences in time.

The study found a significant inverse relationship between the child mortality rate and the number of children with disabilities. Statistical analysis shows that the number of children with disabilities has increased by 0.245 units against the decrease in child mortality rate per unit. In addition, there is a relationship between the increase in disability with increasing expenditure in the health sector and the increase in the rate of premature (preterm) births. The disability rate has increased by 0.87 units with an increase in health expenditure per unit and the disability rate has increased by 0.182 units with an increase in the rate of preterm births.

According to researchers, many of the children who previously died due to premature birth, respiratory distress, infection, birth defects or other complications are now surviving due to improvements in modern medicine and neonatal care. However, a portion of them are at risk of long-term physical and mental complications. As a result, although child mortality has decreased, the number of children with disabilities is increasing.

According to the World Health Organization, about 240 million children in the world are currently living with disabilities. A large portion of them live in Asian and African countries.

The study said that about 14 percent of children under the age of 18 in South Asia are living with disabilities. Among these, cerebral palsy, intellectual disability, hearing and visual impairment and autism spectrum disorder are notable.

According to researchers, malnutrition, marriage between close relatives, infections, lack of timely prenatal and postnatal care, limited use of maternal health services and the spread of non-communicable diseases at an early age increase the risk of children becoming disabled.

They also said that due to improved medical care, many premature babies are now surviving. However, these babies are at higher risk of various developmental complications, including cerebral palsy, intellectual disability and sensory problems. The problem is compounded by the lack of adequate follow-up, early intervention and rehabilitation services for these children in South Asian countries.

The study also noted that due to improved healthcare, improved disability identification methods, increased training of doctors and increased awareness, various problems including autism and intellectual disability are being detected more than before. As a result, the number of disabled people seems to have increased.

According to the researchers, malnutrition is still a major problem in South Asia. Currently, about one-third of children in the region are stunted, which negatively affects their physical and mental development and increases health risks in the long term.

In addition, limited access to healthcare in low-income families, delayed diagnosis of diseases and lack of treatment also increase the risk of disability. In addition, genetic and environmental factors and marriage between close relatives are also responsible for children becoming disabled.

However, researchers caution that there are some limitations in determining the true picture of children with disabilities because data has been collected at different times and in different ways. In many developing countries, reliable monitoring of disabilities is still lacking.