Background In 1999 UNICEF, in cooperation government of Iraq and the local
authorities In "autonomous" (northern Kurdish) region, conducted similar su
rveys to provide regionally representative and reliable estimates of child
mortality (the subject of this paper) and maternal mortality.
Methods In a cross-sectional household survey in the south/centre of Iraq i
n February and March, 1999, 23 105 ever-married women aged 15-49 years livi
ng in sampled households were interviewed by trained interviewers with a st
ructured questionnaire that was developed using the Demographic and Health
Surveys questionnaire and following a pre-test. In a similar survey in the
autonomous region in April and May 14 035 ever-married women age 15-49 were
interviewed.
Findings In the south/centre, infant and under-5 mortality increased during
the 10 years before the survey, which roughly corresponds to the period fo
llowing the Gulf conflict and the start of the United Nations sanctions. In
fant mortality rose from 47 per 1000 live births during 1984-89 to 108 per
1000 in 1994-99, and under-5 mortality rose from 56 to 131 per 1000 live bi
rths. In the autonomous region during the same period, infant mortality dec
lined from 64 to 59 per 1000 and under-5 mortality fell from 80 to 72 per 1
000. Childhood mortality was higher among children born in rural areas, chi
ldren born to women with no education, and in boys, and these differentials
were broadly similar in the two regions.
Interpretation Childhood mortality clearly increased after the Gulf conflic
t and under UN sanctions in the south/centre of Iraq, but in the autonomous
region since the start of the Oil-for-Food Programme childhood mortality h
as begun to decline. Better food and resource allocation to the autonomous
region contributed to the continued gains in lower mortality, whereas the s
ituation in the south/centre deteriorated despite the high level of literac
y in that region.