The Ministry of Health of Ghana is currently reviewing child health trends and interventions in light of findings from the 2003 Ghana Demographic and Health Survey (GDHS),1 which showed that childhood mortality in the country has levelled off in recent years. The findings and recommendations from The Lancet's neonatal survival series are highly pertinent in this context.
Trends in GDHS data from surveys in 1988,2 1993, 1998, and 2003 are shown in the figure. Although these findings must be interpreted with caution because of the wide confidence intervals (shown only for neonatal mortality for the 2003 GDHS), the data suggest that although Ghana's under-5 mortality rate dropped by 28% (44 per 1000 livebirths) between the 5 years preceding the 1988 survey and the 5 years preceding the 2003 survey, 72% of this decline is due to a reduction in deaths in the 12—59-month age-group, and 26% is due to a reduction in mortality in those aged 1—11 months. Aside from a possible decline during the years preceding the 1998 GDHS survey, neonatal mortality (ie, in those younger than 1 month) has remained largely unchanged throughout this period.