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BMJ 2011; 343 doi: (Published 28 September 2011) Cite this as: BMJ 2011;343:d6092

Most developing countries will miss maternal and child mortality targets

Countries signing up to millennium development goals 4 and 5 pledged to reduce childhood mortality by two thirds and to reduce maternal mortality by three quarters between 1990 and 2015. With four years to go, it is clear that most countries will fail to achieve these ambitious targets, although global estimates disagree about which will fall short, and by how much.

The latest update, which models data from 187 countries, suggests that although progress is accelerating globally, only 11 countries will achieve both targets on time for 2015. Nine are developing countries—China, Egypt, Iran, Libya, Maldives, Mongolia, Peru, Syria, and Tunisia.

Some of the slowest progress has been in sub-Saharan Africa, where most countries look set to miss both targets by decades. Here, maternal mortality and childhood mortality remain an order of magnitude higher than the best performing countries in the developed world. In Zambia, Burundi, Angola, and the Republic of Congo, more than one in 10 babies still die before their 5th birthday. In Equatorial Guinea it is closer to one in five. Mortality for under 5s in Sweden is 2.8 per 1000 live births (one death in 357).

A linked comment welcomes the new estimates but calls for a more streamlined research effort to help reduce the confusion caused by incremental updates with different results (doi:10.1016/S0140-6736(11)61419-0) The authors suggest a standardised reporting framework, analogous to CONSORT guidance for reporting trials, to help make sense of the expected “deluge” of further updates as 2015 approaches.

High mortality after the weekend break from dialysis

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Adults in the US who need haemodialysis typically have three sessions a week, a regimen that includes a two day break over the weekend—from Friday to Monday, or Saturday to Tuesday. Does the long break put them …

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