Routes to Low Mortality in Poor Countries

TLDR

Low‑mortality societies have long historical antecedents, and some socialist countries have substituted similar strategies, suggesting other Third‑World nations could adopt comparable approaches. The study investigates how specific populations achieved low mortality and whether those strategies can be applied by other poor countries. The authors compare mortality across Third‑World countries by income level, classifying them as superior or poor health achievers, and analyze variables such as population density, family planning, religion, education, female autonomy, political openness, and primary‑health‑center–based community outreach to identify common strategies. The study identifies Sri Lanka, Kerala (India), and Costa Rica as low‑mortality societies, notes breakthrough periods linked to large‑scale health service roll‑outs, and finds that religious culture can either retard or accelerate mortality decline.

Abstract

This paper examines how certain populations have achieved low mortality and whether these methods might be utilized by other poor populations. Mortality levels are examined relative to income levels for Third World countries classified as either superior health achievers or poor health achievers; other variables examined are population density family planning use religion and educational level. 3 societies with exceptionally low mortality are Sri Lanka Kerala India) and Costa Rica; these 3 settings are examples of successful breakthrough health programs. Similarities among the 3 include a substantial degree of female autonomy dedication to education an open political system a largely civilian society with no rigid class structure and a history of egalitarianism and radicalism. All 3 populations are small; dense settlement and widely diffused commercial farming in rural areas demonstrated in these 3 regions appear to favor reduction in rural-urban mortality levels. Breakthrough periods are identified for each of the societies when provision of health services was implemented on a large scale. In rural areas the primary health center is a base for midwives and health auxiliaries and household visits are an integral part of the program. By substantially raising the proportion of budgetary allocations to education and health (particularly emphasizing education for women) other countries can advance towards low mortality levels. Though the characteristics of the low mortality societies have long historical antecedents effective substitution for this historical experience has been made by some socialist countries and other substitutions are possible in the rest of the Third World. Religion is shown to have been associated with cultures that in some cases have retarded mortality decline and in others assisted it.