Contribution of Mexico's universal immunization program to the Fourth Millennium Development Goal/Contribucion del programa de vacunacion universal de Mexico al cuarto Objetivo de Desarrollo del Milenio

Objective. To identify and describe 1) progress achieved thus far in meeting the commitments of the Fourth Millennium Development Goal (MDG 4) in Mexico, mainly the contribution of the Universal Immunization Program (UIP) over the last 20 years, and 2) new opportunities for further reducing mortality among children under 5 years old. Methods. An observational, descriptive, retrospective study was carried out to examine registered causes of death in children under 5 between 1990 and 2010. Indicators were built according to the recommendations of the United Nations. Results. In 2010, deaths among children under 5 decreased 64.3% compared to the baseline (1990) figure. Of the total deaths of the children under 5, the neonatal period was the most affected (52.8%), followed by the 1 to 11 months (30.9%), and the 12 to 59 months (16.2%) groups. A 34% overall mortality reduction was observed after the universalization of immunization against influenza, rotavirus, and pneumococcus in children under 5. Conclusions. Despite a significant reduction in under-5 mortality in Mexico over the last 20 years, largely due to the successes of the UIP, several challenges remain, particularly in improving preventive and curative services during pre- and postnatal care. Key words Infant mortality; child mortality; Millennium Development Goals; immunization programs; Mexico. Objetivo. Determinar y describir 1) el progreso logrado hasta el momento en el cumplimiento de los compromisos del cuarto Objetivo de Desarrollo del Milenio en Mexico, principalmente la contribucion del Programa de Vacunacion Universal (PVU) durante los 20 ultimos anos; y 2) las nuevas oportunidades para reducir aun mas la mortalidad en ninos menores de cinco anos. Metodos. Se llevo a cabo un estudio de observacion, descriptivo y retrospectivo para analizar las causas registradas de muerte en ninos menores de cinco anos entre 1990 y el 2010. Se elaboraron indicadores segun las recomendaciones de las Naciones Unidas. Resultados. En el 2010, las defunciones en ninos menores de cinco anos se habian reducido en 64,3% en comparacion con las cifras de referencia (1990). La mayor disminucion de la mortalidad se observo en recien nacidos (52,8%), seguidos por los lactantes de 1 a 11 meses (30,9%) y los ninos de 12 a 59 meses (16,2%). Se observo una reduccion total de la mortalidad de 34% tras la universalizacion de la vacunacion contra la gripe, el rotavirus y el neumococo en ninos menores de cinco anos. Conclusiones