New data released today by the United Nations show that under-five mortality rates have dropped by 49 per cent between 1990 and 2013. The average annual reduction has accelerated – in some countries it has even tripled – but overall progress is still short of meeting the global target of a two-thirds decrease in under-five mortality by 2015.
New estimates in Levels and Trends in Child Mortality 2014 show that in 2013, 6.3 million children under five died from mostly preventable causes, around 200,000 fewer than in 2012, but still equal to nearly 17,000 child deaths each day.
In 2013, 2.8 million babies died within the first month of life, which represents about 44 per cent of all under-five deaths. About two-thirds of these deaths occurred in just 10 countries. While the number of neo-natal deaths have declined, progress has been slower than for the overall under-five mortality rate.
In June this year, WHO, UNICEF and partners issued the first-ever global plan to end preventable newborn deaths and stillbirths by 2035. The Every Newborn Action Plan calls for all countries to take steps to provide basic, cost-effective health services – in particular around the time of childbirth, as well as for small and sick babies – and to improve the quality of care.
Among the report’s other major findings:
Eight of the 60 countries identified as ‘high mortality countries’ – with at least 40 under-five deaths for every 1,000 live births – have already reached or surpassed the MDG target (67 per cent reduction). The countries are Malawi (72), Bangladesh (71), Liberia (71), Tanzania (69), Ethiopia (69), Timor-Leste (68), Niger (68) and Eritrea (67).
Eastern Asia, Latin America and the Caribbean and Northern Africa, have already reduced the under-five mortality rate by more than two-thirds since 1990.
Two countries, India (21 per cent) and Nigeria (13 per cent), together account for more than one-third of deaths among children below 5 years of age.
While Sub-Saharan Africa has cut under-five mortality rates by 48 per cent since 1990, it still has the world’s highest rate – 92 deaths per 1,000 live births – nearly 15 times the average in high-income countries.
Children born in Angola, which has the highest under-five mortality rate in the world (167 deaths per 1,000 live births), are 84 times more likely to die before the age of five than children born in Luxembourg, with the lowest rate (2). Within countries, relative wealth, education, and location are key – a child’s risk of dying increases if she or he is born in a remote rural area, into a poor household or to a mother with no education.
The leading causes of under-five deaths are pre-term birth complications (17 per cent); pneumonia (15 per cent); complications during labour and delivery (11 per cent); diarrhoea (9 per cent); and malaria (7 per cent). Under-nutrition contributes to nearly half of all under-five deaths.
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