Under-five mortality rate at country level

© UN

ICEF-NYHQ

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2013 Statistical snapshot

Child Mortality

Under-five mortality: Levels, trends and causes

Infectious diseases such as pneumonia, diarrhoea and malaria are the leading killers of children under age 5; roughly 44% of deaths in children under 5 occur during the neonatal period

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Global distribution of deaths among children under age 5, by cause, 2012

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Globally, nearly half of all deaths among children under 5 are attributable to undernutrition

Estimates are rounded, and therefore may not sum to 100%.

Deaths of children under five by different age groups, 2012

Three quarters of the child deaths occur in the first year of life

0

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75

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1.8 million deaths from age 1 to 4 (27%)

1.9 million deaths from first to 11th month of life (30%)

2.9 million deaths in first month of life (44%)

Child deathsInfant deaths

Neonatal deaths

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Around 44% of deaths in children under-5 occur during the neonatal period and nearly three-quarters occur in the first year of life.

Of the 6.6 million under-five deaths in 2012, most were from preventable causes such as pneumonia, diarrhoea or malaria.

Many under-five deaths occur in children already weakened by undernutrition, which is a contributing factor in around half of global under-five deaths.

Global progress in reducing child deaths since 1990 has been very significant. The under-five mortality rate has declined by nearly half—from 90 deaths per 1,000 live births in 1990 to 48 per 1,000 in 2012.

The estimated annual number of under-five deaths has fallen from 12.6 million to 6.6 million over the same period.

Put another way, 17,000 fewer children died each day in 2012 than did in 1990, but still 18,000 children died each day in 2012.

Global under-five, infant and neonatal mortality rates, 1990–2012

The global under-five mortality rate has almost halved since 1990

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1990 1995 2000 2005 2010 2015

Dea

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Global under-five deaths, 1990–2012

The global burden of under-five deaths has fallen steadily since 1990

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12.6

10.99.7

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201220102005200019951990

6.67.0

All other causes of death 24%

%

MDG 4target: 30

Lives lost, saved and to be saved

Unless progress in saving lives accelerates across several regions, global achievement of MDG 4 will only occur in 2028

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Achievement of MDG 4 by year, globally and by region, if current trends continue in all countries

2010 2015 2020 2025 2030 2035

World

West & Central Africa

Eastern & Southern Africa

Sub-Saharan Africa

Middle East & North Africa

South Asia

CEE/CIS

Latin America & Caribbean

Many countries have made, and are still making, tremendous strides in lowering child mortality

High-mortality countries* with greatest percentage declines (≥ 50%) in under-five mortality rate from 1990–2012

*Countries with an under-five mortality rate of 40 or more deaths per 1,000 live births in 2012.

0 25 50 75 100Benin

MyanmarYemen

ZambiaIndia

Lao People'sDemocratic Republic

The GambiaGuinea

SenegalSouth Sudan

UgandaMozambiqueMadagascar

RwandaNiger

EritreaBhutan

Bolivia (PlurinationalState of)

EthiopiaTimor-Leste

United Republicof Tanzania

LiberiaNepal

MalawiBangladesh

Progress in improving child survival has saved 90 million children’s lives since 1990; additional millions of children must be saved if all countries are to meet MDG 4 on time

Number of lives saved since 1990 among children under age 5, and number of lives to be saved in order to achieve MDG 4

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Since 1990, 90 million children’s lives have been saved.

However, 216 million children have died before their fifth birthday during this period.

Based on current projections, an ad-ditional 35 million children will die be-tween 2015 and 2028 – children who could have lived, had we met MDG 4 on time and sustained the progress.

To achieve MDG 4 by 2015, an ad-ditional 3.5 million children’s lives must be saved between 2013 and 2015 above the current trend rate. Two-thirds of these lives need to be saved in sub-Saharan Africa and about one-quarter in South Asia.

Lives lost, saved and to be saved

Accelerating progress in reducing child mortality

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Most regions have reduced their under-five mortality rates by more than 50% since 1990

Under-five mortality rate by region, 1990 and 2012, and % declines

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Number of children under age 5, by region, 1950-2050

Fast progress in reducing the number of under-five deaths in sub-Saharan Africa is imperative as its child population soars

All regions with the exception of West and Central Africa and sub-Saharan Africa as a whole have at least halved their rates of under-five mortality since 1990.

The global annual rate of reduction has steadily accelerated since 1990- 1995, when it stood at 1.2%, more than tripling to 3.9% in 2005-2012.

Both sub-Saharan African regions — particularly Eastern and South-ern Africa but also West and Central Africa — have seen a consistent acceleration in reducing under-five deaths, particularly since 2000.

By mid-century, it is estimated that 37% of the world’s children under 5 will live in sub-Saharan Africa; and close to 40% of all live births will take place in that region.

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Since 1990 sub-Saharan Africa has experienced continuing acceleration in the decline of under-five mortality

Annual rates of reduction (ARR) in the under-five mortality rate, %, by region, since 1990

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5.3

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Sub-Saharan

Africa

Eastern &Southern

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West &CentralAfrica

Accelerating progress in reducing child mortality

© UN

ICEF-INDA

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World

Latin America & Caribbean

East Asia

South Asia

Middle East & North Africa

Sub-Saharan Africa

West & Central Africa

Eastern & Southern Africa

Deaths per 1,000 live births0 50 100 150 200

CEE/CIS

177

195

163118

77

98

7130

12960

5820

5419

19

45% decline

39% decline

53% decline

58% decline

54% decline

65% decline

65% decline

60% decline

47% decline

47

4890

Disparities in under-five mortality

Under-five mortality rates have declined globally even among the poorest households in all regions

Under-five mortality rate among the poorest households, by region, 1987–2008

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Under-five mortality rate by country income levels, 1990 and 2012, and % declines

Upper-middle-income countries have registered the greatest percentage decline in the under-five mortality rate since 1990

Since 1990, countries at all income levels reduced child mortality. Gains in some low- and middle-income countries have been substantial.

The gaps in under-five mortality between the richest and poorest households within most regions narrowed from 1987 to 2008, with the exception of sub-Saharan Africa.

The unequivocally good news is that under-five mortality rates have decreased even among the poorest in all regions of the world.

Distribution of deaths among children under 5, by cause, low- and high-income countries, 2012

Preventable infectious diseases are still a major cause of under-five deaths in low- and lower-middle-income countries

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Leading infectious

diseases in 2012

Low-income High-income

Estimates are rounded, and therefore may not sum to 100%.

Deaths per 1,000 live births

16682 51% decline

11862

5420

48% decline

63% decline

156 57% decline

0 50 100 150 200

High-income

Upper-middle-income

Lower-middle-income

Low-income

19902012

The causes of under-five death vary by national income level. Leading infectious diseases are the greatest cause of under-five mortal-ity in low-income countries. Their share diminishes with higher levels of national income.

Under-five mortality rate at country level

Prepared by: UNICEF Data & Analytics, Division of Policy and Strategy, September 2013Source: Committing to Child Survival: A Promise Renewed, Progress Report, 2013, UNICEFFind the latest statistics on children at www.childinfo.org & www.childmortality.org

Neonatal deaths

*This map is stylized and not to scale. It does not reflect a position by UNICEF on the legal status of any country or area or the delimitation of any frontiers. The dotted line represents approximately the Line of Control agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the Parties. The final boundary between the Republic of the Sudan and the Republic of South Sudan has not yet been determined. The final status of the Abyei area has not yet been determined.

Less than 20

20–39

40–79

80–119

120 or more

Data not available

Under-five mortality rate, 2012 (deaths per 1,000 live births)

Children in sub-Saharan Africa and South Asia face a higher risk of dying before their fifth birthday

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Most neonatal deaths are from preventable causesGlobal distribution of neonatal deaths, by cause, 2012

About the chart: The cause distribution is calculated by applying the percentage breakdown by cause in 2010 provided by CHERG to the estimates of the number of under-five deaths in 2012 provided by IGME. Estimates are rounded, and therefore may not sum to 100%

Global neonatal mortality is declining

Neonatal mortality rates and % declines by region, 1990 and 2012

Neonatal mortality is on the decline globally. The world’s neonatal mortality rate fell from 33 deaths per 1,000 live births in 1990 to 21 per 1,000 in 2012. However, neonatal deaths account for an increasing proportion of under-five deaths, rising from 37% in 1990 to 44% in 2012.

The number of neonatal deaths fell from 4.6 million in 1990 to 2.9 million in 2012. Of the 2.9 million, around 1 million died during their first day of life.

Children who die before they complete 28 days of life often do so as a result of diseases and conditions that are readily preventable or treat-able with proven, cost-effective interventions.

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This statistical snapshot summarizes the key findings from Committing to Child Survival: A Promise Renewed Progress Report 2013. The findings indicate that although there have been substantial gains in reducing global child deaths since 1990, child survival remains an urgent concern and immediate action is needed to redouble efforts to end preventable child deaths.

Other 6%Other 6%CCoonnggeenniittaall

aabbnnoorrmmaalliittiieess 99%%

SSeeppssiiss//

mmeenniinnggiittiiss

1122%%

Pneumonia 10%Pneumonia 10%

Preterm Preterm birth birth

complicationscomplications3434%%

Intrapartum-related

complications24%

Diarrhoea 2%Tetanus 2%

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World

Latin America & Caribbean

East Asia

South Asia

Middle East & North Africa

Sub-Saharan Africa

Deaths per 1,000 live births

39% decline

28% decline

37% decline0 20 40 60

CEE/CIS

48% decline

56% decline

56% decline

54% decline

5132

2915

4532

2511

2210

199

3321