News

“The news that the rate of child mortality in Sub-Saharan Africa is declining twice as fast as it was a decade ago shows that we can make progress even in the poorest places, but we cannot for a moment forget the chilling fact of around 21,000 children dying every day from preventable causes,” said Anthony Lake, UNICEF Executive Director. “Focusing greater investment on the most disadvantaged communities will help us save more children’s lives, more quickly and more cost effectively.”

Between 1990 and 2010, the under-five mortality rate dropped by more than one-third, from 88 deaths per 1,000 live births to 57.

Unfortunately, this rate of progress is still insufficient to meet Millennium Development Goal 4 (MDG4), which calls for a two-thirds reduction in the under-five mortality rate by 2015.

"Reductions in child mortality are linked to many factors, particularly increased access to health care services around the newborn period. As well as prevention and treatment of childhood illnesses, and improved nutrition, immunization coverage, and water and sanitation," said Dr Margaret Chan, WHO Director General. "This is proof that investing in children's health is money well spent, and a sign that we need to accelerate thatinvestment through the coming years."

Some of the greatest improvements are in countries where children are most vulnerable.

One example is Niger, where the 1990 under-five mortality rate was 311 per 1,000 live births. To address the often large distances between people and health centres, a strategy of deploying trained community health workers to deliver high-impact interventions at thousands of new health posts across the country was used. In 2010, Niger was one of the five countries with the greatest absolute reductions in overall under-five mortality rates, together with Malawi, Liberia, Timor-Leste and Sierra Leone.

Dr. Chan and Mr. Lake agreed that the commitment of governments and the implementation of strategies to overcome local constraints to access and use of essential services are critical success factors. The report shows that newborns and infants are the most at risk of dying, and there has been less progress for them than within the under-five age category as a whole. More than 40 per cent of under-five deaths occur within the first month of life and over 70 per cent in the first year of life.

The improvements and progress are encouraging – but stark disparities persist. Sub-Saharan Africa is still home to the highest rates of child mortality, with one in eight children dying before reaching five – more than 17 times the average for developed regions (1 in 143). Southern Asia has the second highest rates with 1 in 15 children dying before age five.

Under-five deaths are increasingly concentrated in sub-Saharan Africa and Southern Asia. In 1990, 69 per cent of under-five deaths occurred in these two regions – in 2010, that proportion increased to 82 per cent. About half of all under five deaths in the world took place in just five countries in 2010: India, Nigeria, Democratic Republic of Congo, Pakistan and China.

The new estimates are published in the 2011 report Levels & Trends in Child Mortality, issued by the UN Inter-agency Group for Child Mortality Estimation (IGME), which is led by UNICEF and WHO and includes the World Bank and the UN Population Division.