What progress has been made in reducing child mortality?

Dereje Ketema
Consultant, World Bank
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Future of Global Health and Healthcare

Millennium Development Goal 4  is to “Reduce child mortality” and is measured against a target to “Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate”. It includes indicators to measure the under-5 mortality rate, the infant mortality rate and the proportion of 1-year olds immunized against measles.

17,000 fewer children now die each day compared with 1990

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In 1990 13 million children died before their fifth birthday, by 1999 it was less than 10 million, and by 2013 it had fallen to just over 6 million. This means that at least 17,000 fewer children now die each day compared with 1990.

In 1990 the average under-five mortality rate for all developing countries was 99 deaths per 1,000 live births; in 2013 it had fallen to 50 or about half the 1990 rate. This is tremendous progress. But based on the current trend, developing countries as a whole are likely to fall short of the Millennium Development Goal target. Despite rapid improvements since 2000, child mortality rates in Sub-Saharan Africa and South Asia remain considerably higher than in the rest of the world


74 percent of deaths of children under age 5 occur in the first year of life

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Almost 74 percent of deaths of children under age 5 occur in the first year of life, and 60 percent of those occur in the neonatal period (the first month). Preterm birth (before 37 weeks of pregnancy) complications account for 35 percent of neonatal deaths, and complications during birth another 24 percent. Because declines in the neonatal mortality rate are slower than declines in the postneonatal mortality rate, the share of neonatal deaths among all under-five deaths increased from 37 percent in 1990 to 44 percent in 2013. Tackling neonatal mortality will have a major impact in reducing the under-five mortality rate.

Although there has been a dramatic decline in deaths, most children still die from causes that are readily preventable or curable with existing interventions. Pneumonia, diarrhea, and malaria are the leading causes, accounting for 30 percent under-five deaths.

Measles immunization rates are stagnating

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In developing countries measles vaccinations of one-year-old children reached about 83 percent in 2013. Both Sub-Saharan Africa and South Asia have seen the coverage of measles vaccinations increase since 1990, but the trend has recently slowed in both regions. This is concerning, as it might make further reductions in under-five mortality more challenging

Indicators and codes used in this post:

Mortality rate, under-5 (per 1,000) SH.DYN.MORT
Mortality rate, neonatal (per 1,000 live births) SH.DYN.NMRT
Mortality rate, infant (per 1,000 live births)  SP.DYN.IMRT.IN
Number of under-five deaths SH.DTH.MORT
Number of infant deaths SH.DTH.IMRT
Number of neonatal deaths  SH.DTH.NMRT
Immunization, measles (% of children ages 12-23 months)  SH.IMM.MEAS

This post first appeared on The World Bank Open Data Blog.

Publication does not imply endorsement of views by the World Economic Forum.

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Author: Dereje Ketema, a native of Ethiopia, is a consultant at the World Bank’s Development Data Group.

Image: A woman with a baby on her back looks on at an informal settlement in the capital Luanda. REUTERS/Siphiwe Sibeko 

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