Mortality in under 5s dropped by 35% between 1990 and 2010, says UN report

BMJ 2011; 343 doi: (Published 21 September 2011) Cite this as: BMJ 2011;343:d6013
  1. John Zarocostas
  1. 1Geneva

The number of children under 5 years old who die each year fell by a third between 1990 and 2010, from more than 12 million deaths to 7.6 million, new data from Unicef, the World Health Organization, and other agencies show.

Overall about 12 000 fewer children died every day in 2010 than in 1990, the baseline year for measuring progress, the agencies said in their report.

The global under 5 death rate fell from 88 deaths per 1000 live births in 1990 to 57 in 2010, but the report concludes that the rate of decline is “still insufficient”—especially in sub-Saharan Africa and south Asia—to achieve the United Nations’ fourth millennium development goal of a two thirds reduction by 2015.

Margaret Chan, WHO’s director general, said, “Reductions in child mortality are linked to many factors, particularly increased access to healthcare services around the newborn period, as well as prevention and treatment of childhood illnesses and improved nutrition, immunisation coverage, and water and sanitation.

Mortality in under 5s is increasingly concentrated in sub-Saharan Africa and south Asia, the agencies say. In 2010 these regions accounted, respectively, for a half (3.7 million deaths) and a third (2.5 million) of the global number.

In 2010 a child born in sub-Saharan Africa faced a one in eight chance of dying before reaching 5 years old, more than 17 times the average for developed countries (one in 143). Nearly all (24) of the 26 countries with an under 5 death rate above 100 per 1000 live births last year were in sub-Saharan Africa.

The report shows that five of the world’s nine developing regions registered reductions in under 5 mortality of more than 50% over the review period. The best performing developing area was north Africa, which achieved a reduction of 67%, followed by east Asia (63%), Latin America and the Caribbean (57%), southeastern Asia (55%), and west Asia (52%).

“Substantial progress is required in both regions,” concludes the joint report, compiled by the UN Inter-Agency Groups for Child Mortality, which also includes the World Bank and the UN’s population division.

On a more hopeful note the report also shows that 14 of the 66 countries with an under 5 death rate of greater than 40 per 1000 live births in 2010 reduced their rates by at least half between 1990 and 2010.

Of these, the biggest reductions in absolute numbers were in Niger, Malawi, Liberia, Timor-Leste, and Sierra Leone.

Anthony Lake, executive director of Unicef, said that focusing greater investment on the most disadvantaged communities “will help us save more children’s lives more quickly and more cost effectively.”


Cite this as: BMJ 2011;343:d6013


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