Intended for healthcare professionals


Reduction of childhood mortality through millennium development goal 4

BMJ 2011; 342 doi: (Published 10 February 2011) Cite this as: BMJ 2011;342:d357
  1. Adnan A Hyder, director1,
  2. Jeffrey Lunnen, intern 1
  1. 1Johns Hopkins International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
  1. ahyder{at}

Will not be maximised unless injury prevention is integrated into the overall plan

Millennium development goal 4 aims to reduce mortality in children under 5 years by two thirds between 1990 and 2015. Unfortunately, as of 2010, among the 67 countries with high child mortality (≥40 deaths/1000 live births), only 10 are on track to meet this target.1 At the millennium development goal summit in September 2010, the general assembly of the United Nations adopted an outcome document that expressed “deep concerns that [progress] falls short of what is needed.”2 The lack of focus on prevention of childhood injury in many countries is exacerbating the failure to meet the target.

GMB Akash/Panos

About 830 000 children under 18 years die each year as a result of unintentional injuries, including road traffic injuries, poisoning, falls, burns, and drowning. In addition, tens of millions of children require acute hospital care or long term rehabilitation for non-fatal injuries. Globally, injuries are the leading cause of death for children aged 10-19 years, and road traffic injuries and drowning account for nearly half of all unintentional injuries to children.3

More than 260 000 children die as a result of road traffic injuries each year, and up to 10 million more are non-fatally injured.3 Both …

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