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In 2015, the global child mortality rate is less than half its 1990 levels, but the MDG 4 target has not been met

Emi Suzuki's picture
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New child mortality estimates [PDF 4.2 Mb] released today by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) show major progress globally. Between 1990 and 2015, the global under-five mortality rate dropped 53 percent from 91 to 41 deaths per 1,000. But this drop is still not enough to meet the global MDG4 target of a two-thirds reduction between 1990 and 2015.


In this final year of the Millennium Development Goals (MDGs), two out of six regions have met the MDG4 target: East Asia and the Pacific, and Latin America and the Caribbean, whereas the Europe and Central Asia, and Middle East and North Africa regions fell slightly short. In Sub-Saharan Africa and South Asia, progress remains insufficient to reach the target.

At the country level, about a third of low and middle-income countries (46) have reduced their under-five mortality by two thirds or more and achieved the MDG 4 target. This includes 12 low-income countries, 12 lower-middle income countries,  and 22 upper-middle income countries

Sub-Saharan Africa has the highest under-five mortality rate. In 2015, 1 in 12 children in Sub-Saharan Africa died before age 5 - more than 12 times higher than the 1 in 147 rate seen in high-income countries. South Asia has the second-highest rate where 1 in 19 children dies. Fifty percent of global under-five deaths occur in Sub-Saharan Africa, and 31% occur in South Asia, accounting for 81% of global under-five deaths. The report mentions these two regions for focus.

The 44% decline in under-five mortality over the past 15 years has saved the lives of 48 million children


It’s not just the rates that have fallen – the absolute number of under-five deaths worldwide has declined from 12.7 million in 1990 (35,000 deaths per day) to 5.9 million in 2015 (16,000 deaths per day). This is the first year when fewer than 6 million children under five died. The decline in under-five mortality since 2000 has saved the lives of 48 million children - children who would not have survived to their 5th birthday if under-five mortality rates remained unchanged from 2000 onward.

Globally, the rate of progress has also been increasing. Between 1990 and 2000, the annual rate of reduction in the under-five mortality rate was 1.8 percent. But between 2000 and 2015, annual reductions have averaged 3.9 percent. This acceleration has also been observed in Sub-Saharan Africa where the under-five mortality rate is highest.

45 percent of under-five deaths occur within children’s first 28 days of life.


While both under-five and neonatal (the first 28 days of life) mortality rates have come down, neonatal mortality rates are declining more slowly, so the proportion of neonatal deaths has been increasing.

The share of neonatal deaths among overall under-five deaths has increased from 40% in 1990 to 45% in 2015. The neonatal mortality rate fell from 36 deaths per 1,000 live births in 1990 to 19 in 2015 and the number of neonatal deaths declined from 5.1 million in 1990 to 2.7 million in 2015 . The report notes that the biggest challenge remains in the period at or around birth.

Most child deaths are easily preventable by proven interventions

The report and press release emphasize the tremendous progress, but also the work that still remains in the Sustainable Development Goal (SDG) era. Most child deaths are easily preventable by proven and readily available interventions. The rate of reduction of child mortality can be sped up considerably by concentrating on regions with the highest levels – Sub-Saharan Africa and South Asia – and ensuring a targeted focus on newborns.

The previous UN IGME report noted the leading causes of death among children under age five include preterm birth complications, pneumonia, intrapartum-related complications, diarrhea and malaria. Globally nearly half of under-five deaths are attributable to undernutrition.

The MDGs have brought statisticians together to produce better data

Lastly, on the occasion of the MDG’s target year, I would like to acknowledge large effects that the MDGs brought to monitoring work. Following the adoption of the Millennium Declaration by the United Nations General Assembly in 2000, various international agencies including the World Bank resolved to invest in using high-quality harmonized data to monitor the MDGs.

These efforts included fostering international collaboration through establishment and participation in the inter-agency groups to monitor the progress towards MDG target. The MDGs brought many statistical workers together to produce increasingly better data. I believe the UN IGME has been one of the most successful efforts in MDG monitoring.

Continued efforts to produce reliable and transparent child mortality estimates

 The new estimates discussed in this post were released by the UN IGME, which includes UNICEF, World Health Organization, The World Bank Group and the United Nations Population Division.  The UN IGME was formed in 2004 to share data on child mortality, harmonize estimates within the UN system, improve methods for child mortality estimation, and to report on progress towards the MDGs.

All data, estimates, and details on UN IGME methods are available on the Child Mortality Estimates (CME Info) website at childmortality.orgThe new UNIGME child mortality estimates are also available in World Bank Development Data Group's World Development Indicators and HealthStats databases.


Submitted by Bahie Mary Rassekh on

Excellent analysis, Emi! It is heartening that EAP and LAC met the MDG4 Target, and that the rates and absolute number of <5 deaths worldwide have decreased substantially over the past 15 years. Accelerating progress in reducing the <5MR - especially in SSA where the annual rate of reduction increased so dramatically - is positive, as we look ahead to working toward the SDGs. Looking forward to reading the report.

Submitted by Ed Bos on

This is a very clear analysis, and a nice presentation of the data. Well done.
The decline in child mortality is impressive, and one may wonder whether it matters that an arbitrary target set in the 1990s that was not based on any analysis of what could be achieved is relevant. Health programs around the world should celebrate the achievement, and focus further efforts on reducing lagging declines among the poorest in many countries (even those that have made a lot of progress).

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