This blog is based on new mortality estimates released today by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME)
There has been remarkable progress in reducing mortality among children and young adolescents in the past several decades. Between 1990 and 2017, the global under-five mortality rate dropped by 58 percent from 93 deaths per 1,000 live births to 39 deaths per 1,000 live births. During the last 17 years, the reduction in under-five mortality rates accelerated to an average 4% annual reduction, compared to an average 1.9% annual reduction between 1990 and 2000. For children aged 5-14, mortality dropped by 53 percent, from 15 deaths to 7 deaths per 1,000 children.
However, while a substantial reduction from the 14.3 million in 1990, an estimated 6.3 million children under age 15 still died in 2017, mostly from preventable causes. The vast majority of these deaths—5.4 million—occurred in the first five years of life. Nearly half of the deaths of children under age 5 were accounted for by neonatal deaths (2.5 million). The first month of life is the most vulnerable period for children. Progress toward reducing neonatal mortality between 2000 and 2017 has been 1.5 times slower than for older children (under 5 deaths after the first month of life) for the same period.
The World Bank’s World Development Indicators database shows nearly half of births in Sub-Saharan Africa and more than a quarter of births in South Asia were not attended by skilled health staff. To further reduce child deaths, universal access to quality, affordable health services is critical, particularly around the time of birth and through the early years. This includes access to safe, quality, affordable obstetric, anesthesia and surgical care.
The report says in 2017, 118 countries already had an under-five mortality rate below the SDG target (no more than 25 deaths per 1,000 live births). Among the remaining 77 countries, progress will need to be accelerated in about 50 countries to achieve the SDG target by 2030.
Children continue to face large regional and income disparities in their chances of survival. More than 80 percent of global under-five deaths occur in just two regions — Sub-Saharan Africa and South Asia. Sub-Saharan Africa remains the region with the highest under-five mortality rate in the world, with 76 deaths per 1,000 live births. This translates to 1 in 13 children dying before their fifth birthday, 14 times higher than the average ratio of 1 in 185 children dying before age 5 in high-income countries.
The chance of survival highly depends on where and to whom children are born. By country, Somalia has the highest under-five mortality rate, at 127 per 1,000 (1 in 8 children dies), while Iceland and Slovenia have the lowest ratio, at 2.1 per 1,000 (1 in 476 children dies). Children in Somalia are 60 times more likely to die in the first five years of life than those in Iceland and Slovenia.
Disparities persist within countries as well. Globally, under-five mortality rates among children in rural areas are 50 percent higher than among children in urban areas. Babies born to uneducated mothers are more than twice as likely to die before the age of five than those born to mothers with secondary or higher education. According to the press release, reducing inequality by assisting the most vulnerable newborns, children and mothers is essential for achieving the target of the Sustainable Development Goals in ending preventable childhood deaths and for ensuring that no one is left behind.
Last year, World Bank Group President Dr. Jim Yong Kim announced the Human Capital Project, an accelerated effort to encourage investment in people as a critical step to boosting economic growth and ending extreme poverty. Investing in the health and education of all people is critical to build the human capital needed for future prosperity and better quality of life. Improving the survival chances of newborns, children and young adolescents remains an urgent challenge.
Continued efforts to produce reliable and transparent child mortality estimates to monitor SDG 3
As we wrote in our earlier blog on child mortality, the UN’s original Millennium Development Goals brought statisticians together to produce better data to monitor progress. The UN Inter-agency Group for Child Mortality Estimation (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 Millennium Development Goals. The group includes UNICEF, the World Health Organization, the World Bank Group and the United Nations Population Division as full members, and it continues to produce reliable and transparent child and adolescent mortality estimates in order to track countries’ progress towards SDG target 3.2. All data, estimates and details on UN IGME methods are available on the Child Mortality Estimates (CME INFO) website at childmortality.org. The new UN IGME child mortality estimates are also available in the World Bank’s World Development Indicators and HealthStats databases.