Professional Documents
Culture Documents
Goal 4: Reduce Child Mortality
Goal 4: Reduce Child Mortality
Target 4.A
Southern Asia
126
60%
50
Caucasus and Central Asia
73
55%
33
South-Eastern Asia
Key facts 71
62%
27
XX The global under-five mortality Northern Africa
rate has declined by more than 73
67%
half, dropping from 90 to 43 24
deaths per 1,000 live births Western Asia
between 1990 and 2015. 65
65%
23
XX The rate of reduction in under-
Latin America and the Caribbean
five mortality has more than 54
69%
tripled globally since the early 17
1990s.
Eastern Asia
53
XX Measles vaccination helped 78%
11
prevent nearly 15.6 million deaths
Developed regions
between 2000 and 2013.
15
61%
6
XX About 84 per cent of children
worldwide received at least one Developing regions
100
dose of measles-containing 53%
47
vaccine in 2013.
World
90
XX Every day in 2015, 16,000 53%
43
children under five continue to
die, mostly from preventable
0 50 100 150 200
causes. Child survival must
remain the focus of the post-2015 1990 2015 projection 2015 target
development agenda. Percentage change between 1990 and 2015
The dramatic decline in preventable child deaths over the Focusing on newborns is critical to further
past quarter of a century is one of the most significant accelerating progress in child survival
achievements in human history. According to preliminary
estimates, the global under-five mortality rate has
declined by more than half, dropping from 90 to 43 Number of deaths by day in the first 28 days of life,
deaths per 1,000 live births between 1990 and 2015. 2013 (thousands)
This translates into almost 6 million deaths of children 1,000
under five in 2015, a decline from 12.7 million in 1990.
The under-five mortality rate has fallen by 50 per cent or
800
more in every region except Oceania.
h
y2
y4
y6
y8
Da 2
Da 4
Da 6
Da 18
Da 0
Da 2
4
7
malaria.
irt
y2
y1
y2
y2
y1
y1
y1
y2
y
Da
Da
Da
Da
fb
Da
Da
Da
yo
Da
Though sub-Saharan Africa has the world’s highest child 1 million deaths on the first day of life = 36% of neonatal deaths
2 million deaths in the first week = 73% of neonatal deaths
mortality rate, the absolute decline in child mortality
has been the largest over the past two decades. The
under-five mortality rate has fallen from 179 deaths per The first day, week and month of life are the most critical
1,000 live births in 1990 to 86 in 2015. Yet the region still for the survival of children. Of the almost 6 million
faces an urgent need to accelerate progress. Not only children who die before their fifth birthday in 2015, about
does sub-Saharan Africa carry about half of the burden 1 million will take their first and final breath on the day
of the world’s under-five deaths—3 million in 2015—but they are born. An additional 1 million will die in the first
it is also the only region where both the number of live week, and around 2.8 million will die during their first
births and the under-five population are expected to rise 28 days of life (the neonatal period).
substantially over the next decades. This means that the
number of under-five deaths will increase unless progress Between 1990 and 2015, the worldwide neonatal
in reducing the under-five mortality rate is enough to mortality rate has fallen from 33 deaths to 19 deaths per
outpace population growth. 1,000 live births. As the decline in neonatal mortality
has been slower than the decline in mortality for children
Southern Asia also continues to have both a high rate of aged 1–59 months, neonatal deaths now represent a
under-five mortality, at 50 deaths per 1,000 live births in larger share of total under-five deaths. Every region of
2015, and a large number of total deaths, at 1.8 million. the world is experiencing an increase in the proportion of
under-five deaths that occur in the neonatal period.
Child mortality rates are falling Under-five mortality is declining faster than at any other
faster than ever time during the past two decades. The global annual
rate of reduction has more than tripled since the early
Annual rate of reduction in the under-five mortality rate 1990s. In sub-Saharan Africa, despite the relatively high
in developing regions, 1990¬2013 (percentage) rate of under-five mortality, the rate of decline was over
five times faster during 2005–2013 than it was during
Oceania 1990–1995, accelerating from 0.8 per cent per year to
1.4 4.2 per cent per year.
0.7
1.0
2.1 The annual rate of reduction in under-five mortality has
South-Eastern Asia accelerated since 1995 in countries of all income levels
4.0 except in high-income countries. Although there is a
3.8 link between a country’s level of income and its child
4.3
3.7
mortality, the strong reductions in under-five mortality
rates in a number of low-income countries—notably,
Latin America and the Caribbean
Bangladesh, Cambodia, Eritrea, Ethiopia, Liberia,
4.7
5.6 Madagascar, Malawi, Mozambique, Nepal, Niger,
5.1 Rwanda, Uganda and United Republic of Tanzania—
4.1
prove that low income need not be an impediment to
Southern Asia saving children’s lives.
2.9
3.4
3.9
4.1
Northern Africa
4.8
5.0
4.9
4.1
Sub-Saharan Africa
0.8
1.9
3.8
4.2
Western Asia
4.0
4.5
4.1
4.4
Eastern Asia
2.7
4.7
8.7
7.7
-1 0 1 2 3 4 5 6 7 8 9 10
Measles immunization has saved millions Measles deaths have declined rapidly since 2000, from
of children’s lives, but progress towards 544,200 deaths to 145,700 deaths in 2013, mostly
among children under five years of age. Compared
eliminating measles has stalled with estimated mortality in the absence of a measles
vaccination programme, nearly 15.6 million deaths were
Estimated child deaths due to measles (thousands) and averted by measles vaccination between 2000 and 2013.
proportion of children in the appropriate age group who Measles deaths in sub-Saharan Africa (96,000) and
received at least one dose of measles-containing vaccine Southern Asia (39,800) accounted for 93 per cent of the
(percentage), 1990¬2013 estimated measles deaths worldwide during 2013.
Thousands Percentage
700 100 Also, between 2000 and 2013, the number of annual
reported measles cases globally declined by 67 per cent,
from more than 853,000 in 2000 to under 279,000 in
600 95
2013. However, the number of measles cases in 2013
increased from the 2012 level of 227,700. Unfortunately,
500 90 continued outbreaks—due to weak routine immunization
systems and delayed implementation of accelerated
400 85
disease control—have stalled momentum towards
achievement of regional and global targets for measles
control and elimination.
300 80
Measles can be prevented with two doses of a safe,
200 75 effective and inexpensive vaccine. Between 2000 and
2009, global coverage with the first dose of measles-
containing vaccine (MCV1) increased from 73 per cent
100 70
to 83 per cent, but it stagnated at 83–84 per cent from
2010 to 2013. The most impressive progress was made
0 65 in sub-Saharan Africa, where coverage increased from
1990 1995 2000 2005 2010 2013 53 per cent in 2000 to 74 per cent in 2013. Between
Left axis: Child deaths in sub-Saharan Africa 2000 and 2013, the number of countries providing a
second dose of the vaccine (MCV2) increased from
Child deaths in Southern Asia
96 to 148, and global coverage of MCV2 increased from
Child deaths in other regions
15 to 53 per cent.
Right axis: Global proportion of children who received vaccine
Impressive as these gains are, progress has stalled
since 2010 and remains fragile. An estimated 21.6
million infants did not receive MCV1 in 2013. Many
of them are from the poorest and most marginalized
communities, residing in especially hard-to-reach areas.
Ramping up progress will require countries and the
international community to continue to campaign for
measles elimination. Achieving equitable increases in
immunization coverage will also require substantial and
sustained investments in strengthening health systems.
Goal 4: Reduce child mortality | 37
Child survival must remain at the heart of the post-2015 global development agenda
Reducing under-five mortality requires political will, Achievement of Goal 4 by a significant number of
sound strategies and adequate resources. The MDGs countries, even very poor countries, shows that it can be
have led to dramatic and unprecedented progress done. With millions of women and children still at risk
in reducing child deaths. Effective and affordable of dying of preventable causes, maternal, newborn and
treatments, improved service delivery and political child survival must remain at the heart of the post-2015
commitment have all contributed. Yet every minute global development agenda.
around the world, 11 children die before celebrating their
fifth birthday, mostly from preventable causes. More
work is needed to improve child survival rates.