Children: reducing mortality
- 6.9 million children under the age of five died in 2011.
- More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.
- Leading causes of death in under-five children are pneumonia, preterm birth complications, diarrhoea, birth asphyxia and malaria. About one third of all child deaths are linked to malnutrition.
- Children in sub-Saharan Africa are about 16.5 times more likely to die before the age of five than children in developed regions.
A child's risk of dying is highest in the neonatal period, the first 28 days of life. Safe childbirth and effective neonatal care are essential to prevent these deaths. 43% of child deaths under the age of five take place during the neonatal period.
Preterm birth, intrapartum-related complications (birth asphyxia or lack of breathing at birth), and infections cause most neonatal deaths. From the end of the neonatal period and through the first five years of life, the main causes of death are pneumonia, diarrhoea and malaria. Malnutrition is the underlying contributing factor in over one third of all child deaths, making children more vulnerable to severe diseases.
Overall, substantial progress has been made towards achieving Millennium Development Goal (MDG) 4. Since 1990 the global under-five mortality rate has dropped from 87 deaths per 1 000 live births in 1990 to 51 in 2011. But the rate of this reduction in under-five mortality is still insufficient to reach the MDG target of a two-thirds reduction of 1990 mortality levels by the year 2015.
|Leading causes of death in children under five in the world - 2011|
|Deaths of children under five|
|Preterm birth complications||14%|
Who is most at risk?
Over 70% of all child deaths occur in Africa and South-East Asia. Within countries, child mortality is higher in rural areas, and among poorer and less educated families.
More than three million babies die every year in their first month of life and a similar number are stillborn. Within the first month, one quarter to one half of all deaths occur within the first 24 hours of life, and 75% occur in the first week. The 48 hours immediately following birth is the most crucial period for newborn survival. This is when the mother and child should receive follow-up care to prevent and treat illness.
Prior to birth, the mother can increase her child's chance of survival and good health by attending antenatal care consultations, being immunized against tetanus, and avoiding smoking and use of alcohol.
At the time of birth, a baby's chance of survival increases significantly with the presence of a skilled birth attendant. After birth, essential care of a newborn should include:
- ensuring that the baby is breathing;
- starting the newborn on exclusive breastfeeding right away;
- keeping the baby warm; and
- washing hands before touching the baby.
Identifying and caring for illnesses in a newborn are also very important, as a baby can become very ill and die quickly if an illness is not recognized and treated appropriately. Sick babies must be taken immediately to a trained health care provider.
Children under age five
More than half of under-five child deaths are due to diseases that are preventable and treatable through simple, affordable interventions. Strengthening health systems to provide such interventions to all children will save many young lives.
In 2010 about 20 million children worldwide were estimated to suffer from severe acute malnutrition, leaving them more vulnerable to serious illness and early death. Most of these children can be successfully treated at home with ready-to-use therapeutic foods (RUTF). Globally, in 2010, an estimated 171 million children below five years of age, were stunted and 104 million were underweight.
Leading causes of death in post-neonatal children: risk factors and response
|Cause of death||Risk factors||Prevention||Treatment|
|Pneumonia, or other acute respiratory infections||Low birth weight
Appropriate care by a trained health provider
Oxygen for severe illness
|Childhood diarrhoea||Non-breastfed children
Unsafe drinking water and food
Poor hygiene practices
Safe water and food
Adequate sanitation and hygiene
Low-osmolarity oral rehydration salts (ORS)
Prevention with vaccines
For some of the most deadly childhood diseases, such as measles, polio, diphtheria, tetanus, pertussis, pneumonia due to Haemophilius influenzae type B and Streptococcus pneumoniae and diarrhoea due to rotavirus, vaccines are available and can protect children from illness and death.
Global response: Millennium Development Goals 4 and 5
The Millennium Development Goals adopted by the United Nations in 2000 aim to decrease child and maternal deaths worldwide by 2015. The fourth Millennium Development Goal (MDG) is to reduce the 1990 mortality rate among under-five children by two thirds. Child mortality is also closely linked to MDG 5 to improve maternal health.
Since more than one third of all child deaths occur within the first month of life, providing skilled care to mothers during pregnancy, as well as during and after birth, greatly contributes to child survival. Member States have set targets and developed specific strategies to reduce child mortality and monitor progress.