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UNICEF STATISTICS
  UNICEF Data: Monitoring the Situation of Children and Women
Multiple Indicator Cluster Surveys (MICS)
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Since 1990, the world has cut both the rate and number of child deaths by more than one half. This progress, while remarkable, falls short of the Millennium Development Goal 4 (MDG 4) target of a two-thirds reduction in the under-five mortality rate. In 2015, an estimated 5.9 million children under the age of five will still die, equivalent to 11 every minute. This underscores that child survival needs to be a continued priority when we look beyond the MDGs.

UNDER-FIVE MORTALITY

The global under-five mortality rate has fallen by 53 per cent, from 91 deaths per 1,000 live births in 1990 to an estimated 43 in 2015. The infant mortality rate has fallen by nearly half. Neonatal mortality has declined less steeply than the other rates, dropping 47 per cent. Over the same period, the absolute number of child deaths per year has also fallen substantially. In 1990, 12.7 million children around the world died before reaching their fifth birthday; in 2015, that number has fallen to 5.9 million children. Over the same period, the number of newborn babies who died within the first 28 days of life declined from 5.1 million to 2.7 million.

Both the under-five mortality rate and the number of under-five deaths have fallen by more than half since 1990
Global under-five, infant and neonatal mortality rates and number of deaths, 1990-2015

Note: The shaded bands in Figure 1A are the 90 per cent uncertainty intervals around the estimates of under-five mortality rates.

Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), as published in UNICEF: Committing to Child Survival: A promise renewed-Progress report 2015, UNICEF, New York 2015.

This progress, while remarkable, falls short of the MDG 4 target of a two-thirds reduction in the under-five mortality rate. If every country had further accelerated progress in improving child survival since 2000 and achieved the MDG 4 target by 2015, an additional 14 million under-five deaths would have been averted between 2000 and 2015.

At a regional level, the overall trends are positive but vary. Since 1990, every region of the world has reduced its under-five mortality rate by at least half. East Asia and the Pacific and Latin America and the Caribbean each met the MDG 4 target of a two-thirds reduction in the under-five mortality rate.

Every region has reduced under-five mortality by at least half since 1990
Percentage decline in under-five mortality rate by region, 1990-2015

* Central and Eastern Europe and the Commonwealth of Independent States

Note: The blue bar shows the median estimate, and the yellow vertical lines represent the 90 per cent uncertainty intervals around the value.

Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), as published in UNICEF: Committing to Child Survival: A promise renewed-Progress report 2015, UNICEF, New York 2015.

Promisingly, progress in reducing under-five mortality in sub-Saharan Africa – the region with the highest under-five mortality rate in the world – has been accelerating even faster than the global average. Its annual rate of reduction increased from just 1.6 per cent in the 1990s to 4.1 per cent over the 2000-2015 period, and all but five of the 49 sub-Saharan African countries had higher annual rates of reduction in 2000-2015 than in the 1990s.

Progress on reducing under-five mortality is accelerating
Annual rate of reduction in the under-five mortality rate, per cent, by region, 1990–2000 and 2000–2015

Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), as published in UNICEF: Committing to Child Survival: A promise renewed-Progress report 2015, UNICEF, New York 2015.

At a national level, sixty-two countries have met the MDG 4 target for reducing under-five mortality by two-thirds between 1990 and 2015. Among them are 12 low-income countries and another dozen lower-middle income countries. These successes demonstrate that dramatic reductions are possible even in resource-constrained settings.

While falling short of the MDG 4 target, another 74 countries cut their under-five mortality rates by at least half. Combined, 70 per cent of the 195 countries with available data reduced under-five mortality by 50 per cent or more.

Sixty-two countries met the MDG 4 target of reducing under-five mortality rates by two thirds from 1990 levels
Percentage decline in under-five mortality rate, 1990–2015 and gross domestic product (GDP) per capita, by country, 2014

How to read the graph: Each bubble represents a country. The size of each bubble represents the number of estimated under-five deaths in the country in 2015. Countries above the blue horizontal line achieved a two-thirds reduction.

Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), as published in UNICEF: Committing to Child Survival: A promise renewed-Progress report 2015, UNICEF, New York 2015.

Even with the progress made in reducing under-five deaths during the MDG period, over the past 25 years, a total of 236 million children died before reaching their fifth birthday. This number is staggering – more than the current population of Brazil, the world’s fifth most populous country. About 16,000 children under the age of five still die every day.

The remaining burden of child mortality is not evenly shared across regions and countries. The 5.9 million under-five deaths that are estimated to occur in 2015 are heavily concentrated in sub-Saharan Africa and South Asia, and in lower income countries.

The highest national under-five mortality rates are found in sub-Saharan Africa
Under-five mortality rate and under-five deaths by country, 2015

Note: The number of under-five deaths is affected by not only the under-five mortality rates but also the under-five population in a country

Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), as published in UNICEF: Committing to Child Survival: A promise renewed-Progress report 2015, UNICEF, New York 2015.

This map does not reflect a position by UNICEF on the legal status of any country or territory or the delimitation of any frontiers. The dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. The final boundary between the Sudan and South Sudan has not yet been determined. The final status of the Abyei area has not yet been determined.

Globally, the main killers of children under age five in 2015 were pneumonia (16 per cent), preterm birth complications (16 per cent), intrapartum-related complications (11 per cent), diarrhoea (9 per cent), neonatal sepsis (7 per cent) and malaria (5 per cent). Infectious diseases and neonatal complications are responsible for the vast majority of under-five deaths around the world. Of the 5.9 million under-five deaths in 2015, almost half were caused by leading infectious diseases and conditions such as pneumonia, diarrhoea, malaria, meningitis, tetanus, measles, sepsis and AIDS.

Despite progress, key infectious diseases remain the main killers of children under age 5; preterm birth and intrapartum-related complications are responsible for the majority of neonatal deaths
Global distribution of deaths among children under age five by cause, 2015

Source: WHO and Maternal and Child Epidemiology Estimation Group (MCEE) provisional estimates 2015

 

The leading causes of under-five deaths vary between high and low mortality groupings and among high mortality regions. In very-low-mortality countries (with an under-five mortality less than 10 deaths per 1,000 live births in 2015), infectious diseases are not the main causes of death for children under five. In those countries, pneumonia, diarrhoea, malaria, sepsis, pertussis, tetanus and meningitis, measles and AIDS together only account for 10 per cent of all under-five deaths. In higher-mortality regions, however, these key infectious diseases still kill many children under age 5, accounting for 39 per cent, 54 per cent and 47 per cent of all under-five deaths in South Asia, West and Central Africa, and Eastern and Southern Africa, respectively.

Infectious diseases remain the main killers of children under age five in Sub-Saharan Africa
Distribution of deaths among children under age 5 by cause, by region, 2015

Very-low-mortality countries are those with an under-five mortality rate of less than 10 deaths per 1,000 live births in 2015.

Note: Estimates are rounded and therefore may not sum up to 100%.

Source: WHO and Maternal and Child Epidemiology Estimation Group (MCEE) provisional estimates 2015

 

 

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Publication

Committing to Child Survival: A Promise Renewed - Progress Report 2014

Child Survival

This report looks at causes of death and coverage of key interventions for mother and newborn and highlights initiatives by governments, civil society and the private sector to accelerate progress on child survival.

 
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Publication

Levels and Trends in Child Mortality Report 2014

Child Survival

Recent estimates show that the number of under-five deaths worldwide has declined by half since 1990, from 12.7 million to 6.3 million today. Yet, 17,000 children under age five still die every day in 2013.

 
Download full report (PDF)

Journal Article

National, regional, and global sex ratios of infant, child, and under-5 mortality and identifi cation of countries with outlying ratios: a systematic assessment

Child Survival

The Lancet, vol. 2, no.9, 2014, pp. e521-e530.

 
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Journal Article

UNICEF Report: enormous progress in child survival but greater focus on newborns urgently needed

Child Survival

Reproductive Health, vol. 11, no.8, 2014, pp.1-4.

 
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Levels and Trends in Child Mortality 2015

This report presents the group’s latest estimates of under-five, infant and neonatal mortality up to the year 2015, and assesses progress at the country, regional and global levels. The report also provides an overview on the estimation methods used for child mortality indicators.

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Committing to Child Survival: A Promise Renewed 2015

Since its initiation, A Promise Renewed has focused on promoting two goals: first, keeping the promise of Millennium Development Goal (MDG) 4 – to reduce the under-five mortality rate by two thirds, between 1990 and 2015; and second, continuing the fight beyond 2015, until no child or mother dies from preventable causes.  By focusing on priority actions and core principles, countries are already achieving progress, bending the curve on child mortality and moving towards a world where no mother or child dies from a preventable cause. As we begin the work of the Sustainable Development Goals, maintaining this momentum must be our top priority

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Journal Article

Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation

Child Survival

In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. The report aims to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030.

 
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Notes on the Data

DEFINITION OF INDICATORS

Under-five mortality rate: Probability of dying between birth and exactly 5 years of age, expressed per 1,000 live births.
Infant mortality rate: Probability of dying between birth and exactly 1 year of age, expressed per 1,000 live births.

Neonatal mortality rate: Probability of dying during the first 28 days of life, expressed per 1,000 live births.

DATA SOURCES AND METHODOLOGY

If each country had a single source of high-quality data covering the last few decades, reporting on child mortality levels and trends would be straightforward. But few countries do, and the limited availability of high-quality data over time for many countries makes generating accurate estimates of child mortality a considerable challenge.

Nationally representative estimates of child mortality can be derived from several sources, including civil registration, censuses and sample surveys. Demographic surveillance sites and hospital data are excluded because they are rarely representative. The preferred source of data is a civil registration system that records births and deaths on a continuous basis, collects information as events occur and covers the entire population. If registration coverage is complete and the systems function efficiently, the resulting child mortality estimates will be accurate and timely. However, many countries remain without viable or fully functioning vital registration systems that accurately record all births and deaths—only around 60 countries have such systems. Therefore, household surveys, such as the UNICEF-supported Multiple Indicator Cluster Surveys and the US Agency for International Development–supported Demographic and Health Surveys, which ask women about the survival of their children, are the basis of child mortality estimates for most developing countries.

The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) seeks to compile all available national-level data on child mortality, including data from vital registration systems, population censuses, household surveys and sample registration systems. To estimate the under-five mortality trend series for each country, a statistical model is fitted to data points that meet quality standards established by IGME and then used to predict a trend line that is extrapolated to a common reference year, set at 2015 for the estimates presented here. Infant mortality rates are generated by either applying a statistical model or transforming under-five mortality rates based on model life tables. Neonatal mortality rates are produced using a statistical model that uses under-five mortality rates as input. These methods provide a transparent and objective way of fitting a smoothed trend to a set of observations and of extrapolating the trend from the earliest available data point to the present.

An overview on the methodology is available in this year’s UN IGME report

A peer-reviewed collection of articles that makes a vital contribution to transparency on UN IGME's methodology for child mortality estimation.

Topics include: an overview of the child mortality estimation methodology developed by UN IGME, methods used to adjust for bias due to AIDS, estimation of sex differences in child mortality, and more. The collection was produced with support from UNICEF and the independent technical advisory group of IGME Read more.

CHANGE IN ESTIMATION PROCESS

The UN IGME continually seeks to improve its methods. Since 2013, estimates and projections of under-five mortality have been produced using the Bayesian B-splines bias-adjusted model, referred to as the B3 model.  Compared with the previously applied Loess estimation approach the B3 model better accounts for data errors, including biases and sampling and nonsampling errors in the data. It can better capture short-term fluctuations in the under-five mortality rate and its annual rate of reduction and thus is better able to account for evidence of acceleration in the decline of under-five mortality from new surveys. Validation exercises show that the B3 model also performs better in short-term projections.

Estimates of infant mortality rates are generated by applying the B3 model for countries with high-quality vital registration data. For other countries, infant mortality rates are derived from under-five mortality rates using model life tables that contain known regularities in age patterns of child mortality. This approach ensures that the internal relationships of the two indicators are consistent with established norms. Estimates of neonatal mortality rates are produced using a statistical model that uses under-five mortality rates as an input. These methods provide a transparent and objective way of fitting a smoothed trend to a set of observations and of extrapolating the trend to the present.

In 2012 the UN IGME produced sex-specific estimates of the under-five mortality rate for the first time. In many countries fewer sources provide data disaggregated by sex than for both sexes combined. So the UN IGME uses the available data by sex to estimate a time trend in the sex ratio (male–female) of child mortality rather than estimating child mortality trends by sex directly from reported mortality levels by sex. Since 2013 a Bayesian model developed by the UN IGME has been used to estimate sex ratios of child mortality, with a focus on identifying countries with outlying levels or trends.

In 2015 the UN IGME method for estimating NMR were updated. The new Bayesian methodology is similar to that used to estimate U5MR and estimates by sex. It has the advantage that, compared to the previous model, it can capture data-driven trends in NMR within countries and over time for all countries.

More details on the data used in deriving estimates are available in CME Info http://www.childmortality.org.

RECENT RESOURCES

UNICEF, Committing to Child Survival: A Promise Renewed. Progress Report 2015, New York, 2015.

United Nations Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report 2015, New York, 2015.

KEY REFERENCES

  1. For a detailed description of the B3 methodology, see Alkema, L. and New, J.R. (2014). ‘Global estimation of child mortality using a Bayesian B-spline bias-reduction method’, Annals of Applied Statistics, Vol. 8, No. 4, 2122-2149. Available at  http://arxiv.org/abs/1309.1602 [PDF].  

  2. Full details of the methodology used in the estimation of child mortality for 2015 are available in the PLOS Medicine Collection on Child Mortality Estimation methods (www.ploscollections.org/childmortalityestimation).

  3. For changes to methods used for the 2013 estimates, refer to UN IGME Inter-agency Levels and Trends in Child Mortality: Report 2015. 

  4. For changes to data and methods used for the 2010 estimates click here.
  5. For detailed information on the methodology used for the 2009 estimates, click Estimation Methods used by the United Nations Inter-agency Group for Child Mortality Estimation.
  6. The full details of the methodology used in the estimation of infant and under-five mortality rates for 2006 are available in the following working paper: UNICEF, WHO, The World Bank and UN Population Division, Levels and Trends of Child Mortality in 2006: Estimates developed by the Inter-agency Group for Child Mortality Estimation’, New York, 2007. Working Paper [PDF]

 

Other references include:

Hill, K., et al., Trends in Child Mortality in the Developing World: 1960-1996 [Full publication [zip]. 

Alkema, L. et al., ‘National, regional, and global sex ratios of infant, child, and under-5 mortality and identification of countries with outly­ing ratios: a systematic assessment’, The Lancet Global Health, vol. 2, 9, 1 September 2014, pp. e521-e530, DOI: 10.1016/S2214-109X(14)70280-3

United Nations Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report 2014.

United Nations Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report 2013. 

United Nations Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report 2012.

United Nations Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report 2011. 

United Nations Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report 2010.