This technical report analyzes global progress in reducing child mortality. It finds that the global under-five mortality rate declined nearly in half between 1990 and 2012, saving 90 million lives. However, 6.6 million children still die each year before age five. Over half of under-five deaths occur in sub-Saharan Africa and South Asia. The leading causes of under-five death are neonatal conditions, pneumonia, diarrhea, and malaria. While progress has been made, accelerated efforts are needed to achieve the MDG target and ensure all children survive to their fifth birthday.

1. • Technical report providing
most recent country,
regional and global
estimates on child mortality
and includes methods
• 2nd annual report on progress
achieved on APR
commitments and includes
more in-depth mortality and
causes of death analysis

2. Great progress in reducing child deaths
• Global U5MR declined by nearly by half, from 90
per 1,000 live births in 1990 to 48 per 1,000 in
2012
• Annual number of under-five deaths reduced
from 12.6 million to 6.6 million over the same
period
• 17,000 fewer children died each day in 2012 than
did in 1990
• Annual < 5 deaths in Ethiopia declined from
around 440,000 per year in 1990 to 205,000 in
2012

3. 26 high mortality countries have reduced
under-five mortality rate by at least 50%
High-mortality
countries with
greatest
percentage
declines
in under-five
mortality rate
from 1990–2012
Source: IGME 2013.

4. Some poor countries have made great
progress in reducing under-five mortality
Decline in under-five mortality rate 1990–2012 and GDP per capita in 2012, by country
Source:UNICEFanalysisbasedonIGME2013and
WorldBankGDPpercapitaestimatespublishedin2013.

5. Exciting new findings on disparities
• Many regions have
reduced disparities in
under-five mortality
between the poorest
and the richest except
Sub-Saharan Africa and
South Asia
• Under-five mortality rate
has declined among
even the poorest in most
regions
Source: UNICEF analysis based on Pedersen, J., et al., Levels and Trends in Inequity
and Child Mortality: Evidence from DHS and MICS surveys', working paper,
unpublished, 2013.'

6. Where are deaths occurring?
Half of the 6.6 million under-five deaths occurred in
Sub-Saharan Africa
Number and % of under-five deaths by region, 2012
(thousands and % of global total)
Source: IGME 2013.
Half of all child
deaths occur in
just 5 countries:
India, Nigeria,
Pakistan, DR
Congo, China

7. Children in Sub-Saharan Africa and Southern Asia
face a higher risk of dying before their fifth birthday
Source: IGME 2013.

8. Progress in Ethiopia in Context:
Under 5 Mortality Declines and Targets, 1990-2035
0
50
100
150
200
250
1990 2012 MDG Target 2015APR Target 2035
Ethiopia
Somalia
Kenya
Brazil
Under 5
MR per
1000 live
births

9. Malaria
7%
Injury
5%
AIDS
2%
Other
22%
Neonatal
44%
Pneumonia
17%
Diarrhoea
9%
Globally, nearly
half of all deaths
among children
under 5 are
attributable to
undernutrition
Infectious diseases such as pneumonia, diarrhoea and malaria are
the leading killers of children under age 5; roughly 44% of deaths in
children under 5 occur during the neonatal period
Estimates are rounded, and therefore may not sum to 100%.
Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013.
Global distribution of deaths among children under age 5, by cause, 2012

10. Despite declining rates, neonatal deaths are growing as
a share of global under-five deaths, amid faster progress
in reducing mortality in the post-neonatal period

11. 90 million lives saved since 1990 – more than
the current population size of Germany
Number of lives saved since 1990 among children under age 5, and number of lives to be saved
in order to achieve MDG4
Source: UNICEF analysis based on IGME 2013.

12. 90 million lives saved since 1990 – more than
the current population size of Germany
Number of lives saved since 1990 among children under age 5, and number of lives to be saved
in order to achieve MDG4
Source: UNICEF analysis based on IGME 2013.

13. Unfinished business
• Good news
• Outstanding progress in decreasing under five
mortality at global and regional levels
• Even in some of the most disadvantaged countries and
households
• ESAR countries making strong progress
• Ethiopia and Malawi notable front-runners
• Bad news
• Nearly 6.6 million children still died in 2012
• 18,000 children under age five died each day
• Not likely to reach MDG4 unless accelerate++
• World needs examples such as Ethiopia