PROGRESS TOWARDS Millennium Development Goal 4:
KEY FACTS AND FIGURES
Only four years remain to achieve Millennium Development Goal 4 (MDG 4), which calls for reducing the under-five mortality rate by twothirds between 1990 and 2015. Since 1990 the under-five mortality rate has dropped 35 percent, with every developing region seeing at least a 30 percent reduction. However, at the global level progress is behind schedule, and the target is at risk of being missed by 2015. The global underfive mortality rate needs to be halved from 57 deaths per 1,000 live births to 29—that implies an average rate of reduction of 13.5 percent a year, much higher than the 2.2 percent a year achieved between 1990 and 2010.
Child mortality is a key indicator not only of child health and nutrition but also of the implementation of child survival interventions and, more broadly, of social and economic development. As global momentum and investment for accelerating
child survival grow, monitoring progress at the global and country levels has become even more critical. The United Nations Inter-agency Group for Child Mortality Estimation (IGME) updates child mortality estimates annually for monitoring progress. This report presents the IGME’s latest estimates of under-five, infant and neonatal mortality and assesses progress towards MDG 4 at the country, regional and global levels.
Child Mortality Report 2011/ Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation
• Overall, substantial progress has been made towards achieving MDG 4. The
number of under-five deaths worldwide has declined from more than 12 million
in 1990 to 7.6 million in 2010. Nearly 21,000 children under five died every day
in 2010—about 12,000 fewer a day than in 1990.
• Since 1990 the global under-five mortality rate has dropped 35 percent—from
88 deaths per 1,000 live births in 1990 to 57 in 2010. Northern Africa, Eastern
Asia, Latin America and the Caribbean, South-eastern Asia, Western Asia and the developed regions have reduced their under-five mortality rate by 50 percent
• The rate of decline in under-five mortality has accelerated—from 1.9 percent a year over 1990–2000 to 2.5 percent a year over 2000–2010—but remains insufficient
to reach MDG 4, particularly in Sub- Saharan Africa, Oceania, Caucasus and
Central Asia, and Southern Asia.
• The highest rates of child mortality are still in Sub-Saharan Africa—where 1 in 8
children dies before age 5, more than 17 times the average for developed regions
(1 in 143)—and Southern Asia (1 in 15). As under-five mortality rates have fallen
more sharply elsewhere, the disparity between these two regions and the rest of
the world has grown.
• Under-five deaths are increasingly concentrated in Sub-Saharan Africa and Southern Asia, while the share of the rest of the world dropped from 31 percent in 1990 to 18 percent in 2010.
• In Sub-Saharan Africa the average annual rate of reduction in under-five mortality
has accelerated, doubling from 1990–2000 to 2000–2010. Six of the fourteen best-performing countries are in Sub-Saharan Africa, as are four of the five countries with the largest absolute reductions (more than 100 deaths per 1,000 live
• About half of under-five deaths occur in only five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and China. India (22 percent) and Nigeria
(11 percent) together account for a third of all under-five deaths.
• Over 70 percent of under-five deaths occur within the first year of life.
• The proportion of under-five deaths that occur within the first month of life (the neonatal period) has increased about 10 percent since 1990 to more than 40 percent.
• Almost 30 percent of neonatal deaths occur in India. Sub-Saharan Africa has the highest risk of death in the first month of life and has shown the least
• Globally, the four major killers of children under age 5 are pneumonia (18
percent), diarrhoeal diseases (15 percent), preterm birth complications (12
percent) and birth asphyxia (9 percent). Undernutrition is an underlying cause in
more than a third of under-five deaths. Malaria is still a major killer in Sub-Saharan Africa, causing about 16 percent of under-five deaths.
This report was prepared at UNICEF Headquarters by Danzhen You, Gareth Jones and Tessa Wardlaw on behalf of the United Nations Inter‑agency Group for Child Mortality Estimation.Organizations and individuals involved in generating country-specific estimates on child mortality
United Nations Children’s Fund
Danzhen You, Tessa Wardlaw
World Health Organization
Ties Boerma, Colin Mathers, Mie Inoue, Mikkel Oestergaard
The World Bank
United Nations Population Division
Francois Pelletier, Gerhard Heilig, Kirill Andreev, Patrick Gerland, Danan Gu, Nan Li, Cheryl Sawyer, Thomas Spoorenberg
United Nations Economic Commission for Latin America and the Caribbean Population Division
Dirk Jaspers Faijer, Guiomar Bay, Tim Miller
Special thanks to the Technical Advisory Group of the Inter-agency Group for Child Mortality Estimation for providing technical guidance on methods for child mortality estimation
Kenneth Hill (Chair), Harvard University
Michel Guillot, University of Pennsylvania
Leontine Alkema, National University of Singapore
Jon Pedersen, Fafo
Simon Cousens, London School of Hygiene and Tropical Medicine
Neff Walker, Johns Hopkins University
Trevor Croft, Measure DHS, ICF Macro
John Wilmoth, University of California, Berkeley
Gareth Jones, Consultant
Further thanks go to Priscilla Akwara, Mickey Chopra, Archana Dwivedi, Jimmy Kolker, Richard Morgan, Holly Newby and Ian Pett from UNICEF for their support as well as to Joy Lawn from Save the Children for her comments. And special thanks to
Mengjia Liang from UNICEF for her assistance in preparing the report. Communications Development Incorporated provided overall design direction, editing and layout.
Copyright © 2011
by the United Nations Children’s Fund