The Lancet medical journal reports that progress is being made on reducing child mortality rates across the globe. According to estimates from the UN Inter-agency Group for Child Mortality Estimation (IMGE), rates of mortality in children under five have declined by one-third at the global level and have gone from 89 deaths per 1,000 live births in 1990 to 60 in 2009. The total number of child deaths has decreased from 12.4 million in 1990 to 8.1 million in 2009. Many regions have reduced rates by 50% or more.
Some regions, however, continue to struggle. In 2009, about half of all under-5 deaths occurred in only five countries, including India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. India and Nigeria contained one-third of the total deaths alone. Sub-Saharan Africa has the highest rates with one in every eight children dying before the age of five.
Countries that have made significant progress, especially in sub-Saharan African, have expanded basic public health and interventions, such as vitamin A supplementation. Such low-cost programs can help prevent pneumonia, diarrhea, and malaria, which together cause over half of under-5 deaths in sub-Saharan Africa. Unfortunately, coverage of these interventions remains low and access is limited. While the under-5 mortality has been reduced, disparity between rich and poor has increased. Policy interventions that make low-cost curative programs available to all include removing financial and social barriers, targeting services to the poor, and increasing accountability of health systems.
Table from The Lancet: Levels and trends in under-5 mortality rate, 1990-2009 (per 1,000 live births)