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Child Mortality
Report 2012
Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation
United Nations
This report was prepared at UNICEF Headquarters by Danzhen You, Jin Rou New 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 Childrens Fund Danzhen You, Jin Rou New, Tessa Wardlaw World Health Organization Mie Inoue, Colin Mathers, Ties Boerma The World Bank Emi Suzuki United Nations, Department of Economic and Social Affairs, 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 Guiomar Bay, Tim Miller, Dirk Jaspers Faijer 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 Leontine Alkema, National University of Singapore Simon Cousens, London School of Hygiene and Tropical Medicine Trevor Croft, Measure DHS, ICF Macro Gareth Jones, Consultant Michel Guillot, University of Pennsylvania Jon Pedersen, Fafo Neff Walker, Johns Hopkins University John Wilmoth, University of California, Berkeley
Further thanks go to David Anthony, Ivana Bjelic, Liliana Carvajal, Yadigar Coskun, Archana Dwivedi, Attila Hancioglu, Priscilla Idele, Claes Johansson, Rolf Luyendijk, Colleen Murray, Holly Newby, Ian Pett, Tyler Porth, Turgay Unalan, DanielVadnais and Laxmisubha Venkatraman 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 and to KhinWityeeOo from UNICEF for proofreading. Communications Development Incorporated provided overall design direction, editing and layout. Copyright 2012 by the United Nations Childrens Fund The Inter-agency Group for Child Mortality Estimation (IGME) constitutes representatives of the United Nations Childrens Fund, the World Health Organization, the World Bank and the United Nations Population Division. The child mortality estimates presented in this report have been reviewed by IGME members. As new information becomes available, estimates will be updated by the IGME. Differences between the estimates presented in this report and those in forthcoming publications by IGME members may arise because of differences in reporting periods or in the availability of data during the production process of each publication and other evidence. While every effort has been made to maximize the comparability of statistics across countries and over time, users are advised that country data may differ in terms of data collection methods, population coverage and estimation method used. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of UNICEF, the World Health Organization, the World Bank or the United Nations Population Division concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. United Nations Childrens Fund 3 UN Plaza, New York, New York, 10017 USA The World Bank 1818 H Street, NW, Washington, DC, 20433 USA World Health Organization Avenue Appia 20, 1211 Geneva 27, Switzerland United Nations Population Division 2 UN Plaza, New York, New York, 10017 USA
Introduction
It has been 12 years since world leaders committed to Millennium Development Goal 4 (MDG 4), which sets out to reduce the under-five mortality rate by two-thirds between 1990 and 2015. Only three years remain before the 2015 deadline. The world has made substantial progress, reducing the under-five mortality rate 41 percent, from 87 (85, 89) deaths per 1,000 live births in 1990 to 51 (51, 55) in 2011. However, this progress has not been enough, and the target risks being missed at the global level. The global under-five mortality rate needs to be reduced to 29 deaths per 1,000 live birthswhich implies an annual rate of reduction of 14.2 percent for 20112015, much higher than the 2.5 percent achieved over 19902011. Still, in 2011, 6.9 (6.8, 7.4) million children died before reaching their fifth birthday. Almost twothirds of them4.4 milliondied of infectious diseases, nearly all of which were preventable. In addition, inequities in child mortality between developing and developed regions remain large. In 2011 the under-five mortality rate in developing regions was 57 deaths per 1,000 live births more than 8 times the rate in developed regions (about 7). Many countries still have very high under-five mortalityparticularly those in SubSaharan Africa and Southern Asia, home to all 24 countries with an under-five mortality rate above 100 deaths per 1,000 live births. Reducing these inequities across countries and saving more childrens lives by ending preventable child deaths are important priorities. This year, the governments of Ethiopia, India and the United States, in close collaboration with UNICEF, convened the Child Survival Call to Action Forum to mobilize political leadership to end preventable child deaths. Historical trends show that for most countries progress has been too slow and that only 15 of the 66 countries with a high under-five mortality rate (at least 40 deaths per 1,000 live births) are on track to achieve MDG 4. Millions of children still die each year from preventable causes and treatable diseases even though the knowledge and technologies for lifesaving interventions are available. More than half the worlds governments have pledged support for A Promise Renewed, committing to a global movement to end preventable child deaths so that more countries will achieve MDG 4 and all countries will sustain momentum beyond 2015. 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, and this report presents the IGMEs latest estimates of under-five, infant and neonatal mortality and assesses progress towards MDG 4 at the regional and global levels.
Data sources and methodology Generating accurate estimates of child mortality is a considerable challenge because of the limited availability of high-quality data for many developing countries. Vital registration systems are the preferred source of data on child mortality because they collect information as events occur and they cover the entire population. However, many developing countries lack fully functioning vital registration systems that accurately record all births and deaths. Therefore, household surveys, such as the UNICEF-supported Multiple Indicator Cluster Surveys and the US Agency for International Developmentsupported Demographic and Health Surveys, are the primary sources of data on child mortality in developing countries.
The IGME seeks to compile all available nationallevel 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
4
Changes in the estimation process The IGME continually seeks to improve its methods and may introduce changes from one year to the next. This year, the IGME produced sexspecific estimates, added uncertainty intervals for the estimates and implemented other changes. Details can be found in CME Info (at www.childmortality.org).
In addition, a substantial amount of newly available data has been incorporated: data from more than 20 of the most recent surveys and censuses conducted since 2009 for more than 20 countries, new data from vital registration systems for about 70 countries and data from more than 50 surveys and censuses conducted before 2009 for more than 20 countries. The increased data availability has substantially changed the estimates for some countries from previous editions partly because the fitted underfive mortality rate trend line is based on the entire time series of data available for each country. Furthermore, model life tables and a statistical model are used to derive estimates of infant and neonatal mortality rates based on under-five
Why does the iGME generate estimates on child mortality based on national data from censuses, surveys or vital registration systems but not directly use these national data as its official estimates?
Many developing countries lack a single source of high-quality data covering the last several decades. Available data collected by countries are often inconsistent across sources. It is important to analyse, reconcile and evaluate all data sources simultaneously for each country. Each new survey or data point must be examined in the context of all other sources, including previous data. Data suffer from sampling or nonsampling errors (such as misreporting of age and survivor selection bias; underreporting of child deaths is also common). IGME assesses the quality of underlying data sources and adjusts data when necessary. In the absence of error-free data, there will always be uncertainty around data and estimates, both national and interagency. To allow for added comparability, the IGME generates such estimates with uncertainty bounds. The latest data produced by countries often are not current estimates but refer to an earlier reference period. This is particularly the case for estimates from the most recent national survey (such as a Demographic and Health Survey or Multiple Indicator Cluster Survey), which typically refers to a period
before the survey year that is often several years before the target year of IGME estimates. Thus, the IGME also projects estimates to a common reference year. A consistent and comparable trend line from 1990 is needed for monitoring progress towards MDG 4 for each country. The IGME aims to minimize the errors for each estimate, harmonize trends over time and produce up-to-date and properly assessed estimates of child mortality. Applying a consistent methodology also allows for comparisons between countries, despite the varied number and types of data sources. One objective of the IGME is to provide valid and comparable child mortality estimates for policymakers. To do so, the IGME applies a common methodology across countries and uses original empirical data from each country but does not report figures produced by individual countries using other methods, which would not be comparable to other country estimates. All data, estimates and details on IGME methods are available on the Child Mortality Estimation Information (CME Info) website at www.childmortality.org.
mortality rates. Therefore, the estimates presented in this report may differ from and are not necessarily comparable with previous sets of IGME estimates or the most recent underlying country data.
Country consultation A joint WHOUNICEF country consultation was undertaken in August 2012 to give each countrys Ministry of Health and National Statistics Office the opportunity to review all data inputs and the draft estimates for their country. The objective was to identify relevant data not included in CME Info
and to allow countries to review and provide feedback on estimates; it was not, however, a country clearance process. In this round of country consultation process 95 of 195 countries showed interest and received the preliminary estimates; 61 of them provided comments or data; and estimates were revised for 30 countries using new data.
Capacity strengthening at the country level Modelled estimates of child mortality can only be as good as the underlying data. IGME members, including UNICEF, the WHO and other UN
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Examples of country data Under-five mortality estimation is challenging in the absence of complete vital registration systems, as is the case in many developing countries. Existing data sources often suffer from various data quality issues, including underreporting of deaths, misreporting of ages, selection bias and other sampling and nonsampling errors. Below are examples of the real underlying mortality data used to calculate the estimates of the under-five mortality rate from countries with sparse data (Equatorial Guinea and Angola), a country with abundant data but wide variations in the rates and trends between data sources (Nigeria) and a country with abundant data and small variations between data points (Senegal). The Senegal example also shows the trend line of the under-five mortality rate that results from the curve-fitting (black line) with the corresponding 90 percent uncertainty range (red band). Detailed graphs showing all the underlying data and the IGME trend estimates are available for all countries at www.childmortality.org.
Examples of country data sources Countries with sparse data Equatorial Guinea
Under-ve mortality rate (deaths per 1,000 live births) 300
Angola
Under-ve mortality rate (deaths per 1,000 live births) 300
200
200
100
100
0 1980
1990
2000
2010
0 1980
1990
2000
2010
Countries with abundant data Country with wide variations in mortality rates from different data sources Nigeria
Under-ve mortality rate (deaths per 1,000 live births) 400
Country with more consistent trends between different data sources Senegal
Under-ve mortality rate (deaths per 1,000 live births) 400
300
300
200
200
100
100
0 1950
1960
1970
1980
1990
2000
2010
0 1950
1960
1970
1980
1990
2000
2010
agencies, are actively involved at the country level in strengthening national capacity in data collection, estimation techniques and interpretation of results. Population-based survey data are critical for developing sound estimates for countries lacking functioning vital registration systems. The UNICEF-supported Multiple Indicator Cluster Surveys programme has been working since 1995 to build country-level capacity for survey implementation, data analysis and dissemination. The surveys are government owned and implemented, and UNICEF provides support through workshops, technical consultations and peer-topeer mentoring. Some 230 surveys have been conducted in more than 100 countries. In addition to population-based surveys, the WHO and the UN Statistics Division work with countries to strengthen vital registration systems. UNICEF supports this work by promoting and monitoring progress in birth registration. The United Nations Population Fund provides technical assistance for population censuses, another important source of under-five mortality data. The IGME strengthens capacity by working with countries to improve understanding of under-five mortality data and estimation. CME Info (www. childmortality.org), a comprehensive data portal on child mortality funded by UNICEF and
launched by the IGME, is a powerful platform for sharing underlying data and collaborating with national partners on child mortality estimates. Since 2008 a series of regional workshops has been held, training more than 250 participants from 94 countries in the use of CME Info as well as the demographic techniques and modelling methods underlying the estimates. In the last three years UNICEF and the IGME have sent experts to some 10 countries to conduct training on child mortality estimation. As part of the data review process, UNICEFs network of field offices provides opportunities to assess the plausibility of estimates by engaging in a dialogue about the estimates and the underlying data. WHO also engages its Member States in a country consultation process through which governments provide feedback on the estimates and their underlying data. Guiding this capacity strengthening work is a fundamental principle: child mortality estimation is not simply an academic exercise but a fundamental part of effective policies and programming. UNICEF works with countries to ensure that child mortality estimates are used effectively at the country level, in conjunction with other data on child health, to improve child survival programmes and stimulate action through advocacy. This work involves partnering with other agencies, organizations, and initiatives such as the Countdown to 2015.
doing so with a 64 percent reduction. Sub-Saharan Africa, with a 39 percent reduction, and Oceania, with a 33 percent reduction, have further to go. However, Sub-Saharan Africaalso combating the HIV/AIDS scourge that has affected countries in the region more than elsewhere in the worldhas doubled its annual rate of reduction from 1.5 percent over 19902000 to 3.1 percent over 20002011.
Under-five deaths are increasingly concentrated in Sub-Saharan Africa and Southern Asia The share of under-five deaths that occur in SubSaharan Africa and Southern Asia is large and growing (83 percent in 2011). Of the 24 countries with an under-five mortality rate above 100 deaths per 1,000 live births in 2011, 23 are in Sub-Saharan Africa and the remaining one is in Southern Asia (map 1). Thus, substantial progress is
levels and trends in the under-five mortality rate, by Millennium Development Goal region, 19902011 (deaths per 1,000 live births)
Annual rate ofreduction (percent) 1990 2011 1990 2000 2000 2011
Region
1990
1995
2000
2005
2010
2011
15 97
10 80 45 154 34 61 35 30 88 87 47 42 61 73
8 69 34 133 26 52 24 19 74 72 37 37 56 63
7 59 26 112 22 44 16 17 63 62 30 31 51 53
7 57 25 109 19 42 15 17 61 60 29 30 50 51
5 32 26 59 18 25 16 9 39 40 23 21 25 29
55 41 68 39 64 44 70 38 47 50 58 52 33 41
3.8 2.5 5.5 2.3 4.8 2.8 5.7 2.3 3.1 3.3 4.1 3.5 1.9 2.5
4.2 1.9 5.4 1.5 4.4 2.2 3.3 0.7 2.8 3.2 3.9 4.1 1.8 1.8
3.5 3.1 5.5 3.1 5.2 3.3 7.8 5.0 3.3 3.4 4.4 3.0 1.9 3.2
On track Insufficient progress On track Insufficient progress On track Insufficient progress On track On track Insufficient progress Insufficient progress On track On track Insufficient progress Insufficient progress
Northern Africa 77 Sub-Saharan Africa 178 Latin America and the Caribbean 53 Caucasus and Central Asia 76 Eastern Asia 48 Excluding China 28 Southern Asia 116 Excluding India 119 South-eastern Asia 69 Western Asia 63 Oceania 74 World 87
Note: All calculations are based on unrounded numbers.
a On track indicates that under-five mortality is less than 40 deaths per 1,000 live births in 2011 or that the annual rate of reduction is at least 4 percent over 19902011; insufficient progress indicates that under-five mortality is at least 40 deaths per 1,000 live births in 2011 and that the annual rate of reduction is at least 1percent but less than 4 percent over 19902011. These standards may differ from those in other publications by Inter-agency Group for Child Mortality Estimation members.
FiGuRE
FiGuRE
Under-ve mortality rate, by Millennium Development Goal region, 1990 and 2011 (deaths per 1,000 live births) 200
178
Many regions reduced the under-five mortality rate by at least 50percent between 1990 and 2011
Decline in under-ve mortality rate, by Millennium Development Goal region, 19902011 (percent)
70
75 150
116
68 64 58
109
87
44
100
76 77 74 69
47
50
97
52
55 41
61
63
39
53
57
50
42
50
48
51
30
29
25
25
19 15 15
Sub-Saharan Africa
Western Asia
South-eastern Asia
Northern Africa
Southern Asia
Eastern Asia
Oceania
Developed regions
Developing regions
World
Northern Africa
South-eastern Asia
Sub-Saharan Africa
Eastern Asia
Western Asia
Southern Asia
Oceania
Developed regions
1990
2011
TAblE
levels and trends in the number of deaths of children under agefive, by Millennium Development Goal region, 19902011 (thousands)
Share of global under-five deaths (percent) 1990
Region
1990
1995
2000
2005
2010
2011
Developed regions Developing regions Northern Africa Sub-Saharan Africa Latin America and the Caribbean Caucasus and Central Asia Eastern Asia Excluding China Southern Asia Excluding India South-eastern Asia Western Asia Oceania World
228 11,740 284 3,821 610 152 1,325 29 4,454 1,393 826 255 14 11,968
149 10,621 198 4,034 502 117 905 46 3,942 1,190 681 227 15 10,770
127 9,435 146 3,988 390 85 746 30 3,366 1,010 514 187 15 9,562
111 8,086 117 3,793 295 78 406 16 2,786 792 433 165 14 8,198
58 42 69 12 67 52 80 42 47 51 62 39 7 42
1.9 98.1 2.4 31.9 5.1 1.3 11.1 0.2 37.2 11.6 6.9 2.1 0.1 100.0
1.4 98.6 1.3 48.7 2.9 1.0 3.8 0.2 33.9 9.9 4.5 2.2 0.2 100.0
10
World
33
41
MAP
Children in Sub-Saharan Africa and Southern Asia face a higher risk of dying before theirfifthbirthday
Under-ve mortality rate (deaths per 1,000 live births) Less than 40 4099 100149 150 or more Data not available Note: This map is stylized and not to scale. It does not reflect a position by UN IGME agencies on the legal status of any country or territory or the delimitation of any frontiers.
needed in both regions to achieve MDG4. In the coming years the number of under-five deaths in the world may stagnate or even increase without greater progress in Sub-Saharan Africa, because its number of live births and population of children under age five are set to grow rapidly. By 2050, 1 in 3 children will be born in Sub-Saharan Africa, and almost 1 in 3 will live there.
Half of under-five deaths occur in only five countries Some 80 percent of the worlds under-five deaths in 2011 occurred in only 25 countries, and about half in only five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and China. India (24 percent) and Nigeria (11 percent) together account for more than a third of under-five deaths worldwide. Substantial progress has been made, but it is still insufficient to achieve MDG 4 Overall, substantial progress has been made towards achieving MDG 4. About 14,000 fewer children died every day in 2011 than in 1990, the baseline year for measuring progress. Improvement in child survival is evident in all regions. The number of countries with under-five mortality rates of 100 deaths per 1,000 live births or
higher has been more than halved from 53 in 1990 to 24 in 2011. In addition, no country had an under-five mortality rate above 200 deaths per 1,000 live births in 2011, compared with 13 in 1990. The annual rate of reduction has accelerated from 1.8 (1.7, 2.1) percent over 19902000 to 3.2 (2.5, 3.2) percent over 20002011. In SubSaharan Africa, the region with the greatest burden of under-five deaths, the annual rate of reduction has more than doubled. But these rates are still insufficient to achieve MDG 4 by 2015: only 6 of 10 regions are on track, and of the 66 countries with at least 40 deaths per 1,000 live births in 2011, only 15 are.
Moreover, disparity is growing between Sub-Saharan Africa and Southern Asia and the other regions As under-five mortality rates have fallen more sharply in richer developing regions, the disparity between Sub-Saharan Africa and other regions has grown. In 1990 a child born in SubSaharan Africa faced a probability of dying before age five that was 1.5 times higher than in Southern Asia, 3.4 times higher than in Latin America and the Caribbean, 3.7 times higher than in Eastern Asia and 12.1 times higher than in developed regions. By 2011 that probability
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was 1.8 times higher than in Southern Asia, 5.7times higher than in Latin America and the Caribbean, 7.4 times higher than in Eastern Asia and 16.5times higher than in developed regions. The disparity between Southern Asia and richer regions has also grown, though not as much.
(42percent) and Eastern Asia (33 percent); the smallest in Oceania (9percent; table 3).
The proportion of neonatal deaths is increasing as under-five mortality declines Neonatal mortality, covering deaths in the first month after birth, is of interest because the health interventions needed to address the major causes of neonatal deaths generally differ from those needed to address other under-five deaths. Neonatal mortality is increasingly important because the proportion of under-five deaths that occur during the neonatal period is increasing as under-five mortality declines. Because declines in the neonatal mortality rate are slower than those in the mortality rate for older children, worldwide, the share of neonatal deaths among under-five deaths increased from about 36 percent in 1990 to about 43percent in 2011, and the trend is expected to continue. While the relative increase is modest (17 percent) at the global level, there are differences across regions. The largest increases have been in Northern Africa
All regions are experiencing slower declines in neonatal mortality than in under-five mortality Over the last 22 years all regions have seen slower reductions in neonatal mortality than in underfive mortality. Globally, neonatal mortality has declined 32 percent, from 32 deaths per 1,000 live births in 1990 to 22 in 2011an average of 1.8 percent a year, much slower than for underfive mortality (2.5 percent per year). The fastest reduction was in Eastern Asia (61 percent), followed by Latin America and the Caribbean and Northern Africa (both 55 percent); the slowest in Oceania (23 percent), followed by Sub-Saharan Africa (24 percent; see table 3). More than half the under-five deaths in Eastern Asia, Latin America and the Caribbean, and Southern Asia are neonatal deaths In Eastern Asia, the region with the largest reduction in under-five mortality, neonatal deaths accounted for 57% of under-five deaths in 2011. In Latin America and the Caribbean neonatal deaths accounted for 53% of under-five deaths
TAblE
neonatal mortality rate, number of neonatal deaths and neonatal deaths as a share of under-fivedeaths, by Millennium Development Goal region, 1990 and 2011
Neonatal mortality rate (deaths per 1,000 live births) Decline (percent) 19902011 Number of neonatal deaths Neonatal deaths as a share of under-five deaths (thousands) (percent) Relative increase (percent) 19902011
Region
1990
2011
1990
2011
1990
2011
Developed regions Developing regions Northern Africa Sub-Saharan Africa Latin America and the Caribbean Caucasus and Central Asia Eastern Asia Excluding China Southern Asia Excluding India South-eastern Asia Western Asia Oceania World
7 35 25 45 22 25 22 11 47 46 26 26 26 32
4 24 11 34 10 17 9 9 32 29 14 15 20 22
48 32 55 24 55 33 61 23 32 35 46 42 23 32
108 4,254 93 1,018 256 49 569 13 1,832 544 321 111 5 4,362
47 36 33 27 42 32 43 46 41 39 39 44 37 36
55 43 47 33 53 39 57 47 52 50 50 49 40 43
15 17 42 25 26 20 33 3 26 27 28 13 9 17
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in 2011. Both regions will have to scale up health interventions that tackle neonatal mortality in order to continue their success in reducing underfive mortality. Southern Asia also needs to address neonatal mortality: neonatal deaths account for more than half of under-five deaths, and almost 30 percent of global neonatal deaths occurred in India. Sub-Saharan Africa, which accounts for 38percent of global neonatal deaths, has the highest neonatal mortality rate (34 deaths per 1,000 live births in 2011) and is among the regions that have shown the least progress in reducing that rate over the last two decades. Neonatal deaths there account for about a third of under-five deaths (1.1 million neonatal deaths), and greater emphasis should be on reducing both these deaths and other important causes of under-five deaths.
of neonatal infections can be provided alongside treatment of childhood pneumonia, diarrhoea and malaria. Care at birth brings a triple return on investment, saving mothers, newborns and unborn children. Scaling up low cost solutions to address preterm birth could reduce these deaths by three-quarters, notably with antenatal steroid injections to women in preterm labour, and kangaroo mother care, where the preterm babies are held skin to skin with their mothers.1
Systemic action is required to reduce neonatal mortality With the proportion of under-five deaths during the neonatal period increasing in every region and almost all countries, systematic action is required by governments and partners to reach women and babies with effective care. Highly cost-effective interventions are feasible even at the community level, and most can be linked with preventive and curative initiatives for mothers and for babies. For example, early postnatal home visits are effective in promoting healthy behaviours such as breastfeeding and clean cord care as well as in reaching new mothers. Case management
Coverage of effective interventions needs to be expanded Accelerating the reduction in under-five mortality is possible by expanding effective preventive and curative interventions that target the main causes of post-neonatal deaths (pneumonia, diarrhoea, malaria and undernutrition) and the most vulnerable newborn babies and children. Empowering women, removing financial and social barriers to accessing basic services, developing innovations that make the supply of critical services more available to the poor and increasing local accountability of health systems are policy interventions that have allowed health systems to improve equity and reduce mortality. Countries in Sub-Saharan Africa and Southern Asia, in particular, need to place high priority on reducing child mortality.
Reference
1. March of Dimes, Partnership for Maternal, Newborn and Child Health, Save the Children, and World Health Organization, 2012, Born Too Soon: The Global Action Report on Preterm Birth, eds C.P. Howson, M.V. Kinney, J.E. Lawn, Geneva: World Health Organization.
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StatiStical table
country, regional and global estimates of under-five, infant and neonatal mortality
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Country or territory Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijana Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Cte d'Ivoire Croatia Cuba
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 126 22 47 4 231 10 16 24 6 5 65 19 12 51 22 7 5 19 124 73 58 9 29 18 9 14 183 199 61 135 7 25 213 206 9 17 21 117 107 17 11 122 6 7 64 14 22 3 81 9 9 16 3 3 32 7 7 46 6 6 3 15 59 46 40 6 18 19 4 7 70 61 39 48 3 19 56 69 6 16 11 41 40 6 6 51 4 4
192 41 66 8 243 27 28 47 9 9 95 22 21 139 18 17 10 44 177 138 19 53 58 12 22 208 183 117 145 8 58 169 208 19 49 34 122 119 19 17 151 13 13
160 36 60 8 219 21 26 42 8 9 84 20 18 130 17 16 9 40 165 122 113 17 50 54 11 21 194 169 110 137 8 50 157 193 18 44 32 104 111 16 16 142 12 13
210 48 73 9 285 34 30 51 10 10 105 24 22 143 21 19 11 50 185 152 125 20 60 64 14 24 220 205 126 155 9 66 194 225 19 54 36 146 129 24 19 161 14 15
136 26 46 5 199 15 20 30 6 6 69 17 12 84 17 14 6 26 140 89 81 10 81 36 10 21 182 165 102 140 6 39 172 189 11 35 25 100 109 17 13 139 8 9
151 31 54 5 241 16 22 34 7 6 80 19 14 89 19 14 6 29 151 103 86 11 90 40 11 22 199 196 108 148 7 42 202 211 11 37 27 123 116 20 14 145 9 9
3.1 5.0 3.8 4.4 2.1 6.0 3.2 4.7 3.4 3.8 3.6 1.4 3.4 5.3 0.5 5.3 4.0 4.5 2.4 4.5 4.1 4.3 3.4 6.3 2.6 2.9 1.7 1.3 4.8 0.6 1.9 4.8 0.2 1.0 3.6 5.8 3.2 2.0 0.9 3.3 2.5 1.3 4.4 4.0
1.6 2.8 1.5 4.0 0.1 4.0 2.5 3.1 1.9 3.0 1.7 0.3 2.3 4.6 1.0 4.4 3.2 3.8 1.7 2.9 3.4 3.4 3.0 5.5 1.5 2.2 0.5 0.3 3.1 0.4 0.9 3.6 1.0 0.1 3.2 5.0 2.4 0.2 0.6 0.6 1.9 1.0 3.8 3.3
3.9 6.7 5.3 4.7 3.6 7.9 4.0 6.0 4.7 4.7 4.3 3.1 4.6 5.7 1.2 6.2 4.8 5.8 2.9 5.2 4.9 4.9 4.8 7.0 3.6 3.7 2.2 2.3 5.7 1.4 2.7 5.8 1.4 1.7 4.1 6.4 4.0 4.3 1.7 6.1 3.5 2.1 5.2 4.9
14
country, regional and global estimates of under-five, infant and neonatal mortality
Number of under-five deaths (thousands) 1990 Country or territory Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijana Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Cte d'Ivoire Croatia Cuba 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Neonatal Number of mortality rate Number of infant (deaths per neonatal deaths 1,000 live deaths (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011
196 43 70 9 254 30 31 51 10 11 100 23 21 140 20 20 11 49 183 147 127 21 57 64 14 25 215 190 125 154 9 62 175 219 21 50 38 130 124 22 19 164 14 15
188 39 62 8 232 23 25 43 8 8 88 20 20 138 16 15 9 39 171 130 112 16 49 52 11 20 202 175 108 137 7 54 163 198 17 48 31 113 113 17 15 138 11 12
103 15 32 4 165 9 16 19 5 5 47 17 10 48 22 6 5 19 109 57 54 9 28 17 8 13 151 145 47 135 6 23 170 177 10 15 20 85 103 11 11 125 6 6
73 13 26 3 96 6 13 16 4 4 39 14 9 37 18 4 4 15 68 42 39 7 20 14 6 11 82 86 36 79 5 18 108 97 8 15 59 64 8 9 81 4 5
80 3 42 0 74 0 18 3 2 1 16 0 0 351 0 2 1 0 23 2 19 1 2 170 0 2 44 27 23 44 3 1 13 30 5 25 1 7 0 1 52 1 2
94 1 18 0 72 0 9 1 1 0 7 0 0 105 0 0 0 0 24 1 10 0 1 39 0 1 57 24 11 55 2 0 16 46 2 215 14 2 9 0 1 53 0 0
51 17 29 3 53 13 16 23 5 4 31 9 7 52 9 8 5 18 40 44 37 12 21 27 7 12 41 50 37 36 4 21 46 47 9 23 19 41 35 9 10 47 9 7
36 7 17 1 43 4 8 11 3 3 19 7 4 26 10 3 2 8 31 25 22 5 11 10 4 7 34 43 19 33 4 10 46 42 5 9 11 32 32 5 6 41 3 3
38 1 23 0 29 0 11 2 1 0 6 0 0 195 0 1 1 0 9 1 9 1 1 97 0 1 18 13 15 19 2 0 6 13 3 555 17 1 3 0 1 25 0 1
51 0 12 0 35 0 5 1 1 0 4 0 0 80 0 0 0 0 11 0 6 0 1 29 0 0 25 12 6 24 1 0 7 22 1 143 10 1 5 0 0 28 0 0
1,173 1,448
13 1,036
15
country, regional and global estimates of under-five, infant and neonatal mortality
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Country or territory Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuadorb Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgiac Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Holy See Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of)d Iraq Ireland Israel Italy Jamaica
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 4 4 42 235 4 123 15 28 30 23 22 235 82 4 93 19 3 5 81 139 33 5 95 5 15 38 160 216 50 84 25 7 3 68 40 33 53 5 5 4 24 4 5 15 61 3 41 6 19 18 29 20 63 46 7 66 10 2 3 32 55 16 3 40 4 7 26 76 70 21 48 18 6 2 38 27 20 15 3 4 3 12
11 14 45 181 9 122 17 58 52 86 60 190 138 20 198 30 7 9 94 165 47 9 121 13 21 78 228 210 63 143 55 19 6 114 82 61 46 9 12 10 35
10 13 36 172 8 111 15 53 48 81 53 156 125 19 179 27 6 8 84 154 39 8 114 12 18 72 212 183 56 130 50 17 6 107 77 54 41 8 11 9 31
12 15 57 208 9 138 19 60 59 88 65 252 145 21 209 33 7 9 105 189 58 9 127 14 24 81 241 238 68 148 60 20 7 120 85 70 54 10 12 10 40
7 7 73 213 6 127 17 41 40 46 38 211 110 12 145 25 5 6 94 158 39 6 107 8 17 53 194 222 57 112 38 12 4 91 57 50 50 7 7 6 31
6.0 6.2 1.4 0.4 4.1 1.5 1.8 4.1 4.0 6.7 6.6 2.3 3.4 8.1 4.5 2.8 4.0 3.6 1.7 2.3 3.9 3.6 2.1 5.0 2.4 4.5 2.8 1.3 2.7 3.4 4.5 5.2 4.4 3.0 4.5 4.3 0.9 3.9 4.7 4.6 3.0
5.1 5.4 1.0 3.1 0.1 0.3 3.3 2.5 6.1 4.6 1.3 2.5 7.3 3.4 2.5 3.1 2.9 0.9 1.0 1.2 2.8 1.1 4.4 1.3 3.3 1.7 0.2 1.0 2.5 3.7 4.5 3.9 2.3 3.3 2.7 0.5 3.2 4.0 3.7 2.3
6.7 6.8 1.5 4.7 2.8 3.2 5.1 5.7 7.1 7.5 6.0 3.7 8.6 5.2 3.3 4.5 4.4 2.8 3.5 5.9 4.4 2.9 6.0 3.5 6.2 3.3 2.2 3.4 4.0 5.9 5.8 5.1 3.4 5.1 5.4 2.1 4.8 5.3 5.4 3.8
16
country, regional and global estimates of under-five, infant and neonatal mortality
Number of under-five deaths (thousands) 1990 Country or territory Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuadorb Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgiac Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Holy See Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of)d Iraq Ireland Israel Italy Jamaica 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Neonatal Number of mortality rate Number of infant (deaths per neonatal deaths 1,000 live deaths (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011
12 16 47 192 10 129 19 62 56 86 65 199 151 23 212 32 7 10 103 175 52 10 128 14 22 82 232 227 70 152 58 21 7 110 88 62 50 10 12 11 39
10 12 43 171 8 114 16 54 49 86 55 180 125 17 184 27 6 8 86 154 42 7 114 12 20 74 224 193 55 134 52 17 6 119 75 60 42 8 11 9 29
3 3 26 111 3 72 11 21 20 18 13 80 46 3 52 14 2 3 49 58 18 3 52 4 10 24 79 98 29 53 18 5 2 47 25 21 31 3 4 3 16
5 10 22 49 4 39 12 26 19 20 18 47 32 12 52 13 4 3 32 44 27 4 38 9 10 28 53 50 29 37 22 13 3 47 29 27 23 5 6 6 19
1 2 18 47 2 33 8 14 10 7 6 37 22 2 31 8 2 2 25 34 15 2 30 3 7 15 39 44 20 25 11 4 1 32 15 14 20 2 2 2 11
0 0 6 137 0 1 0 3 3 14 1 1 4 0 82 0 0 2 1 2 1 2 23 0 0 7 15 3 0 7 2 0 0 876 66 17 23 0 0 1 1
1,519 1,855
2,174 1,273
17
country, regional and global estimates of under-five, infant and neonatal mortality
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Country or territory Japan Jordan Kazakhstane Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (FederatedStates of) Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Niue Norway
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 4 24 43 98 70 12 44 59 10 16 95 102 17 7 4 86 97 7 13 197 7 33 143 19 18 77 4 46 9 39 121 84 51 47 57 5 7 32 156 147 47 4 2 12 19 33 29 6 23 49 7 11 29 80 15 6 3 54 76 6 35 86 4 17 42 8 16 19 3 36 6 27 75 36 24 13 45 3 4 22 105 71 5 3
6 37 57 98 88 17 70 148 21 33 88 241 44 17 8 161 227 17 105 257 11 52 125 24 49 56 8 107 18 81 226 107 73 40 135 8 11 66 314 214 14 8
6 35 52 91 78 17 63 128 20 28 84 209 41 16 8 145 209 16 98 240 11 46 116 21 44 50 7 97 16 74 203 92 65 34 121 8 10 61 290 196 11 8
7 40 61 105 103 19 78 159 23 35 99 256 49 19 9 165 235 20 116 270 12 59 137 27 54 66 8 117 20 85 241 115 77 45 136 9 12 70 329 227 16 9
5 28 42 113 65 13 47 81 17 19 117 164 27 12 5 104 164 11 53 214 8 38 118 19 29 49 5 63 13 53 172 84 74 40 83 6 7 42 216 188 29 5
5 30 51 120 84 14 59 95 18 23 126 172 29 13 5 119 172 12 55 231 8 44 134 21 33 69 6 73 13 57 182 97 82 44 89 6 8 47 231 196 32 5
3 17 26 64 34 10 25 29 7 8 71 63 14 5 3 57 73 6 9 153 5 21 87 12 14 25 3 25 6 27 88 45 36 33 45 4 5 22 99 111 18 3
3.0 2.7 3.3 1.4 2.9 2.1 4.0 6.0 4.3 6.0 0.1 5.4 4.8 5.3 4.6 4.6 4.8 4.6 10.9 1.8 3.1 3.3 0.5 2.2 5.4 1.5 3.3 5.9 4.3 4.3 3.7 2.6 2.7 0.0 4.9 3.5 3.0 4.5 4.4 2.6 1.9 4.7
2.3 2.0 1.4 0.1 1.5 1.7 2.4 4.0 3.6 3.2 0.3 3.8 4.5 4.4 3.8 2.8 3.9 3.9 9.9 1.4 2.5 2.3 0.6 1.1 4.6 1.2 2.6 3.9 3.1 3.3 2.7 1.2 1.6 1.1 3.9 2.9 2.3 3.3 3.2 1.7 6.3 3.9
3.8 3.9 3.7 2.1 4.2 2.9 4.8 7.7 5.2 6.4 1.3 6.3 5.6 6.0 5.4 4.7 5.4 6.0 11.7 2.3 3.8 4.2 1.7 3.4 6.2 3.7 4.0 7.0 5.1 5.2 4.5 3.9 3.2 1.1 5.1 3.9 3.8 5.3 5.5 3.1 1.1 5.4
18
country, regional and global estimates of under-five, infant and neonatal mortality
Number of under-five deaths (thousands) 1990 Country or territory Japan Jordan Kazakhstane Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (FederatedStates of) Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Niue Norway 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Neonatal Number of mortality rate Number of infant (deaths per neonatal deaths 1,000 live deaths (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011
3 3 10 93 0 1 3 4 0 1 4 10 2 0 0 41 45 3 0 104 0 0 10 0 30 0 0 2 0 17 73 37 2 0 31 1 0 3 69 668 0 0
7 37 64 104 92 18 77 156 23 34 95 255 46 19 9 171 235 19 110 267 13 57 134 27 53 64 9 121 19 86 233 119 78 56 137 9 12 72 320 222 14 9
6 36 50 92 83 15 63 139 18 32 80 227 42 15 7 152 219 16 101 248 10 46 115 21 44 48 7 91 16 77 218 96 67 24 133 7 10 60 307 205 14 7
2 18 25 48 38 9 27 34 7 8 63 58 13 5 2 43 53 6 9 98 5 22 76 13 13 34 3 26 7 28 72 48 30 32 39 3 5 22 66 78 18 3
5 4 19 62 0 1 8 17 1 2 4 15 3 1 0 51 56 7 1 53 0 0 6 1 91 0 0 6 0 44 84 82 3 0 66 1 1 7 53 519 0 0
3 3 9 72 0 1 4 5 0 1 4 9 2 0 0 31 34 3 0 68 0 0 9 0 29 0 0 2 0 18 59 40 2 0 27 1 0 3 49 480 0 0
3 19 24 33 28 10 28 38 13 16 45 49 21 10 4 40 48 9 36 58 7 19 43 16 17 22 4 27 11 35 53 42 29 22 51 5 4 25 49 51 7 4
1 12 14 27 19 5 16 18 5 5 39 27 10 3 2 23 27 3 7 49 4 12 40 9 7 17 2 12 5 19 34 30 18 22 27 3 3 13 32 39 10 2
3 2 9 32 0 0 4 7 0 1 3 5 2 1 0 20 21 4 0 25 0 0 3 0 41 0 0 2 0 25 32 44 2 0 37 1 0 4 21 220 0 0
1 2 5 42 0 0 2 2 0 0 2 4 1 0 0 17 18 2 0 36 0 0 5 0 15 0 0 1 0 12 30 25 1 0 20 0 0 2 25 254 0 0
19
country, regional and global estimates of under-five, infant and neonatal mortality
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Country or territory Occupied Palestinian Territory Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan f
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 27 12 86 30 26 65 30 19 30 7 4 8 6 22 14 14 67 12 19 27 26 3 129 12 91 10 16 310 3 8 3 24 252 60 171 5 13 117 47 113 3 5 19 164 14 16 41 11 11 29 18 25 19 6 5 7 3 12 13 9 52 9 8 9 10 4 32 14 45 10 6 89 3 6 4 14 60 21 72 4 10 41 17 28 2 3 12 38
33 25 103 30 31 80 41 40 42 11 8 13 6 29 28 22 187 19 20 26 27 6 117 24 136 15 16 281 4 12 6 34 216 87 201 7 21 121 51 126 4 6 26 130
15 7 58 12 15 45 18 16 22 5 3 7 4 11 12 11 47 6 12 16 11 1 71 7 59 5 12 130 2 7 3 14 126 32 93 4 10 66 22 73 3 4 12 40
3.2 8.1 2.5 2.6 2.5 2.0 4.1 6.8 3.8 5.2 6.9 4.6 2.1 3.7 5.2 4.0 5.1 6.4 1.7 1.1 2.2 9.0 0.4 7.3 3.5 6.6 0.9 1.7 5.0 3.9 6.2 3.1 0.0 1.4 2.8 4.5 4.1 1.7 2.7 1.0 4.2 2.9 4.1 2.8
2.2 6.3 1.5 0.1 1.4 1.7 2.5 6.3 3.0 4.4 6.2 4.0 1.2 2.4 4.7 3.2 4.2 4.0 0.7 0.0 0.6 6.9 1.0 6.4 1.9 4.9 0.2 0.7 4.8 3.7 5.5 2.9 1.6 0.4 1.0 4.1 3.8 0.3 0.4 1.4 3.5 1.8 3.0 1.8
5.0 9.3 3.5 5.5 3.8 3.0 5.0 7.4 4.3 6.0 7.8 5.2 3.5 5.2 5.4 4.3 5.9 7.8 3.2 3.2 4.9 10.2 1.4 8.2 4.0 8.4 2.1 3.7 5.7 4.2 6.7 4.9 1.7 3.4 4.3 4.7 5.0 3.1 4.5 1.1 4.5 3.9 5.4 5.0
20
country, regional and global estimates of under-five, infant and neonatal mortality
Number of under-five deaths (thousands) 1990 Country or territory Occupied Palestinian Territory Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan f 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Neonatal Number of mortality rate Number of infant (deaths per neonatal deaths 1,000 live deaths (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011
4 3 544 0 2 12 7 49 115 9 2 0 4 3 15 62 50 0 0 0 0 0 0 23 41 4 0 43 0 1 0 0 52 67 54 4 10 96 0 3 1 1 16 25
3 3 495 0 2 11 6 45 106 8 2 0 4 3 15 58 48 0 0 0 0 0 0 20 39 3 0 39 0 1 0 0 44 61 46 4 9 89 0 3 1 1 14 21
3 0 352 0 1 12 3 11 57 2 0 0 3 1 3 20 23 0 0 0 0 0 0 6 30 1 0 42 0 0 0 0 71 47 43 2 5 95 0 4 0 0 7 12
2 0 280 0 1 9 3 9 50 2 0 0 2 1 3 19 20 0 0 0 0 0 0 5 27 1 0 28 0 0 0 0 48 32 33 2 4 72 0 2 0 0 6 7
20 7 59 14 17 45 19 14 20 5 3 6 4 14 11 10 38 6 14 20 16 2 58 8 47 6 12 119 2 7 2 18 108 35 76 4 11 57 26 69 2 4 13 53
3 3 426 0 2 9 6 35 82 8 1 0 4 2 13 51 31 0 0 0 0 0 0 19 21 3 0 25 0 1 0 0 33 51 32 4 8 61 0 2 1 0 13 19
3 0 293 0 1 9 3 8 45 2 0 0 2 1 2 17 17 0 0 0 0 0 0 5 22 1 0 27 0 0 0 0 43 35 28 2 4 63 0 2 0 0 6 10
22 21 49 14 14 29 24 26 22 11 7 10 3 15 17 13 39 17 13 16 11 5 31 20 40 15 10 58 4 12 5 17 50 26 51 7 16 38 24 32 3 4 18 35
13 5 36 9 9 23 13 9 12 4 2 4 2 8 8 7 21 5 9 13 8 1 29 5 26 4 9 49 1 4 2 11 50 19 38 3 8 31 16 35 2 3 9 25
2 2 218 0 1 4 3 17 45 6 1 0 2 1 5 26 12 0 0 0 0 0 0 11 13 2 0 10 0 1 0 0 15 28 13 3 6 32 0 1 0 0 8 7
2 0 169 0 1 5 2 5 29 1 0 0 1 0 2 11 9 0 0 0 0 0 0 3 12 0 0 11 0 0 0 0 21 20 13 1 3 35 0 1 0 0 4 5
21
country, regional and global estimates of under-five, infant and neonatal mortality
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Country or territory Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkeyg Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania United States Uruguay Uzbekistan Vanuatu Venezuela (BolivarianRepublic of) Viet Nam Yemen Zambia Zimbabwe
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 17 12 72 139 22 39 20 20 74 40 105 12 7 6 81 8 12 66 18 16 24 92 110 74 12 13 60 49 8 12 17 24 31 19 59 7 7 3 53 4 8 25 13 10 17 42 64 26
12 10 54 110 15 28 16 15 53 30 90 10 7 5 68 8 10 49 13 15 22 77 83 67
8 8 46 92 11 21 13 12 41 24 84 9 6 5 62 7 9 38 10 14 20 58 76 53
5.0 6.5 5.7 1.4 2.2 1.4 5.5 7.4 2.8 3.1 3.3 3.1 5.8 2.8 4.0 2.0 3.8 2.1 5.1 3.4 4.0 2.4 4.0 0.8
3.3 5.4 4.2 0.4 1.1 0.4 4.5 5.9 1.3 1.4 2.4 2.2 5.5 2.3 3.1 1.6 3.3 0.7 3.9 2.9 3.2 1.5 2.4 0.3
7.0 7.1 6.7 2.1 3.8 2.3 6.4 8.6 3.8 4.4 3.6 4.2 6.8 3.1 4.4 2.3 4.4 3.5 6.0 4.0 4.7 3.6 4.3 2.1
Estimates of under-five, infant and neonatal mortality by Millennium Development Goal regionh,i
Developed regions Developing regions Northern Africa Sub-Saharan Africa Latin America & Caribbean Caucasus & Central Asia Eastern Asia Excluding China Southern Asia Excluding India South-eastern Asia Western Asia Oceania World 15 97 77 178 53 76 48 28 116 119 69 63 74 87 14 94 73 173 51 73 44 25 110 113 66 60 69 85 15 98 78 181 55 80 54 32 119 122 71 65 80 89 10 80 45 154 34 61 35 30 88 87 47 42 61 73 9 78 43 148 33 59 32 25 84 83 45 39 54 71 10 81 46 156 35 69 37 36 90 91 49 44 67 73 7 57 25 109 19 42 15 17 61 60 29 30 50 51 7 56 22 107 18 40 14 15 57 54 27 26 40 51 7 61 28 120 20 59 17 21 66 67 33 35 55 55 5 32 26 59 18 25 16 9 39 40 23 21 25 29 3.8 2.5 5.5 2.3 4.8 2.8 5.7 2.3 3.1 3.3 4.1 3.5 1.9 2.5 3.5 2.1 4.7 1.8 4.5 1.2 4.9 1.9 2.5 2.6 3.4 2.8 1.6 2.1 4.0 2.6 5.8 2.4 5.1 3.1 6.3 2.6 3.4 3.8 4.4 4.1 2.8 2.6
22
country, regional and global estimates of under-five, infant and neonatal mortality
Number of under-five deaths (thousands) 1990 Country or territory Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkeyg Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania United States Uruguay Uzbekistan Vanuatu Venezuela (BolivarianRepublic of) Viet Nam Yemen Zambia Zimbabwe 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Neonatal Number of mortality rate Number of infant (deaths per neonatal deaths 1,000 live deaths (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011
38 1 5 22 0 1 12 96 12 0 146 14 1 7 169 44 1 55 0 18 96 73 64 30
34 1 4 20 0 1 10 88 11 0 137 13 1 7 157 42 1 50 0 16 85 67 57 28
10 0 2 21 0 1 3 20 5 0 131 5 1 4 122 32 1 30 0 9 32 70 46 24
7 0 2 17 0 0 2 16 4 0 122 4 1 4 111 30 0 23 0 8 28 52 42 19
14 0 3 27 0 1 4 27 8 0 154 6 1 5 146 34 1 41 0 10 35 85 63 27
13 11 57 118 18 31 18 16 57 33 97 11 7 6 70 8 11 55 14 17 25 80 86 73
11 9 51 102 13 24 15 14 48 27 83 9 6 5 65 7 9 42 12 13 19 73 80 61
11 9 46 73 13 25 14 12 45 25 58 9 6 4 45 6 9 42 11 13 17 57 53 43
31 1 4 13 0 1 9 78 10 0 89 12 1 6 105 37 1 45 0 15 69 52 38 20
9 0 2 14 0 0 3 15 5 0 86 5 1 4 83 27 0 25 0 8 25 53 30 16
18 17 48 42 12 23 23 29 31 22 39 9 12 5 41 6 11 20 16 15 22 43 43 32
8 6 24 36 8 18 10 9 22 14 28 5 4 3 25 4 5 15 7 8 12 32 27 30
20 1 2 6 0 1 5 41 4 0 35 6 1 4 47 22 1 14 0 9 45 27 15 12
6 0 1 7 0 0 2 12 2 0 43 2 0 2 48 18 0 9 0 5 17 30 17 11
Estimates of under-five, infant and neonatal mortality by Millennium Development Goal regionh,i (continued)
Developed regions Developing regions Northern Africa Sub-Saharan Africa Latin America & Caribbean Caucasus & Central Asia Eastern Asia Excluding China Southern Asia Excluding India South-eastern Asia Western Asia Oceania World 228 284 3,821 610 152 29 1,393 826 255 14 223 269 3,716 588 146 25 233 289 632 161 34 96 87 203 72 265 17 686 312 155 13 94 79 192 68 244 14 613 292 135 10 101 100 213 102 298 20 775 357 179 15 16 98 79 186 57 83 49 29 113 122 76 67 77 89 13 95 75 168 48 69 47 26 119 117 63 59 70 85 7 58 26 114 21 47 15 18 60 63 32 32 52 53 6 56 23 103 17 38 15 16 62 57 26 28 47 50 12 67 59 107 42 62 38 17 83 88 48 50 54 61 6 41 21 16 36 14 47 23 24 39 190 215 481 124 17 81 74 170 62 229 13 551 245 123 10 7 35 25 45 22 25 22 11 47 46 26 26 26 32 4 24 11 34 10 17 9 9 32 29 14 15 20 22 108 93 1,018 256 49 569 13 1,832 544 321 111 5 53 40 1,122 107 28 151 8 1,216 340 155 77 5 11,740 11,423 11,934 6,818 6,748 7,339 8,164 4,908 4,254 2,902
69 2,318 2,170
13 1,053
4,454 4,220 4,595 2,341 1,312 1,422 786 243 13 843 265 15
2,190 2,564
48 1,022
37 8,354 4,989
4,362 2,955
23
country, regional and global estimates of under-five, infant and neonatal mortality
Estimates of under-five, infant and neonatal mortality by uniCEF regioni
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Region Africa Sub-Saharan Africa West and Central Africa Middle East and North Africa Asia South Asia East Asia and Pacific Latin America and Caribbean Central and Eastern Europe/Commonwealth of Independent States World
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 110 120 94 149 41 47 68 22 20 54 59 54 66 24 28 40 18 18
99 107 83 126 33 42 58 20 18
48 87
47 85
49 89
35 73
33 71
37 73
21 51
20 51
26 55
16 29
3.9 2.5
2.8 2.1
4.1 2.6
Estimates of under-five, infant and neonatal mortality by World Health Organization regioni
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Region Africa Americas Eastern Mediterranean Europe South-East Asia Western Pacific World
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
175 42 99 32 109 48 87
170 40 94 31 104 44 85
153 27 77 21 81 34 73
147 27 73 20 77 31 71
155 28 80 22 83 35 73
107 16 58 13 55 16 51
105 15 53 13 51 15 51
24
country, regional and global estimates of under-five, infant and neonatal mortality
Estimates of under-five, infant and neonatal mortality by uniCEF regioni (continued)
Number of under-five deaths (thousands) 1990 Region Africa Sub-Saharan Africa West and Central Africa Middle East and North Africa Asia South Asia East Asia and Pacific Latin America and Caribbean Central and Eastern Europe/Commonwealth of Independent States World 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Infant Neonatal mortality rate Number of mortality rate Number of (deaths per infant (deaths per neonatal 1,000 live deaths 1,000 live deaths births) (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011 1990 2011
4,189 3,457 3,403 3,835 3,911 3,370 3,313 3,746 1,156 1,321 322 399 3,140 650 213 2,146 2,096 2,001 2,397 678 351
95 103 79 126 34 44 63 19 17
65 2,533 2,245 69 2,318 2,170 55 1,041 83 28 48 16 486 779 274 1,214 1,327
42 45 43 48 27 36 48 24 22
32 34 29 39 16 23 32 11 10
6,227 6,687 2,899 2,762 4,104 4,480 2,309 2,029 2,307 588 632 590 203 563 192
2,156 2,531
358
347
369
125
121
157
52 89
43 85
23 53
19 50
40 61
18
295
105
19 32
10 22
136
57
37 8,354 4,989
4,362 2,955
Estimates of under-five, infant and neonatal mortality by World Health Organization regioni (continued)
Number of under-five deaths (thousands) 1990 Region Africa Americas Eastern Mediterranean Europe South-East Asia Western Pacific World 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Infant Neonatal mortality rate Number of mortality rate Number of (deaths per infant (deaths per neonatal 1,000 live deaths 1,000 live deaths births) (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011 1990 2011
3,667 3,562 3,752 3,179 657 418 635 407 679 428 237 923 149 384 1,368 1,302 1,406
3,120 3,550 226 145 363 247 182 421 841 1,031
166 38 95 29 111 46 85
112 17 61 14 54 17 53
101 14 55 12 56 15 50
106 33 73 27 77 37 61
45 18 36 14 44 21 32
34 8 25 6 29 9 22
4,239 4,010 4,374 2,039 1,907 2,255 1,614 1,486 1,764 11,968 11,652 12,163 6,914 6,845 7,436
25
country, regional and global estimates of under-five, infant and neonatal mortality
Estimates of under-five, infant and neonatal mortality by World bank regioni
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Region Low income Middle income Lower middle income Upper middle income Low and middle income East Asia & Pacific Europe & Central Asia Latin America & Caribbean Middle East & North Africa South Asia Sub-Saharan Africa High income World
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
133 67 88 37 79 40 35 34 48 89 154 8 73
129 64 84 35 77 38 33 33 45 85 148 8 71
136 68 89 38 80 41 37 35 49 92 156 8 73
95 46 62 20 56 21 21 19 32 62 109 6 51
93 45 60 19 56 20 20 18 30 58 107 6 51
2.6 2.7 2.7 4.5 2.5 4.7 3.9 4.9 3.8 3.1 2.3 3.5 2.5
2.0 2.4 2.3 3.9 2.1 4.1 2.8 4.6 3.2 2.5 1.8 3.1 2.1
2.6 2.9 2.9 4.8 2.5 5.0 4.1 5.1 4.1 3.4 2.4 3.6 2.6
Estimates of under-five, infant and neonatal mortality by united nations Population Division regioni
Under-five mortality rate (U5MR) (deaths per 1,000 live births) 1990 Region More developed regions Less developed regions Least developed countries Excluding least developed countries Excluding China Sub-Saharan Africa Africa Asia Europe Latin America & Caribbean Northern America Oceania World
U5MR Lower bound Upper bound U5MR
2000
Lower bound Upper bound U5MR
2011
Lower bound
Millennium Development Goal targetfor Upper bound 2015 7 61 109 48 68 121 110 45 7 20 8 26 55 5 32 57 27 37 60 54 27 6 18 4 11 29
7 57 98 45 64 109 100 42 7 19 7 23 51
7 56 96 43 63 108 99 40 7 18 7 19 51
3.8 2.5 2.7 2.8 2.6 2.4 2.3 3.2 4.6 4.8 2.0 1.8 2.5
3.5 2.1 2.1 2.5 2.2 1.9 1.8 2.8 4.2 4.5 1.5 1.5 2.1
4.0 2.6 2.7 3.0 2.6 2.4 2.4 3.4 4.7 5.1 2.3 2.6 2.6
Definitions Under-five mortality rate: Probability of dying between birth and exactly five years of age, expressed per 1,000 live births. Infant mortality rate: Probability of dying between birth and exactly one year of age, expressed per 1,000 live births. Neonatal mortality rate: Probability of dying in the first month of life, expressed per 1,000 live births. Note: Upper and lower bounds refer to the 90 percent uncertainty intervals for the estimates. Estimates are generated by the United Nations Inter-agency Group for Child Mortality Estimation to ensure comparability; they are not necessarily the official statistics of UN Member States, which may use alternative rigorous methods. not available. a Estimates for Azerbaijan for recent years are based on projections from the 2006 Demographic and Health Survey and earlier surveys. Data from a more recent (2011) Ministry of Health survey are not yet available. Steps are being taken to improve death registration and to implement the international standard definition for live births. The most recent official infant mortality rate from the State Statistical Committee is 11 deaths per 1,000 live births for 2011, compared with the IGME estimate of 39. b Estimates for Ecuador for recent years are based on projections from surveys and censuses. The most recent official national statistics are based on vital registration data and thus differ from the estimates shown here.
26
country, regional and global estimates of under-five, infant and neonatal mortality
Estimates of under-five, infant and neonatal mortality by World bank regioni (continued)
Number of under-five deaths (thousands) 1990 Region Low income Middle income Lower middle income Upper middle income Low and middle income East Asia & Pacific Europe & Central Asia Latin America & Caribbean Middle East & North Africa South Asia Sub-Saharan Africa High income World 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Infant Neonatal mortality rate Number of mortality rate Number of (deaths per infant (deaths per neonatal 1,000 live deaths 1,000 live deaths births) (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011 1990 2011
3,209 8,604 6,148 2,456 2,160 359 609 531 4,340 3,815 155
3,108 3,247 2,383 2,341 2,695 8,333 8,822 4,453 4,310 4,780 5,898 6,297 3,740 3,584 4,032 2,335 2,625 2,024 2,302 348 587 509 370 631 549 713 587 125 202 249 683 560 121 191 229 803 647 158 212 278
100 47 63 21 58 22 23 21 34 61 114 6 53
90 46 62 19 55 20 19 17 30 63 103 5 50
103 59 76 40 66 42 40 42 54 85 107 10 61
63 2,019 1,584 35 6,209 3,340 46 4,266 2,765 16 1,943 17 1,627 18 16 26 48 5 296 480 402 574 481 105 170 204 40 8,228 4,923
46 32 41 23 35 24 19 22 26 48 45 6 32
32 22 28 10 24 11 10 10 15 32 34 3 22
950
849
3,332 2,063 2,298 1,702 1,035 893 137 255 198 1,784 1,016 79 361 310 57 106 119 1,199 1,120 42 4,283 2,912
2,156 2,531 75 83
4,362 2,955
Estimates of under-five, infant and neonatal mortality by united nations Population Division regioni (continued)
Number of under-five deaths (thousands) 1990 Region More developed regions Less developed regions Least developed countries Excluding least developed countries Excluding China Sub-Saharan Africa Africa Asia Europe Latin America & Caribbean Northern America Oceania World 2011
UnderUnderfive Lower Upper five Lower Upper deaths bound bound deaths bound bound
2011
Male Female
Infant Neonatal mortality rate Number of mortality rate Number of (deaths per infant (deaths per neonatal 1,000 live deaths 1,000 live deaths births) (thousands) births) (thousands)
1990 2011 1990 2011 1990 2011 1990 2011
227
222
231
96
93
101
6 55 93 44 62 104 95 42 6 17 7 22 50
6 41
189
81
7 35 47 32 38 45 42 34 9 22 6 13 32
4 24 33 21 26 35 32 22 4 10 4 10 22
107 1,027
52 933
11,741 11,424 11,935 6,819 6,749 7,339 3,530 3,430 3,577 2,649 2,612 2,983 8,211 7,935 8,422 4,170 4,026 4,475 10,445 10,157 10,590 6,570 6,497 7,082 3,725 3,619 3,812 3,275 3,215 3,646 4,104 3,995 169 610 47 17 164 588 45 16 4,189 3,457 3,403 3,835 174 632 48 18 56 203 34 15 55 192 32 12 60 213 37 17 7,020 6,745 7,204 3,150 3,020 3,404
8,166 4,909
4,255 2,902
65 2,212 1,757 34 5,953 3,152 45 7,130 4,693 70 2,257 2,108 65 2,533 2,245 33 6 16 6 18 5,147 2,486 142 481 39 13 47 170 29 12
3,227 1,969 3,699 2,759 986 1,088 1,111 79 256 24 7 1,163 30 107 20 6 2,885 1,629
37 8,354 4,989
4,362 2,955
c The results of the 2011 Georgia Reproductive Health Survey are not reflected in the estimates, pending further evaluation. The reported under-five mortality rate according to preliminary survey results is 16.4 per 1,000 live births for 20052010, compared with the IGME estimate of 24. d The results of the 20102011 Iran Multiple Indicator Demographic and Health Survey are not reflected in the estimates, pending further evaluation. The reported under-five and infant mortality rates according to preliminary survey results both show further improvement compared with IGME estimates for 2011. e Estimates for Kazakhstan for recent years are based on projections from surveys and censuses. The most recent official infant mortality rate, based on vital registration data, is 15 deaths per 1,000 live births for 2009, compared with the IGME estimate of 25. f Estimates for Tajikistan for recent years are based on projections from surveys and censuses. The most recent official infant and under-five mortality rates, based on vital registration data, are 12 and 14.8 deaths per 1,000 live births respectively for 2009, compared with the IGME estimates of 56 and 68. g The results of the 2012 Turkey Infant and Child Mortality Survey are not yet included in the estimates, pending further evaluation. The reported infant and under-five mortality rates according to preliminary survey results are 7.7 and 11.25 deaths per 1,000 live births respectively for 20072011, compared with the IGME estimates of 12 and 15 for 2011. h See next page for country classifications by region. i The sum of the number of deaths by region may differ from the world total because of rounding. 27
Regional Classifications
The regional classifications that are referred to in the report and for which aggregate data are provided in the statistical table are Millennium Development Goal regions (see below). Aggregates presented for member organizations of the Inter-agency Group for Child Mortality Estimation may differ. Regions with the same names in different agencies may include different countries.
Developed regions
Albania, Andorra, Australia, Austria, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Canada, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, Montenegro, Netherlands, New Zealand, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, The former Yugoslav Republic of Macedonia, Ukraine, United Kingdom, United States
Oceania
Cook Islands, Fiji, Kiribati, Marshall Islands, Micronesia (Federated States of), Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu
South-eastern Asia
Brunei Darussalam, Cambodia, Indonesia, Lao Peoples Democratic Republic, Malaysia, Myanmar, Philippines, Singapore, Thailand, Timor-Leste, VietNam
Southern Asia
Developing regions
Caucasus and Central Asia
Afghanistan, Bangladesh, Bhutan, India, Iran (Islamic Republic of), Maldives, Nepal, Pakistan, Sri Lanka
Sub-Saharan Africa
Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Uruguay, Venezuela (Bolivarian Republic of)
northern Africa
Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Cte dIvoire, Democratic Republic of the Congo, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia, Zimbabwe
Western Asia
Bahrain, Iraq, Jordan, Kuwait, Lebanon, Occupied Palestinian Territory, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Turkey, United Arab Emirates, Yemen
28
On the cover: A girl stands in her communitys makeshift camp in the city of Hyderabad, Sindh Province, Pakistan. The community has been displaced by rising flood waters. Photo credits: cover, UNICEF/NYHQ2011-1404/Warrick Page; page 2, UNICEF/NYHQ2012-0245/Olivier Asselin; page 3, UNICEF/NYHQ2011-2151/Patricia Esteve; page 7, UNICEF/AFGA2012-00066/Aziz Froutan; page 8, UNICEF/NYHQ2009-2395/Giacomo Pirozzi; page 13, UNICEF/NYHQ2010-1249/Cliff Volpe.
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