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Child Mortalitymortality Estimationestimation LevelsLevels && TrendsTrends inin ReportReport 20142019 ChildChild EstimatesEstimates Developeddeveloped byby thethe UNUN Inter-agencyInter-agency Group Group for for MortalityMortality ChildChild MortalityMortality EstimationEstimation United Nations This report was prepared at UNICEF headquarters by Lucia Hug, David Sharrow and Danzhen You, with support from Mark Hereward and Yanhong Zhang, on behalf of the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Organizations and individuals involved in generating country-specific estimates of child mortality United Nations Children’s Fund Lucia Hug, Sinae Lee, David Sharrow, Danzhen You World Health Organization Bochen Cao, Jessica Ho, Wahyu Retno Mahanani, Kathleen Louise Strong World Bank Group Emi Suzuki United Nations, Department of Economic and Social Affairs, Population Division Kirill Andreev, Lina Bassarsky, Victor Gaigbe-Togbe, Patrick Gerland, Danan Gu, Sara Hertog, Nan Li, Thomas Spoorenberg, Philipp Ueffing, Mark Wheldon United Nations Economic Commission for Latin America and the Caribbean, Population Division Guiomar Bay, Helena Cruz Castanheira Special thanks to the Technical Advisory Group of the UN IGME for providing technical guidance on methods for child mortality estimation Leontine Alkema, University of Massachusetts, Amherst Kenneth Hill (Chair), Stanton-Hill Research Robert Black, Johns Hopkins University Bruno Masquelier, University of Louvain Simon Cousens, London School of Hygiene & Tropical Medicine Colin Mathers, University of Edinburgh Trevor Croft, The Demographic and Health Surveys (DHS) Program, ICF Jon Pedersen, Fafo Michel Guillot, University of Pennsylvania and French Institute for Jon Wakefield, University of Washington Demographic Studies (INED) Neff Walker, Johns Hopkins University Special thanks to the United States Agency for International Development (USAID) and the Bill & Melinda Gates Foundation for supporting UNICEF’s child mortality estimation work. Thanks also go to the Joint United Nations Programme on HIV/AIDS for sharing estimates of AIDS mortality, Rob Dorrington from the University of Cape Town for providing data for South Africa, Jing Liu from Fafo for preparing the underlying data, and Zitong Wang for supporting further data processing and analysis. Thanks also go to the Maternal and Child Epidemiology Estimation Group (MCEE) for providing interim estimates of cause of death for children under 5 years of age, work which involved Robert Black, Li Liu, Jamie Perin, Francisco Villavicencio and Diana Yeung from Johns Hopkins University; Simon Cousens, Amy Mulick, Shefali Oza and David Prieto-Merino from the London School of Hygiene & Tropical Medicine; and Regina Guthold, Dan Hogan, Colin Mathers and Gerard Lopez from WHO. And special thanks to UNICEF and WHO field office colleagues for supporting the country consultations and regional workshops. Thanks also go to Khin Wityee Oo from UNICEF for proofreading and to other UNICEF colleagues, including: Vidhya Ganesh (Director, Division of Data, Analytics, Planning and Monitoring), Mark Hereward (Associate Director, Data and Analytics Section, Division of Data, Analytics, Planning and Monitoring), Yanhong Zhang, Attila Hancioglu, Karen Avanesyan, Sebastian Bania, Karen Carter, Liliana Carvajal, Yadigar Coskun, Enrique Delamónica, Ahmed Hanafy, Karoline Hassfurter, Yves Jaques, Shane Khan, Richard Kumapley, Rada Noeva, Daniele Olivetti, Eva Quintana, Anshana Ranck, Jennifer Requejo, Turgay Unalan and Upasana Young. Thanks to Theresa Diaz from WHO, Mary Mahy and Juliana Daher from the Joint United Nations Programme on HIV/AIDS, William Weiss and Robert Cohen from USAID, and Kate Somers, Savitha Subramanian, Laura Lamberti and Assaye Nigussie from the Bill & Melinda Gates Foundation for their support. Special thanks also to the many government agencies in countries for providing data and valuable feedback through the country consultation process. Naomi Lindt edited the report. Sinae Lee laid out the report. Copyright © 2019 by the United Nations Children’s Fund The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) constitutes representatives of the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), the World Bank Group and the United Nations Population Division. Differences between the estimates presented in this report and those in forthcoming publications by UN IGME members may arise because of differences in reporting periods or in the availability of data and other evidence during the production process of each publication. UN IGME estimates were reviewed by countries through a country consultation process but are not necessarily the official statistics of United Nations Member States, which may use a single data source or alternative rigorous methods. 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, WHO, the World Bank Group 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 Children’s Fund World Bank Group 3 UN Plaza, New York, New York, 10017 USA 1818 H Street, NW, Washington, DC, 20433 USA World Health Organization United Nations Population Division Avenue Appia 20, 1211 Geneva 27, Switzerland 2 UN Plaza, New York, New York, 10017 USA Levels & Trends in Child Mortality Report 2019 Estimates developed by the UN Inter-agency Group for Child Mortality Estimation CHILD SURVIVAL: KEY FACTS AND FIGURES • Tremendous progress in child survival has been (30, 31) in 2000 – a 52 (47, 53) per cent and 42 made over the past two decades. The total (37, 45) per cent decline, respectively. number of deaths among children and young adolescents under 15 years of age dropped • The total number of under-five deaths dropped by 56 per cent from 14.2 (14.0, 14.5)1 million to 5.3 (5.1, 5.7) million in 2018 from 12.5 (12.4, in 1990 to 6.2 (6.0, 6.7) million in 2018. Still, 12.7) million in 1990. On average, 15,000 one child or young adolescent died every five children died before age 5 every day in 2018 seconds in 2018. compared to 34,000 in 1990 and 27,000 in 2000. Among the 5.3 million under-five deaths in 2018, • Globally, 85 per cent of deaths among children 2.9 (2.8, 3.1) million were boys and 2.4 (2.3, 2.6) and young adolescents in 2018 occurred in million were girls. the first five years of life, accounting for 5.3 million deaths, of which 2.5 million (47 per cent) • The global number of neonatal deaths declined occurred in the first month of life, 1.5 million (29 from 5.0 (4.9, 5.2) million in 1990 to 2.5 (2.4, 2.7) per cent) at age 1–11 months, and 1.3 million million 2018 – 7,000 deaths every day in 2018 (25 per cent) at age 1−4 years. An additional 0.9 compared with 14,000 in 1990. Neonatal deaths million deaths occurred among children aged accounted for 47 (45, 49) per cent of all under- 5−14 years. five deaths in 2018, increasing from 40 (39, 41) per cent in 1990 due to a faster global decline • Among children and young adolescents under in mortality among children aged 1–59 months 15 years of age, the risk of dying was highest than for children in their first month of life. in the first month of life, at an average rate of 18 (17, 19) deaths per 1,000 live births globally • For older children and young adolescents aged in 2018. In comparison, the probability of dying 5−14 years, the probability of dying continues after the first month and before reaching age to decline, dropping from 15 (15, 16) deaths per 1 was 11 (11, 12) per 1,000, the probability of 1,000 children aged 5 in 1990 to 7 (7, 8) in 2018. dying after reaching age 1 and before reaching The total number of deaths in this age group age 5 was 10 (9, 11) per 1,000, and the dropped from 1.7 (1.7, 1.8) million in 1990 to 1.4 probability of dying after reaching age 5 and (1.4, 1.5) million in 2000 and to 0.9 (0.9, 1.0) before reaching age 15 was 7 (7, 8) per 1,000. million in 2018. • The global under-five mortality rate fell to 39 • Children continue to face widespread regional (37, 42) deaths per 1,000 live births in 2018 disparities in their chances of survival. Sub- from 93 (92, 95) in 1990 and 76 (75, 78) in 2000 Saharan Africa remains the region with the – a 59 (55, 60) per cent and 49 (46, 52) per cent highest under-five mortality rate in the world. decline, respectively. The neonatal mortality In 2018, the region had an average under-five rate fell to 18 (17, 19) deaths per 1,000 live mortality rate of 78 deaths per 1,000 live births. births in 2018 from 37 (36, 38) in 1990 and 31 This translates to 1 in 13 children dying before 4 his or her fifth birthday – 16 times higher than the • In 2018, 121 countries had already achieved an average ratio of 1 in 199 in high-income countries. under-five mortality rate below the Sustainable Development Goal (SDG) target of 25 or fewer • It is urgent to further accelerate progress in preventing deaths per 1,000 live births; those countries child deaths. Current trends predict that close to 10 should aim to maintain progress and further million 5- to 14-year-olds and 52 million children under reduce disparities among their populations. Of the 5 years of age will die between 2019 and 2030. Almost remaining 74 countries, progress will need to be half of these under-five deaths will be newborns whose accelerated in 53 to reach the SDG target by 2030.
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