Child Mortality Rates Down by Nearly Half Since 1990, Report Finds

While global mortality rates for children under the age of 5 have declined by nearly half since 1990, one million newborns still die within a day from mostly preventable causes, a report from UNICEF finds.

The report, Committing to Survival: A Promise Renewed (104 pages, PDF), found that the child mortality rate fell from ninety deaths per thousand live births in 1990 to forty-six deaths per thousand live births in 2013, while the total number of under-five child deaths fell from 12.7 million to 6.3 million over the same period. The report also found that nearly 2.8 million babies die each year within the first twenty-eight days from causes that can be prevented with simple, cost-effective interventions before, during, and immediately after birth.

According to the study, half of all women do not receive the recommended minimum of four prenatal care visits during their pregnancy, and about a quarter of all neonatal deaths are due to complications during labor and delivery. Countries with the highest number of neonatal deaths also have low coverage rates for postnatal care for mothers; those countries include Ethiopia (84,000 deaths; 7 percent coverage), Bangladesh (77,000; 27 percent), Nigeria (262,000; 38 percent), and Kenya (40,000; 42 percent). In addition, the report found that initiating breastfeeding within one hour of birth reduces the risk of neonatal death by 44 percent — yet less than half of newborns worldwide receive the benefits of immediate breastfeeding — and that even mothers and babies who have contact with the health system rarely receive high-quality care; in ten high-mortality countries, less than 10 percent of babies delivered by a skilled birth attendant went on to receive the seven required post-natal interventions.

According to the report, countries in sub-Saharan Africa and South Asia account for four out of five under-five deaths, with one in eleven children born in sub-Saharan Africa dying before the age of 5, a rate nearly fifteen times the average in high-income countries. What's more, progress in this area is insufficient to meet the United Nations' Millennium Development Goal 4 of reducing the child mortality rate by two-thirds by 2015; indeed, if current trends continue, the MDG target will not be reached until 2026.

"The data clearly demonstrate that an infant's chances of survival increase dramatically when their mother has sustained access to quality health care during pregnancy and delivery," said UNICEF deputy executive director Geeta Rao Gupta. "We need to make sure that these services, where they exist, are fully utilized and that every contact between a mother and her health worker really counts. Special efforts must also be made to ensure that the most vulnerable are reached."