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Levels & Trends in
 
ChildMortality
Report 2011
Estimates Developed by theUN Inter-agency Group forChild Mortality Estimation
United NationsDESA/Population Division
 
This report was prepared at UNICEF Headquarters by Danzhen You, Gareth Jones and Tessa Wardlaw on behalf of theUnited Nations Inter‑agency Group for Child Mortality Estimation.
Organizations and individuals involved in generating country-specifc 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 
Emi Suzuki
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 o the Inter-agency Group or Child Mortality Estimation or providing technical guidance on methods or child mortality estimation
Kenneth Hill (Chair), Harvard UniversityMichel Guillot, University of PennsylvaniaLeontine Alkema, National University of SingaporeJon Pedersen, FafoSimon Cousens, London School of Hygiene and Tropical MedicineNeff Walker, Johns Hopkins University Trevor Croft, Measure DHS, ICF MacroJohn Wilmoth, University of California, Berkeley Gareth Jones, Consultant Further thanks go to Priscilla Akwara, Mickey Chopra, Archana Dwivedi, Jimmy Kolker, Richard Morgan, Holly Newby andIan Pett from UNICEF for their support as well as to Joy Lawn from Save the Children for her comments. And special thanks toMengjia Liang from UNICEF for her assistance in preparing the report.Communications Development Incorporated provided overall design direction, editing and layout.Copyright © 2011by the United Nations Children’s FundThe Inter‑agency Group for Child Mortality Estimation (IGME) constitutes representatives of the United Nations Children’sFund, the World Health Organization, the World Bank and the United Nations Population Division. The child mortality esti‑mates presented in this report have been reviewed by IGME members. As new information becomes available, estimates willbe updated by the IGME. Differences between the estimates presented in this report and those in forthcoming publicationsby IGME members may arise because of differences in reporting periods or in the availability of data during the productionprocess of each publication and other evidence. While every effort has been made to maximize the comparability of statisticsacross countries and over time, users are advised that country data may differ in terms of data collection methods, populationcoverage and estimation methods 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 Divisionconcerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its fron‑tiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.On 9 July 2011 the Republic of South Sudan seceded from the Republic of the Sudan and was subsequently admitted to theUnited Nations on 14 July 2011; disaggregated data for Sudan and South Sudan as separate states are not yet available. Data andmaps in this report refer to Sudan as it was constituted in 2010.United Nations Children’s Fund3 UN Plaza, New York, New York, 10017 USA  World Health Organization Avenue Appia 20, 1211 Geneva 27, SwitzerlandThe World Bank1818 H Street, NW, Washington, DC, 20433 USA United Nations Population Division2 UN Plaza, New York, New York, 10017 USA 
 
1
PROGRESS TOWARDS MillEnniuM DEvElOPMEnT GOAl 4:KEY FACTS AnD FiGuRES
•Overall,substantialprogresshasbeenmadetowardsachievingMDG4.Thenumberofunder-vedeathsworldwidehasdeclinedfrommorethan12mil-lionin1990to7.6millionin2010.Nearly21,000childrenundervediedeverydayin2010—about12,000feweradaythanin1990.•Since1990theglobalunder-vemortal-ityratehasdropped35percent—from88deathsper1,000livebirthsin1990to57in2010.NorthernAfrica,East-ernAsia,LatinAmericaandtheCarib-bean,South-easternAsia,WesternAsiaandthedevelopedregionshavereducedtheirunder-vemortalityrateby50per-centormore.•Therateofdeclineinunder-vemortalityhasaccelerated—from1.9percentayearover1990–2000to2.5percentayearover2000–2010—butremainsinsuf-cient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-vemortalityrateshavefallenmoresharplyelsewhere,thedisparitybe-tweenthesetworegionsandtherestoftheworldhasgrown.•Under-vedeathsareincreasinglycon-centratedinSub-SaharanAfricaandSouthernAsia,whiletheshareoftherestoftheworlddroppedfrom31per-centin1990to18percentin2010.•InSub-SaharanAfricatheaverageannualrateofreductioninunder-vemortal-ityhasaccelerated,doublingfrom1990–2000to2000–2010.Sixofthefourteenbest-performingcountriesareinSub-Sa-haranAfrica,asarefourofthevecoun-trieswiththelargestabsolutereductions(morethan100deathsper1,000livebirths).•Abouthalfofunder-vedeathsoccurinonlyvecountries:India,Nigeria,Dem-ocraticRepublicoftheCongo,PakistanandChina.India(22percent)andNigeria(11percent)togetheraccountforathirdofallunder-vedeaths.•Over70percentofunder-vedeathsoccurwithintherstyearoflife.•Theproportionofunder-vedeathsthatoccurwithintherst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rstmonthoflifeandhasshowntheleastprogress.•Globally,thefourmajorkillersofchil-drenunderage5arepneumonia(18percent),diarrhoealdiseases(15per-cent),pretermbirthcomplications(12percent)andbirthasphyxia(9 percent).Undernutritionisanunderlyingcauseinmorethanathirdofunder-vedeaths.MalariaisstillamajorkillerinSub-Saha-ranAfrica,causingabout16percentofunder-vedeaths.
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