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Levels & Trends in

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

PROGRESS TOWARDS MillEnniuM DEvElOPMEnT GOAl 4: KEY FACTS AnD FiGuRES


Overall, substantial progress has been made towards achieving MDG 4. The number of under-five deaths worldwide has declined from nearly 12 (11.7, 12.2)1 million in 1990 to 6.9 (6.8, 7.4) million in 2011. While that translates into 14,000 fewer children dying every day in 2011 than in 1990, it still implies the deaths of 19,000 children under age five every day in 2011. Since 1990 the global under-five mortality rate has dropped 41 percentfrom 87 (85, 89) deaths per 1,000 live births in 1990 to 51 (51, 55) in 2011. Eastern Asia, Northern Africa, Latin America and the Caribbean, South-eastern Asia and Western Asia have reduced their under-five mortality rate by more than 50 percent. The annual rate of reduction in under-five mortality has acceleratedfrom 1.8 (1.7, 2.1) percent a year over 19902000 to 3.2 (2.5, 3.2) percent over 20002011but remains insufficient to reach MDG 4, particularly in Oceania, Sub-Saharan Africa, Caucasus and Central Asia, and Southern Asia. The highest rates of child mortality are still in Sub-Saharan Africawhere 1 in 9 children dies before age five, more than 16 times the average for developed regions (1 in 152) and Southern Asia (1 in 16). As under-five mortality rates have fallen more sharply elsewhere, the disparity between these two regions and the rest of the world has grown. Under-five deaths are increasingly concentrated in Sub-Saharan Africa and Southern Asia, while the share in the rest of the world dropped from 31percent in 1990 to 17 percent in 2011. By 2050, 1 in 3 children will be born in SubSaharan Africa, and almost 1 in 3 will live there, so the global number of under-five deaths may stagnate or even increase without more progress in the region. However, Sub-Saharan Africa has seen a faster decline in its under-five mortality rate, with the annual rate of reduction doubling between 19902000 and 20002011. About half of under-five deaths occur 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 all under-five deaths. The proportion of under-five deaths that occur within the first month of life (the neonatal period) has increased 17 percent since 1990, from 36 percent to about 43percent, because declines in the neonatal mortality rate are slower than those in the mortality rate for older children. Almost 30 percent of neonatal deaths occur in India. Sub-Saharan Africa has the highest risk of death in the first month of life and is among the regions showing the least progress. The leading causes of death among children under age five are pneumonia (18% of all under-five deaths); preterm birth complications (14%); diarrhoea (11%); intrapartumrelated complications (complications during birth; 9%); and malaria (7%). Globally, more than a third of under-five deaths are attributable to undernutrition.

1. Values in parentheses indicate 90 percent uncertainty intervals for the estimates.

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.

Estimating Child Mortality


The UN Inter-agency Group for Child Mortality Estimation The IGME was formed in 2004 to share data on child mortality, harmonize estimates within the UN system, improve methods for child mortality estimation, report on progress towards the Millennium Development Goals and enhance country capacity to produce timely and properly assessed estimates of child mortality. The IGME, led by UNICEF and the World Health Organization (WHO), also includes the World Bank and the United Nations Population Division of the Department of Economic and Social Affairs as full members.
The IGMEs Technical Advisory Group, comprising leading academic scholars and independent experts in demography and biostatistics, provides guidance on estimation methods, technical issues and strategies for data analysis and data quality assessment. series for each country, a statistical model is fitted to data points that meet quality standards established by the IGME and then used to predict a trend line that is extrapolated to a common reference year, set at 2011 for the estimates in this report. Overall, infant mortality rates are generated by transforming under-five mortality rates based on model life tables. Neonatal mortality rates are produced using a statistical model that uses under-five mortality rates as an input. These methods provide a transparent and objective way of fitting a smoothed trend to a set of observations and of extrapolating the trend over 1960 to the present. Details on these methods can be found in the PLoS Med Collection on child mortality estimation methods published in August 2012 (www.ploscollections.org/ childmortalityestimation).

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
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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.

Levels and Trends in ChildMortality, 19902011


Under-five mortality has declined 41 percent since 1990 The latest estimates of under-five mortality from the IGME show a 41 percent decline in the global under-five mortality rate, from 87 (85, 89) deaths per 1,000 live births in 1990 to 51 (51, 55) in 2011 (table 1 and figure 1). Over the same period, the total number of under-five deaths in the world has declined from nearly 12 (11.7, 12.2) million in 1990 to 6.9 (6.8, 7.4) million in 2011 (table 2). More than half the Millennium Development Goal regions have halved their under-five mortality rate since 1990 Five of nine developing regions show reductions in under-five mortality of more than 50 percent over 19902011 (figure 2). Eastern Asia, with a 70 percent reduction, and Northern Africa, with a 68 percent reduction, have achieved MDG 4, and Latin America and the Caribbean is close to
TAblE

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

MDG Decline target (percent) 2015 19902011

Progress towards Millennium Development Goal4 target a 2011

Developed regions Developing regions

15 97

11 91 59 170 43 70 45 36 102 103 57 52 67 82

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

under-five mortality declined in all regions between 1990 and 2011

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

Caucasus and Central Asia

Latin America and the Caribbean

Eastern Asia

Oceania

Developed regions

Developing regions

World

Northern Africa

South-eastern Asia

Sub-Saharan Africa

Eastern Asia

Latin America and the Caribbean

Western Asia

Southern Asia

Caucasus and Central Asia

Oceania

Developed regions

Developing regions 2011

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

Decline (percent) 19902011

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

99 7,049 92 3,435 238 75 288 17 2,422 706 328 158 13 7,148

96 6,818 87 3,370 203 72 265 17 2,341 686 312 155 13 6,914

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

Note: All calculations are based on unrounded numbers.

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

53 2,902 40 1,122 107 28 151 8 1,216 340 155 77 5 2,955

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

Note: All calculations are based on unrounded numbers.

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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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

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

125 23 41 5 180 14 19 26 5 5 62 16 12 80 16 13 6 25 128 80 74 9 74 34 9 19 168 147 92 127 6 34 153 173 11 32 23 78 99 13 12 126 8 8

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

101 14 30 3 158 8 14 18 5 4 45 16 10 46 20 6 4 17 106 54 51 8 26 16 7 12 146 139 43 127 6 21 164 169 9 15 18 79 99 10 10 115 5 6

84 11 22 3 124 6 12 13 4 4 38 12 8 41 15 5 4 14 94 47 43 7 20 14 6 10 133 116 36 107 5 18 131 146 8 13 15 51 84 6 9 97 5 5

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

Bolivia (Plurinational State of) 120

14

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

2011
Male Female

Infant mortality rate (deaths per 1,000 live births)


1990 2011

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

117 3 52 0 123 0 20 4 2 1 19 0 0 509 0 3 1 0 37 3 28 1 2 205 0 3 87 45 37 71 3 1 20 55 6 1,296 31 2 10 0 1 76 1 2

95 3 47 0 109 0 19 3 2 1 17 0 0 475 0 3 1 0 34 3 26 1 2 191 0 2 80 41 34 66 3 1 18 50 5 28 2 10 0 1 71 1 2

129 4 58 0 149 0 22 4 3 1 22 0 0 527 0 3 1 0 39 3 29 1 3 226 0 3 92 51 40 76 3 1 23 60 6 32 2 11 0 2 81 1 3

128 1 21 0 120 0 10 1 1 0 8 0 0 134 0 1 1 0 36 1 13 0 1 44 0 1 101 39 13 88 2 0 25 79 2 249 16 2 14 0 1 75 0 1

105 0 16 0 92 0 9 1 1 0 7 0 0 120 0 1 0 0 32 1 11 0 1 39 0 1 91 32 11 73 2 0 19 68 2 227 14 1 12 0 1 63 0 1

162 1 33 0 185 0 11 1 2 0 12 0 0 150 0 1 1 0 43 1 15 0 1 52 0 1 130 57 19 93 3 0 33 99 2 281 19 3 15 0 1 80 0 1

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

99 14 28 3 150 7 13 15 4 4 43 15 10 44 18 5 4 15 103 50 48 7 24 14 7 11 142 133 37 120 5 20 157 160 8 14 16 74 94 8 9 105 5 5

129 36 54 7 144 23 24 40 8 8 75 18 18 97 16 14 9 35 107 96 83 17 41 49 9 19 105 110 85 90 7 45 112 113 16 39 28 86 75 16 15 104 11 11

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

StatiStical table (ContInUEd)

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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

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 58 181 6 106 15 39 34 44 34 152 98 11 139 22 4 5 82 130 33 5 99 8 16 48 175 186 49 102 35 11 4 88 53 44 43 7 7 6 26

6 6 46 160 5 91 13 33 30 42 29 117 89 10 124 20 4 5 70 118 28 5 91 7 15 42 161 164 45 91 30 10 4 83 51 37 38 6 6 5 22

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

3 4 33 168 4 90 12 25 23 21 15 118 68 4 77 16 3 4 66 101 21 4 78 4 13 30 126 161 36 70 21 6 3 61 32 25 38 4 4 4 18

3 3 26 139 3 68 9 19 17 19 13 63 60 3 65 14 3 4 50 82 15 4 66 4 11 21 112 132 31 59 16 6 2 56 28 21 30 3 4 3 14

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

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

2011
Male Female

Infant mortality rate (deaths per 1,000 live births)


1990 2011

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

0 2 16 312 1 3 0 12 15 158 10 3 17 0 433 1 0 6 3 7 4 7 67 1 0 26 58 9 1 36 10 3 0 3,061 386 115 30 0 1 5 2

0 2 13 293 1 2 0 11 14 149 9 3 16 0 385 1 0 6 3 6 4 7 63 1 0 24 53 8 1 32 9 2 0 362 101 27 0 1 5 2

0 2 21 365 1 3 0 12 17 163 11 4 18 1 461 1 0 7 4 8 5 8 71 1 0 27 62 10 1 37 11 3 0 403 133 36 1 1 6 2

0 0 12 465 0 2 0 5 7 40 2 3 13 0 194 0 0 3 3 6 1 3 60 1 0 14 48 9 0 19 4 1 0 134 33 42 0 1 2 1

0 0 9 378 0 2 0 4 5 36 2 2 11 0 163 0 0 3 2 5 1 3 50 0 0 9 42 7 0 16 3 1 0 119 27 33 0 1 2 1

0 1 15 681 0 3 0 6 9 43 3 6 16 0 235 0 0 4 3 9 2 3 74 1 0 17 62 12 1 22 5 1 0 169 43 59 0 1 3 1

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 4 35 178 4 95 13 27 25 22 17 124 74 4 82 18 3 5 72 107 23 4 83 5 13 33 128 174 40 74 23 7 3 59 34 25 41 4 5 4 21

3 4 32 158 3 84 11 23 21 20 14 112 61 3 72 15 3 4 59 94 18 4 72 4 12 28 123 147 32 66 20 6 2 64 29 25 35 4 4 3 16

10 13 23 117 7 94 14 45 41 63 47 118 86 16 118 25 6 7 69 78 40 7 76 12 17 56 135 125 48 99 43 17 5 81 54 47 37 8 10 8 28

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

0 2 10 206 0 2 0 9 12 117 8 2 11 0 264 0 0 5 2 3 4 6 43 1 0 18 35 5 1 24 8 2 0 251 87 24 0 1 5 2

0 0 9 307 0 2 0 4 6 34 2 2 9 0 129 0 0 3 2 4 1 2 40 0 0 11 30 5 0 14 4 1 0 104 28 35 0 1 2 1

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 1 9 91 0 1 0 6 6 36 3 1 4 0 122 0 0 3 1 2 2 3 22 1 0 10 15 2 1 10 4 2 0 1,288 140 48 15 0 1 3 1

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

2,856 3,221 1,655

1,519 1,855

2,174 1,273

17

StatiStical table (ContInUEd)

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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

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

4 25 38 100 53 12 41 68 16 17 109 140 25 11 5 97 151 10 45 195 8 33 103 16 27 37 5 59 11 47 155 67 66 35 77 6 7 38 192 170 21 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 21 28 73 47 11 31 42 8 9 86 78 16 6 3 62 83 7 11 176 6 26 112 15 16 42 4 31 7 33 103 62 42 40 48 4 6 26 125 124 21 3

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

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

2011
Male Female

Infant mortality rate (deaths per 1,000 live births)


1990 2011

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

8 5 23 95 0 1 10 25 1 2 5 22 5 1 0 79 94 9 1 103 0 0 10 1 116 0 0 8 0 57 128 115 4 0 94 2 1 10 125 876 0 0

7 4 21 88 0 1 9 21 1 2 5 19 4 1 0 71 86 8 1 95 0 0 9 1 104 0 0 7 0 51 113 98 3 0 84 1 1 9 114 796 0 0

8 5 25 102 0 1 11 27 1 3 6 24 5 1 0 81 98 10 1 109 0 0 11 1 127 0 0 9 0 60 138 124 4 0 96 2 1 10 132 939 0 1

4 3 11 107 0 1 4 6 0 1 5 12 2 0 0 45 52 4 0 121 0 0 13 0 34 0 0 2 0 21 86 53 2 0 34 1 0 4 89 756 0 0

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

4 4 16 145 0 1 6 8 0 1 6 16 2 0 0 63 61 4 0 138 0 0 17 0 38 0 0 3 0 25 102 72 3 0 40 1 0 5 114 908 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

4 22 32 78 50 12 34 44 9 10 93 83 17 6 3 65 87 7 12 182 7 29 120 16 17 47 4 35 8 35 107 69 45 56 49 4 7 29 127 129 21 3

3 19 24 67 45 10 28 39 8 9 79 74 16 5 3 58 79 6 10 169 5 23 104 14 14 36 3 26 7 30 99 56 38 24 47 4 5 22 122 119 21 3

5 31 48 64 64 14 58 102 17 27 71 161 33 14 7 98 134 15 76 132 10 41 81 21 38 44 6 76 16 64 151 77 49 32 94 7 9 50 133 127 12 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

StatiStical table (ContInUEd)

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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

43 48 122 32 33 88 53 75 57 17 15 20 8 35 37 27 156 28 23 30 12 96 43 136 29 17 267 8 18 10 42 180 62 217 11 29 123 52 83 7 8 36 114

39 43 112 26 30 82 46 70 53 16 14 18 7 31 36 26 151 25 21 25 27 10 86 36 130 24 16 244 7 17 10 38 155 57 189 11 27 114 46 79 6 7 33 99

47 51 129 41 38 97 57 78 59 19 16 22 9 39 38 29 170 33 25 33 34 13 111 50 146 34 19 309 8 18 11 49 205 75 256 11 31 136 61 99 7 9 40 128

30 22 95 25 26 72 35 39 39 10 7 13 6 24 27 21 183 16 18 22 23 5 93 21 130 13 14 241 4 12 5 31 180 74 165 7 19 104 40 114 4 6 23 95

26 19 86 21 22 62 30 36 36 9 7 12 5 19 26 19 164 14 17 20 19 5 80 17 118 11 13 216 4 11 5 24 147 61 143 7 17 92 34 103 4 5 21 81

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

22 9 72 19 20 58 22 18 25 6 3 8 5 16 13 12 54 7 16 21 19 2 89 9 65 7 14 185 3 8 3 22 180 47 121 4 12 86 30 104 3 4 15 63

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

Saint Vincent and the Grenadines 27

20

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

2011
Male Female

Infant mortality rate (deaths per 1,000 live births)


1990 2011

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

4 4 578 0 2 13 8 51 119 10 2 0 5 3 16 66 55 0 0 0 0 0 0 28 44 5 0 51 0 2 0 1 60 81 66 5 11 107 1 4 1 1 17 28

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

4 1 425 0 2 14 5 11 69 3 0 0 3 1 3 23 29 0 0 0 0 0 1 8 42 1 0 77 0 0 0 0 105 61 64 2 5 132 0 4 0 0 9 33

46 49 126 40 36 92 57 79 63 19 16 22 8 39 41 31 165 32 25 29 33 12 99 46 143 30 18 280 8 20 12 41 190 66 220 12 31 129 57 91 7 9 39 122

41 46 118 24 31 84 48 71 51 15 13 19 7 30 33 23 148 25 20 24 26 12 93 39 129 27 15 253 7 15 9 43 170 58 215 10 27 116 46 76 6 7 33 106

23 9 76 23 21 60 25 20 29 6 4 8 5 17 14 13 57 8 17 23 21 2 92 10 69 8 15 194 3 9 3 21 190 50 122 5 13 91 33 113 3 5 16 70

21 8 68 14 18 55 20 17 22 5 3 7 4 15 11 10 51 6 14 19 16 2 86 8 60 6 13 176 2 7 3 22 170 44 119 4 11 81 26 94 3 4 14 56

36 36 95 27 26 64 41 54 40 15 11 17 6 29 31 23 95 22 18 21 25 11 62 34 69 25 14 158 6 16 9 34 108 48 129 9 24 77 44 61 6 7 30 89

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

StatiStical table (ContInUEd)

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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

35 38 180 147 25 37 51 72 94 58 178 19 22 9 158 11 23 75 39 31 50 126 193 79

32 34 164 138 22 33 42 66 86 51 168 18 21 9 148 11 22 70 34 29 44 116 175 75

39 40 199 161 29 44 57 76 103 64 188 22 25 10 164 12 25 85 45 34 55 136 195 86

19 16 109 128 20 32 30 35 71 43 141 19 12 7 126 9 17 61 23 22 34 99 154 106

17 16 100 116 16 27 25 31 62 38 129 17 12 6 115 8 16 54 20 21 31 85 142 97

22 18 121 147 25 41 34 39 86 48 146 20 13 7 129 9 18 73 29 24 37 110 167 115

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

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

2011
Male Female

Infant mortality rate (deaths per 1,000 live births)


1990 2011

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

43 1 5 24 0 1 13 101 14 0 155 16 1 7 176 45 1 62 0 20 106 79 65 32

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

39 39 190 158 28 41 55 76 103 63 192 22 24 10 163 13 26 82 41 34 57 131 200 86

31 36 169 136 21 33 47 68 86 52 164 17 20 8 152 10 21 68 36 28 43 121 186 72

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

29 34 135 85 21 32 40 60 75 45 106 17 19 8 97 9 20 62 31 26 36 89 114 53

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

3,911 3,370 3,313 3,746

69 2,318 2,170

1,325 1,202 1,478

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

3,196 1,824 568 200 10

48 1,022

11,968 11,652 12,163

6,914 6,845 7,436

37 8,354 4,989

4,362 2,955

23

StatiStical table (ContInUEd)

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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

163 178 197 72 85 119 55 53

159 173 156 191 70 82 113 52 51

166 181 165 205 75 87 122 58 55

141 154 135 175 52 65 89 39 34

137 148 130 166 49 63 85 37 33

144 156 138 180 54 67 92 40 35

100 109 84 132 36 44 62 20 19

99 107 83 126 33 42 58 20 18

2.3 2.3 3.1 1.9 3.3 3.2 3.1 4.7 4.8

1.8 1.8 2.5 1.3 2.7 2.7 2.5 4.1 4.5

2.4 2.4 3.2 2.1 3.7 3.4 3.4 5.0 5.1

Eastern and Southern Africa 162

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

Millennium Development Goal targetfor Upper bound 2015 118 16 64 16 60 17 55 58 14 33 11 36 16 29

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

175 42 99 32 109 48 87

170 40 94 31 104 44 85

179 43 101 33 113 52 89

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

2.4 4.7 2.5 4.3 3.3 5.2 2.5

1.9 4.4 2.0 3.3 2.7 4.6 2.1

2.4 5.0 2.9 4.4 3.6 5.7 2.6

24

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

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

4,104 3,821 2,058 656 6,504 4,340 2,164 610

3,995 3,716 1,980 634

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

171 186 171 206 75 85 116 57 57

155 168 153 188 70 85 122 52 48

105 114 89 138 38 43 61 21 21

95 103 79 126 34 44 63 19 17

100 107 100 116 54 62 85 41 42

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

1,111 1,018 456 530 244 2,679 1,784 895 256

1,163 1,122 429 658 158 1,511 1,199 312 107

Eastern and Southern Africa 1,664

1,601 1,702 1,177

6,227 6,687 2,899 2,762 4,104 4,480 2,309 2,029 2,307 588 632 590 203 563 192

34 4,739 2,280 3,109 1,796 484 170 481 17 1,631

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

11,968 11,652 12,163 6,914 6,845 7,436

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

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

184 45 102 35 108 49 89

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

68 2,231 2,053 13 44 11 520 1,013 346 200 710 125 324

45 18 36 14 44 21 32

34 8 25 6 29 9 22

981 1,065 280 502 169 686 127 398 70 209

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

42 2,978 1,574 13 1,263 37 8,354 4,989

1,742 1,083 4,362 2,955

25

StatiStical table (ContInUEd)

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

Millennium Development Goal targetfor Upper bound 2015 107 50 67 22 60 23 26 20 36 68 120 6 55 55 27 37 17 32 19 16 18 23 40 59 4 29

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

164 82 110 51 95 56 48 53 70 119 178 12 87

159 80 106 48 93 52 46 51 68 113 173 12 85

166 84 112 54 97 59 49 55 73 122 181 13 89

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

Annual rate of reduction (ARR) (percent) 19902011


ARR Lower bound Upper bound

15 97 171 82 110 180 163 82 18 53 11 34 87

15 94 167 79 107 175 159 79 17 51 11 32 85

15 98 173 83 111 183 166 84 18 55 11 37 89

10 80 136 65 89 156 141 63 11 34 8 31 73

9 77 132 63 87 150 137 60 11 33 8 28 71

10 81 139 66 90 158 144 64 12 35 9 34 73

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

StatiStical table (continued)

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

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

171 83 110 53 97 58 52 57 72 116 186 13 89

156 81 109 48 93 53 43 48 68 122 169 11 85

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

11,813 11,498 12,008 6,836 6,765 7,358

4,104 4,480 2,309 150 159 78

2,156 2,531 75 83

3,109 1,796 127 66

3,710 3,905 3,365 3,308 3,740

69 2,314 2,166 37 8,354 4,989

11,968 11,652 12,163 6,914 6,845 7,436

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

Sex-specific under-five mortalityrate (deaths per 1,000 live births) 1990


Male Female

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

17 98 178 82 112 189 171 82 20 57 12 36 89

13 95 164 80 107 170 155 82 15 48 10 32 85

7 58 102 46 66 115 105 42 8 21 8 25 53

6 55 93 44 62 104 95 42 6 17 7 22 50

12 67 107 59 75 108 100 60 15 42 9 26 61

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

11,968 11,652 12,163 6,914 6,845 7,436

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

Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan


Eastern Asia

China, Democratic Peoples Republic of Korea, Mongolia, Republic of Korea


latin America and the Caribbean

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

Algeria, Egypt, Libya, Morocco, Tunisia

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.

United Nations

The UN Inter-agency Group for Child Mortality Estimation


The Inter-agency Group for Child Mortality Estimation (IGME) was formed in 2004 to share data on child mortality, harmonize estimates within the UN system, improve methods for child mortality estimation, report on progress towards the Millennium Development Goals and enhance country capacity to produce timely and properly assessed estimates of child mortality. The IGME, led by the United Nations Childrens Fund and the World Health Organization, also includes the World Bank and the United Nations Population Division of the Department of Economic and Social Affairs as full members. The IGMEs independent Technical Advisory Group, comprising eminent scholars and independent experts in demography, provides technical guidance on estimation methods, technical issues and strategies for data analysis and data quality assessment. The IGME updates its child mortality estimates annually after reviewing newly available data and assessing data quality. This report contains the latest IGME estimates of child mortality at the country, regional and global levels. Country-specific estimates and the data used to derive them are available at www.childmortality.org.