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Child mortality rates have fallen by more than half since 1990. Here's why.


There's finally some good news in global health: Over the past 25 years, the number of children who die before reaching their fifth birthday has fallen dramatically, from 12.7 million per year in 1990 to 5.9 million in 2015. And this isn't because of declines in the birthrate; as the chart above shows, the rate of death has plunged dramatically, too.

This is the first time the figure has dropped below the 6 million mark, according to a new report released from UNICEF, and researchers think there are several reasons for the change.

Safer births and improvements in vaccination and sanitation helped

"In 2014, 71 per cent of births had a skilled attendant, compared to 59 per cent in 1990," the report reads. Also, more mothers are getting antiretroviral medicines to prevent mother-to-child transmission of HIV.

Vaccines and other preventive health measures have also helped greatly. "Pneumonia-related deaths have fallen, in part thanks to the rapid roll-out of vaccines, better nutrition and improved care-seeking and treatment for symptoms of pneumonia," according to the report.

Diarrhea-related deaths — a huge killer in the developing world — are dropping because of improvements to drinking water and sanitation, as well as access to a rotavirus vaccine and treatment with rehydration therapies.

This good news about children comes a few weeks after a report in the Lancet about the boost in life expectancy worldwide, which has increased by more than six years since 1990.

The dramatic drop fell short of UN development goals

The UNICEF report also warns that there are major barriers to decreasing childhood deaths even further. Though the dramatic halving in child mortality is cause for celebration, it still fell short of the UN Millennium Development Goal of cutting the rate by two-thirds by 2015.

Nearly half of under-5 deaths occur in the first 28 days of life because of a range of factors — pneumonia, complications during labor and delivery, diarrhea, and malaria. Many of these deaths are attributed to under-nutrition.

What's more, while antenatal care is improving, too many mothers still lack assistance during childbirth. In 2014, 36 million mothers gave birth without a skilled attendant.

Many of these problems are specific to low-income regions where access to adequate health care, medicines, and food is still a persistent problem.


"A child born in a low-income country is, on average, 11 times as likely to die before the age of 5 as a child in a high-income country," the report reads. Indeed, the massive gap in outcomes for children in high- and low-income countries is startling. In sub-Saharan Africa, one child in 12 dies before his or her fifth birthday. That's more than 12 times higher than the average in high-income countries. So inequality remains an issue.

"We have to acknowledge tremendous global progress, especially since 2000 when many countries have tripled the rate of reduction of under-five mortality," UNICEF Deputy Executive Director Geeta Rao Gupta said in a press release. "But the far too large number of children still dying from preventable causes before their fifth birthday — and indeed within their first month of life – should impel us to redouble our efforts to do what we know needs to be done. We cannot continue to fail them."

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