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Child mortality is the mortality of children under the age of five.[2] The child mortality rate, also under-five mortality rate, refers to the probability of dying between birth and exactly five years of age expressed per 1,000 live births.[3]

It encompasses neonatal mortality and infant mortality (the probability of death in the first year of life).[4]

Reduction of child mortality is reflected in several of the United Nations' Sustainable Development Goals. Target 3.2 is "by 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce … under‑5 mortality to at least as low as 25 per 1,000 live births."[5]

Rapid progress has resulted in a significant decline in preventable child deaths since 1990, with the global under-5 mortality rate declining by over half between 1990 and 2016.[4] While in 1990, 12.6 million children under age five died, in 2016 that number fell to 5.6 million children.[4] However, despite advances, there are still 15,000 under-five deaths per day from largely preventable causes.[4] About 80 per cent of these occur in sub-Saharan Africa and South Asia, and just 6 countries account for half of all under-five deaths: China, India, Pakistan, Nigeria, Ethiopia and the Democratic Republic of the Congo.[4] 45% of these children died during the first 28 days of life.[6] Death rates were highest among children under age 1, followed by children ages 15 to 19, 1 to 4, and 5 to 14.[7]

Many child deaths go unreported for a variety of reasons, including lack of death registration and lack of data on child migrants.[8][9] Without accurate data on child deaths, we cannot fully discover and combat the greatest risks to a child's life.

Variation

Huge disparities in under-5 mortality rates exist. Globally, the risk of a child dying in the country with the highest under-5 mortality rate is about 60 times higher than in the country with the lowest under-5 mortality rate.[4] Sub-Saharan Africa remains the region with the highest under-5 mortality rates in the world: All six countries with rates above 10

Huge disparities in under-5 mortality rates exist. Globally, the risk of a child dying in the country with the highest under-5 mortality rate is about 60 times higher than in the country with the lowest under-5 mortality rate.[4] Sub-Saharan Africa remains the region with the highest under-5 mortality rates in the world: All six countries with rates above 100 deaths per 1,000 live births are in sub-Saharan Africa, with Somalia having the highest under-5 mortality rates.[24][4]

Furthermore, approximately 80% of under-5 deaths occur in only two regions: sub-Saharan Africa and South Asia.[4] 6 countries account for half of the global under-5 deaths, namely, India, Nigeria, Pakistan, t

Furthermore, approximately 80% of under-5 deaths occur in only two regions: sub-Saharan Africa and South Asia.[4] 6 countries account for half of the global under-5 deaths, namely, India, Nigeria, Pakistan, the Democratic Republic of the Congo, Ethiopia and China.[4] India and Nigeria alone account for almost a third (32 per cent) of the global under-five deaths.[4] Within low- and middle-income countries, there is also substantial variation in child mortality rates across administrative divisions.[25][26]

Likewise, there are disparities between wealthy and poor households in developing countries. According to a Save the Children paper, children from the poorest households in India are three times more likely to die before their fifth birthday than those from the richest households.[27] A systematic study reports for all the low- and middle-income countries (not including China), the children among the poorest households are twice as likely to die before the age of 5 years old compare to those in the richest household.[28]

A large team of researchers published a major study on the global distribution of child mortality in Nature in October 2019.[29] It was the first global study that mapped child death on the level of subnational district (17,554 units). The study was described as an important step to make action possible that further reduces child mortality.[30]

The child survival rate of nations varies with factors such as fertility rate and income distribution; the change in distribution shows a strong correlation between child survival and income distribution as well as fertility rate, where increasing child survival allows the average income to increase as well as the average fertility rate to decrease.[31][32]