2. A Promise Renewed
• A Promise Renewed, is a global effort to accelerate action
on maternal, newborn and child survival
• In June 2012, the governments of Ethiopia, India and the
United States ― together with UNICEF ― brought
together more than 700 partners from the public, private
and civil-society sectors for the Child Survival Forum Call
to Action
• More than 176 governments, civil society and private
sector organizations have signed a pledge to redouble
their efforts to end all preventable child deaths
3. • Technical report providing
most recent country,
regional and global
estimates on child mortality
and includes methods
• UN-IGME
• 2nd annual report on progress
achieved on APR
commitments and includes
more in-depth mortality and
causes of death analysis
• UNICEF
4. How many children are dying?
Under-five mortality – levels and trends
5. Great progress in reducing child deaths
• Global U5MR declined by nearly by half, from
90 per 1,000 live births in 1990 to 48 per
1,000 in 2012
• Annual number of under-five deaths reduced
from 12.6 million to 6.6 million over the same
period
• 17,000 fewer children died each day in 2012
than did in 1990
6. Under-five mortality rate has declined
in all regions since 1990
Under-five mortality rate by region, 1990 and 2012, and % declines
Source: IGME 2013.
7. Sub-Saharan Africa has substantially
accelerated its reduction
Annual rates of reduction (ARR) in the under-five mortality rate, %,
by region, since 1990
Source: IGME 2013.
8. 26 high mortality countries have reduced
under-five mortality rate by at least 50%
High-mortality
countries with
greatest
percentage
declines
in under-five
mortality rate
from 1990–2012
Source: IGME 2013.
9. Some poor countries have made great
progress in reducing under-five mortality
Source: UNICEF analysis based on IGME 2013 and
World Bank GDP per capita estimates published in 2013.
Decline in under-five mortality rate 1990–2012 and GDP per capita in 2012, by country
10. Exciting new findings on disparities
• Many regions have
reduced disparities in
under-five mortality
between the poorest
and the richest except
Sub-Saharan Africa and
South Asia
• Under-five mortality
rate has declined
among even the
poorest in all regions
Source: UNICEF analysis based on Pedersen, J., et al., Levels and Trends in Inequity
and Child Mortality: Evidence from DHS and MICS surveys', working paper,
unpublished, 2013.'
11. Still, progress is insufficient to achieve MDG4 target
by 2015 and substantial acceleration is required
Achievement of MDG 4 by year, globally and by region, if
current trends continue in all countries
Source: UNICEF analysis based on IGME 2013.
12. Unfinished business
• Good news
• Outstanding progress in decreasing under five
mortality at global and regional levels
• Even in some of the most disadvantaged countries and
households
• Bad news
• Nearly 6.6 million children still died in 2012
• 18,000 children under age five died each day
• Not likely to reach MDG4 unless we dramatically
accelerate progress
13. Where are deaths occurring?
Half of the 6.6 million under-five deaths occurred in
Sub-Saharan Africa
Number and % of under-five deaths by region, 2012
(thousands and % of global total)
Half of all child
deaths occur in
just 5 countries:
India, Nigeria,
Pakistan, DR
Congo, China
Source: IGME 2013.
14. Children in Sub-Saharan Africa and Southern Asia
face a higher risk of dying before their fifth birthday
Source: IGME 2013.
15. Fast progress in reducing the number of under-five deaths in
sub-Saharan Africa is imperative as its child population soars
Number of children under age 5, by region, 1950-2050
Source: UNICEF analysis based on World Population Prospects: The 2012 Revision,
United Nations Population Division, New York, 2013.
17. Infectious diseases such as pneumonia, diarrhoea and malaria are
the leading killers of children under age 5; roughly 44% of deaths in
children under 5 occur during the neonatal period
Global distribution of deaths among children under age 5, by cause, 2012
Pneumonia
17%
Neonatal
44%
Other
22%
AIDS
2%
Injury
5%
Malaria
7%
Diarrhoea
9%
Estimates are rounded, and therefore may not sum to 100%.
Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013.
Globally, nearly
half of all deaths
among children
under 5 are
attributable to
undernutrition
18. Despite declining rates, neonatal deaths are growing as
a share of global under-five deaths, amid faster progress
in reducing mortality in the post-neonatal period
19. Neonatal mortality
Most neonatal deaths are from preventable causes
Global distribution of neonatal deaths, by cause, 2012
Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013.
20. Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013.
The past decade has seen major declines in child
deaths due to leading infectious diseases
Note: For comparability across diseases, this report presents analysis based on IGME 2013, drawing on
provisional analyses by WHO and Child Health Epidemiology Reference Group (CHERG) 2013. These
estimates may differ, therefore, from those presented elsewhere.
21. Leading Causes of Death
• The APR Report reviews the main causes of death
and their geographic distribution
• This section of the Report also focuses on key
interventions that need to accelerate in order to
achieve MDG 4
• The following slides present just one illustrative
example of what is included the Report
22. The diarrhoea belt: Diarrhoea deaths concentrated
across the Sahel and in South Asia
% of under-five deaths attributable to diarrhoea, 2012
Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013.
23. Lowest ORS coverage in countries with the highest
levels diarrhoea deaths among children
Childhood diarrhoea deaths and ORS coverage
Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013, and UNICEF global databases 2013.
25. 90 million lives saved since 1990 – more than
the current population size of Germany
Number of lives saved since 1990 among children under age 5, and number of lives to be saved
in order to achieve MDG4
Source: UNICEF analysis based on IGME 2013.
26. 90 million lives saved since 1990 – more than
the current population size of Germany
Number of lives saved since 1990 among children under age 5, and number of lives to be saved
in order to achieve MDG4
Source: UNICEF analysis based on IGME 2013.
27. About two thirds of the additional 3.5 million
lives need to be saved in Sub-Saharan Africa
Additional lives to be saved by region, 2013-2015 in order to meet MDG 4
(thousands and % of total)
Half of the additional 3.5
million lives need to be
saved in just 4 countries:
Nigeria, DR Congo, India
and Pakistan
Source: UNICEF analysis based on IGME 2013, WHO and CHERG 2013.
Globally the ARR has more than tripled since the early 1990s.But it is particularly encouraging to see that in Sub-Saharan Africa – the region with the highest under five mortality in the world - the rate of decline for the most recent period is more than five times faster than it was in the early 1990s.This acceleration is particularly noteworthy in ESARO. Only EAPRO has a faster rate of decline than ESA – this is quite a surprising and exciting finding.
