• Between 1990 and 2010, under-five mortality dropped by 35% worldwide

• Yet, every day, nearly 21 000 children under-five die mostly from preventable causes.
• 99% of all under-five deaths occur in developing countries.
• About three-quarters of all child deaths happen in two WHO regions (Africa and South-east Asia) where childhood mortality continues to be very high.
• More than 50% of these deaths are clustered in only six countries: China, Democratic Republic of the Congo, Ethiopia, India, Nigeria, and Pakistan.
• Under-five mortality is higher in rural areas and among poorer and less educated communities.
• Three-quarters of all child deaths are mainly due to preventable causes: neonatal conditions, pneumonia, diarrhoea, malaria, and measles. Many of these deaths could be averted by known, affordable, low-technology interventions.
• Appropriate infant and young child feeding and the prevention and management of diarrhea, pneumonia, malaria and HIV infection can save the lives of millions of under-five children.
• Coverage of key child health interventions is low and unequally distributed between and within countries.
• Strengthening the health system and integrating the interventions into packages of care that can be delivered at all levels – from home to hospital – during pregnancy, childbirth, neonatal period, and childhood will be key to increasing the coverage of health interventions and saving the lives of under-five children.
• Good quality information for evidence-based decisions and planning is lacking.

Millennium Development Goals (MDGs)

The Department of Maternal, Newborn, Child and Adolescent Health directly addresses two of the eight Millennium Development Goals (MDGs), adopted by the international community in the year 2000 ¹.
Under MDGs 4 and 5, respectively, countries are committed to:

• Reduce child mortality (MDG4): Target 4.A - to reduce by two thirds, between 1990 and 2015, under-five mortality; and
• Improve maternal health (MDG5): Target 5.A - to reduce the maternal mortality ratio by three quarters between 1990 and 2015

Recent data show that some progress has been made in reducing maternal, newborn and under-five mortality, but not swiftly enough to reach the aimed targets by 2015. MDGs 4 and 5 are the furthest of the eight Goals from being achieved by 2015.
Efforts need to be expanded and intensified to accelerate progress towards reducing the still very wide disparities between developing and developed worlds as well as to provide universal coverage of key interventions over the continuum of care.

Under-five mortality

7.6 million under-five children died in 2010 . The risk of death among under-fives is highest closest to birth and then decreases over the subsequent days, months, and years. An estimated 3 million deaths, or 40% of all under-five deaths, occurred during the first 28 days after birth, and 2.4 million deaths in the following 11 months, meaning that 5.4 million deaths (71% of all under-five deaths) happened within the first year of life. Roughly the same number of deaths that took place between 1-11 months of age, also occurred over the next four-year age period (2.2 million).