Child mortality#Rate

Child mortality refers to number of child deaths under the age of 5 per 1,000 live births. More specific terms include:

• Perinatal mortality rate: Number of child deaths within the first week of birth divided by total number of births.{{cite book|last=Weeks|first=John Robert|title=Population: an introduction to concepts and issues|date=2015-01-01|isbn=978-1-305-09450-5|edition=Twelfth|location=Boston, MA |publisher=Cengage Learning |oclc=884617656|name-list-style=vanc}}
• Neonatal mortality rate: Number of child deaths within the first 28 days of life divided by total number of births.
• Infant mortality rate: Number of child deaths within the first 12 months of life divided by total number of births.
• Under 5 mortality rates: Number of child deaths within the 5th birthday divided by total number of births.
• Child Mortality refers to the premature deaths of any child under the age of 5 years old. However, within those 5 years, there are 5 smaller groups. Perinatal refers to a fetus, a living organism, but not yet born. Typically, peri neonate deaths are due to premature birth or birth defects. Neonatal refers to child death within one month or 28 days of birth. Neonate deaths are reflected in the type of care the hospital is providing as well as birth defects and complications. Infant death refers to the death of a child before their first birthday or within 12 months of life. Some of the main causes include premature birth, SIDS, low birth weight, malnutrition and infectious diseases. And lastly, the under-5 mortality rate refers to children who die under the age of 5 years old or within the first 5 years of life.{{Cite web |title=Child mortality and causes of death |url=https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/child-mortality-and-causes-of-death |archive-url=https://web.archive.org/web/20220901050800/https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/child-mortality-and-causes-of-death |archive-date=1 September 2022 |access-date=2022-04-05 |website=World Health Organization (WHO) |language=en}}

{{Further|Infant mortality}}

The leading causes of death of children under five include:

• Preterm birth complications (18%)
• Pneumonia (16%)
• Interpartum-related events (12%)
• Neonatal sepsis (7%)
• Diarrhea (8%)
• Malaria (5%)
• Malnutrition (34%)

There is variation of child mortality around the world. Countries that are in the second or third stage of the Demographic Transition Mode (DTM) have higher rates of child mortality than countries in the fourth or fifth stage. Chad infant mortality is about 96 per 1,000 live births compared to only 2.2 per 1,000 live births in Japan. In 2010, there was a global estimate of 7.6 million child deaths especially in less developed countries and among those, 4.7 million died from infection and disorder.{{Cite journal |last1=Liu |first1=Li |last2=Johnson |first2=Hope L |last3=Cousens |first3=Simon |last4=Perin |first4=Jamie |last5=Scott |first5=Susana |last6=Lawn |first6=Joy E |last7=Rudan |first7=Igor |last8=Campbell |first8=Harry |last9=Cibulskis |first9=Richard |last10=Li |first10=Mengying |last11=Mathers |first11=Colin |last12=Black |first12=Robert E |date=June 2012 |title=Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000 |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673612605601 |journal=The Lancet |language=en |volume=379 |issue=9832 |pages=2151–2161 |doi=10.1016/S0140-6736(12)60560-1 |pmid=22579125 |s2cid=43866899 |id={{ProQuest|1023015914}}|url-access=subscription }} Child mortality is not only caused by infection and disorder, it is also caused by premature birth, birth defect, new born infection, birth complication and diseases like malaria, sepsis, and diarrhea.{{Cite news |last=Huber |first=Chris |date=2016-01-13 |title=Child mortality: Top causes, best solutions |work=World Vision International |url=https://www.worldvision.org/health-news-stories/child-mortality-causes-solutions |access-date=2018-03-28 |archive-url=https://web.archive.org/web/20220907075539/https://www.worldvision.org/health-news-stories/child-mortality-causes-solutions |archive-date=7 September 2022}} In less developed countries, malnutrition is the main cause of child mortality. Pneumonia, diarrhea and malaria together are the cause of one out of every three deaths before the age of 5 while nearly half of under-five deaths globally are attributable to under-nutrition.

{{Further|Infant mortality}}

{{More citations needed|date=June 2015}}

Child survival is a field of public health concerned with reducing child mortality. Child survival

interventions are designed to address the most common causes of child deaths that occur, which include diarrhea, pneumonia, malaria, and neonatal conditions. Out of the number of children under the age of 5 alone, an estimated 5.6 million children die each year mostly from such preventable causes.

The child survival strategies and interventions are in line with the fourth Millennium Development Goals (MDGs) which focused on reducing child mortality by 2/3 of children under five before the year 2015. In 2015, the MDGs were replaced with the Sustainable Development Goals (SDGs) which aim to end these deaths by 2030. In order to achieve SDG targets, progress must be accelerated in more than 1/4 of all countries (most of which are in sub-Saharan Africa) in order to achieve targets for under-5 mortality and in 60 countries (many in sub-Saharan Africa and South Asia) to achieve targets for neonatal mortality. Without accelerated progress, 60 million children under age five will die between 2017 and 2030, about half of which would be newborns. China achieved its target of reduction in under-5 mortality rates well ahead of schedule.{{cite web | title = MDGs Global Report 2015 | url = http://www.cn.undp.org/content/china/en/home/library/mdg/mdg-report-2015.html | work = United Nations Development Programme }}

File:A young girl sits with a doctor receiving medical care.jpg

Two-thirds of child deaths are preventable.{{Cite web |title=Young child survival and development |url=https://www.unicef.org/childsurvival/index.html |archive-url=https://web.archive.org/web/20090304170358/https://www.unicef.org/childsurvival/index.html |archive-date=4 March 2009 |website=UNICEF}} Most of the children who die each year could be saved by low-tech, evidence-based, cost-effective measures such as vaccines, antibiotics, micronutrient supplementation, insecticide-treated bed nets, improved family care and breastfeeding practices,{{Cite web |title=Goal: Reduce child mortality |url=http://www.unicef.org/mdg/childmortality.html |archive-url=https://web.archive.org/web/20220914090313/https://sites.unicef.org/mdg/childmortality.html |archive-date=14 September 2022 |access-date=14 June 2015 |website=UNICEF}} and oral rehydration therapy.{{Cite web |date=8 May 2002 |title=WHO - New formula for oral rehydration salts will save millions of lives |url=https://www.who.int/mediacentre/news/releases/release35/en/ |archive-url=https://web.archive.org/web/20040825191158/http://www.who.int/mediacentre/news/releases/release35/en/ |archive-date=August 25, 2004 |access-date=14 June 2015 |website=World Health Organization (WHO)}} 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.{{Cite web |title=Levels & Trends in Child Mortality Report 2012 |url=http://www.childinfo.org/files/Child_Mortality_Report_2012.pdf |archive-url=https://web.archive.org/web/20120927052506/http://www.childinfo.org/files/Child_Mortality_Report_2012.pdf |archive-date=27 September 2012 |website=UNICEF}}

In developing countries, child mortality rates related to respiratory and diarrheal diseases can be reduced by introducing simple behavioral changes such as handwashing with soap. This simple action can reduce the rate of mortality from these diseases by almost 50 per cent.{{Cite journal |last1=Curtis |first1=Val |last2=Cairncross |first2=Sandy |name-list-style=vanc |date=May 2003 |title=Effect of washing hands with soap on diarrhoea risk in the community: a systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S1473309903006066 |journal=The Lancet Infectious Diseases |language=en |volume=3 |issue=5 |pages=275–281 |doi=10.1016/S1473-3099(03)00606-6 |pmid=12726975|url-access=subscription }}

Proven cost-effective interventions can save the lives of millions of children per year. The UN Vaccine division as of 2014 supported 36% of the world's children in order to best improve their survival chances, yet still, low-cost immunization interventions do not reach 30 million children despite success in reducing polio, tetanus, and measles.{{Cite journal |last1=Jadhav |first1=S. |last2=Gautam |first2=M. |last3=Gairola |first3=S. |name-list-style=vanc |date=May 2014 |title=Role of vaccine manufacturers in developing countries towards global healthcare by providing quality vaccines at affordable prices |journal=Clinical Microbiology and Infection |language=en |volume=20 |pages=37–44 |doi=10.1111/1469-0691.12568 |pmid=24476201 |doi-access=free}} Measles and tetanus still kill more than 1 million children under 5 each year. Vitamin A supplementation costs only $0.02 for each capsule and given 2–3 times a year will prevent blindness and death. Although vitamin A supplementation has been shown to reduce all-cause mortality by 12 to 24 per cent but only 70 per cent of targeted children were reached in 2015. Between 250,000 and 500,000 children become blind every year with 70 percent of them dying within 12 months. Oral rehydration therapy (ORT) is an effective treatment for lost liquids through diarrhea; yet only 4 in 10 (44 per cent) of children diagnosed with diarrhea are treated with ORT.

Essential newborn care - including immunizing mothers against tetanus, ensuring clean delivery practices in a hygienic birthing environment, drying and wrapping the baby immediately after birth, providing necessary warmth and promoting immediate and continued breastfeeding, immunization, and treatment of infections with antibiotics - could save the lives of 3 million newborns annually. Improved sanitation and access to clean drinking water can reduce childhood infections and diarrhea. {{As of|2017}}, approximately 26% of the world's population do not have access to basic sanitation and 785 million people use unsafe sources of drinking water.{{Cite web |title=Water, sanitation and hygiene overview |url=https://data.unicef.org/topic/water-and-sanitation/overview/ |archive-url=https://web.archive.org/web/20200402094841/https://data.unicef.org/topic/water-and-sanitation/overview/ |archive-date=2 April 2020 |website=UNICEF}}

Agencies promoting and implementing child survival activities worldwide include UNICEF and non-governmental organizations; major child survival donors worldwide include the World Bank, the British Government's Department for International Development, the Canadian International Development Agency and the United States Agency for International Development. In the United States, most non-governmental child survival agencies belong to the CORE Group, a coalition working through collaborative action to save the lives of young children in the world's poorest countries.

Substantial global progress has been made in reducing child deaths since 1990. The total number of under-5 deaths worldwide has declined from 12.6 million in 1990 to approximately 5.5 million in 2020. Since 1990, the global under-5 mortality rate has dropped by 59%, from 93 deaths per 1000 live births in 1990 to 36 in 2020. This is equivalent to 1 in 11 children dying before reaching age 5 in 1990 compared to 1 in 27 in 2019.{{cite web |title=Number of under-five deaths, 1960 to 2020 |url=https://ourworldindata.org/grapher/number-of-under-five-deaths |website=Our World In Data |access-date=15 September 2022 |archive-url=https://web.archive.org/web/20220816021137/https://ourworldindata.org/grapher/number-of-under-five-deaths |archive-date=16 August 2022}} The Sustainable Development Goals has set 2 new goals to reduce under-5 and newborn mortality. The goals set newborn mortality for 12 per 1,000 live births in every country and for under 5 mortality 25 per 1,000 livebirths in every country.{{cite web |title=SUSTAINABLE DEVELOPMENT GOAL 3 Ensure healthy lives and promote well-being for all at all ages |url=https://sdg-tracker.org/good-health |publisher=Our World In Data |access-date=15 September 2022 |archive-url=https://web.archive.org/web/20220907075615/https://sdg-tracker.org/good-health |archive-date=7 September 2022}} In 2019, 122 countries met this and every 10 years, 20 more are expected to follow.{{citation needed|date=September 2022}} World Health Organization (WHO) states they support health equity and universal health care so that all countries may have proper health care with no finances involved.

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|content ={{Global Heat Maps by Year| title=| table=Child Mortality.tab| column=percent_mortality| columnName=Child mortality| year=2017}}

|caption=Mortality in the first five years of life from 1960 to 2017.{{cite journal |last1=Roser |first1=Max |author1-link=Max Roser |last2=Ritchie |first2=Hannah |author2-link=Hannah Ritchie |name-list-style = vanc |title=Child & Infant Mortality |url=https://ourworldindata.org/child-mortality |journal=Our World in Data |access-date=4 October 2019 |date=10 May 2013}}

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Child mortality has been dropping as each country reaches a high stage of DTM. From 2000 to 2010, child mortality has dropped from 9.6 million to 7.6 million. In order to reduce child mortality rates, there need to be better education, higher standards of healthcare and more caution in childbearing. Child mortality could be reduced by attendance of professionals at birth and by breastfeeding and through access to clean water, sanitation, and immunization. In 2016, the world average was 41 (4.1%), down from 93 (9.3%) in 1990. This is equivalent to 5.6 million children less than five years old dying in 2016.

File:Global child mortality over time.png|Global child mortality over time

File:Child Mortality vs Fertility Rate.svg|Child mortality is high in countries where women have many children (high fertility rates). Wealthy countries have lower child mortality rates than poor ones.

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. 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.

Furthermore, approximately 80% of under-5 deaths occur in only two regions: sub-Saharan Africa and South Asia. 6 countries account for half of the global under-5 deaths, namely, India, Nigeria, Pakistan, the Democratic Republic of the Congo, Ethiopia and China. India and Nigeria alone account for almost a third (32 per cent) of the global under-five deaths. Within low- and middle-income countries, there is also substantial variation in child mortality rates across administrative divisions.{{Cite journal |last1=Golding |first1=Nick |last2=Burstein |first2=Roy |last3=Longbottom |first3=Joshua |last4=Browne |first4=Annie J |last5=Fullman |first5=Nancy |last6=Osgood-Zimmerman |first6=Aaron |last7=Earl |first7=Lucas |last8=Bhatt |first8=Samir |last9=Cameron |first9=Ewan |last10=Casey |first10=Daniel C |last11=Dwyer-Lindgren |first11=Laura |last12=Farag |first12=Tamer H |last13=Flaxman |first13=Abraham D |last14=Fraser |first14=Maya S |last15=Gething |first15=Peter W |display-authors=6 |name-list-style=vanc |date=2017-11-11 |title=Mapping under-5 and neonatal mortality in Africa, 2000–15: a baseline analysis for the Sustainable Development Goals |journal=Lancet |language=en |volume=390 |issue=10108 |pages=2171–2182 |doi=10.1016/S0140-6736(17)31758-0 |issn=0140-6736 |pmc=5687451 |pmid=28958464}}{{cite journal | vauthors = Burstein R, Henry NJ, Collison ML, Marczak LB, Sligar A, Watson S, etal | title = Mapping 123 million neonatal, infant and child deaths between 2000 and 2017 | journal = Nature | volume = 574 | issue = 7778 | pages = 353–358 | date = October 2019 | pmid = 31619795 | pmc = 6800389 | doi = 10.1038/s41586-019-1545-0 | bibcode = 2019Natur.574..353B }}

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.[http://www.savethechildren.org.uk/en/54_12286.htm Inequalities in child survival: looking at wealth and other socio-economic disparities in developing countries] {{webarchive |url=https://web.archive.org/web/20110607200429/http://www.savethechildren.org.uk/en/54_12286.htm |date=June 7, 2011 }} 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.{{cite journal |last1=Chao | first1=Fengqing | last2=You | first2=Danzhen | last3=Pedersen | first3=Jon | last4=Hug | first4=Lucia|last5=Alkema|first5=Leontine | title = National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment | language = en | journal = Lancet Global Health | volume = 6 | issue = 5 | pages = e535–e547 | date = May 2018 | pmid = 29653627 | pmc = 5905403 | doi = 10.1016/S2214-109X(18)30059-7 }}

A large team of researchers published a major study on the global distribution of child mortality in Nature in October 2019.{{Cite journal |last1=Burstein |first1=Roy |last2=Henry |first2=Nathaniel J. |last3=Collison |first3=Michael L. |last4=Marczak |first4=Laurie B. |last5=Sligar |first5=Amber |last6=Watson |first6=Stefanie |last7=Marquez |first7=Neal |last8=Abbasalizad-Farhangi |first8=Mahdieh |last9=Abbasi |first9=Masoumeh |last10=Abd-Allah |first10=Foad |last11=Abdoli |first11=Amir |date=October 2019 |title=Mapping 123 million neonatal, infant and child deaths between 2000 and 2017 |journal=Nature |volume=574 |issue=7778 |pages=353–358 |bibcode=2019Natur.574..353B |doi=10.1038/s41586-019-1545-0 |issn=1476-4687 |pmc=6800389 |pmid=31619795}} 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.{{Cite journal |last=Bachelet |first=Michelle |date=2019-10-16 |title=Data on child deaths are a call for justice |journal=Nature |volume=574 |issue=7778 |page=297 |bibcode=2019Natur.574..297B |doi=10.1038/d41586-019-03058-6 |pmid=31619786 |s2cid=204741261 |doi-access=}}

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.{{Cite web |date=February 2006 |title=Hans Rosling shows the best stats you've ever seen |url=https://www.ted.com/talks/hans_rosling_the_best_stats_you_ve_ever_seen?language=en |archive-url=https://web.archive.org/web/20220815101301/https://www.ted.com/talks/hans_rosling_the_best_stats_you_ve_ever_seen?language=en |archive-date=15 August 2022 |publisher=TED (conference)}}

Child mortality unlike mortality throughout other ages actually dropped in 2020 when the COVID-19 pandemic hit the world. Children were among the lowest group of deaths in the world due to COVID-19. About 3.7 million deaths occurred and only 0.4% of them occurred in adolescents under 20 years of age making about 13,400 deaths in adolescents. Out of that small proportion, 42% occurred in children under the age of 9 years old.{{Cite web |title=Child mortality and COVID-19 |url=https://data.unicef.org/topic/child-survival/covid-19/ |archive-url=https://web.archive.org/web/20220901043645/https://data.unicef.org/topic/child-survival/covid-19/ |archive-date=1 September 2022 |access-date=2022-04-05 |website=UNICEF |language=en-US}}

• List of countries by infant mortality rate
• Infant mortality
• Perinatal mortality

{{Reflist}}

{{Commons category}}

{{Wikiquote}}

{{Scholia|topic}}

• [https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-under-5-mortality-in-2020 WHO fact sheet on child mortality]
• {{cite web | url = http://childmortality.org | title = Child mortality estimates for all countries | work = UNICEF}}
• {{Cite web |title=Visualization of child mortality from 2000-2017 in low- and middle-income countries |url=https://vizhub.healthdata.org/lbd/under5# |website=Institute for Health Metrics and Evaluation}}

{{Death}}

{{Public health}}

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{{DEFAULTSORT:Child Mortality}}

Category:Global health

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Mortality

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