The number of children who died before their fifth birthday has reached a historic low, dropping to 4.9 million in 2022, according to the latest estimates released today by the United Nations Inter-agency Group for Child Mortality Estimation.
The report indicates a significant improvement in child survival rates globally, with under-5 mortality decreasing by 51 percent since 2000. Notably, several low- and lower-middle-income nations have surpassed this decline, demonstrating the potential for progress with sufficient investment in primary healthcare, particularly child health initiatives. For instance, countries like Cambodia, Malawi, Mongolia, and Rwanda have achieved remarkable reductions of over 75 percent in under-5 mortality during the same period.
However, despite these advancements, the report highlights the ongoing challenge of preventing all avoidable child and youth deaths. Despite progress, approximately 4.9 million children under the age of 5, with nearly half being newborns, succumb to various preventable causes. Additionally, an estimated 2.1 million children and youth aged 5-24 also face premature mortality, with a disproportionate burden observed in sub-Saharan Africa and Southern Asia.
“Behind these numbers lie the stories of midwives and skilled health personnel helping mothers safely deliver their newborns, health workers vaccinating and protecting children against deadly diseases, and community health workers who make home visits to support families to ensure the right health and nutrition support for children,” said UNICEF Executive Director Catherine Russell. “Through decades of commitment by individuals, communities, and nations to reach children with low-cost, quality, and effective health services, we’ve shown that we have the knowledge and tools to save lives.”
Tragically, many of these deaths result from preventable or treatable conditions, including preterm birth complications, birth-related issues, pneumonia, diarrhea, and malaria. The report underscores the potential to save countless lives through improved access to high-quality primary healthcare, emphasizing essential yet cost-effective interventions such as vaccinations, skilled birth attendance, promotion of breastfeeding, and timely diagnosis and treatment of childhood illnesses.
“While there has been welcome progress, every year millions of families still suffer the devastating heartbreak of losing a child, often in the very first days after birth,” said WHO Director General, Dr Tedros Adhanom Ghebreyesus. “Where a child is born should not dictate whether they live or die. It is critical to improve access to quality health services for every woman and child, including during emergencies and in remote areas.”
Enhancing access to quality healthcare services and reducing preventable child deaths necessitates investment not only in healthcare infrastructure but also in broader social determinants such as education, employment opportunities, and favorable working conditions for healthcare professionals, including community health workers.
Community health workers, serving as trusted members of their communities, play a pivotal role in delivering life-saving healthcare services to children and families. These services include essential vaccinations, diagnostic testing, medication for treatable illnesses, and nutritional support. To optimize their impact, community health workers should be seamlessly integrated into primary healthcare systems, adequately compensated, extensively trained, and provided with necessary resources to deliver optimal care.
Research indicates that implementing community-based child survival interventions in high-risk countries could lead to a substantial reduction in child mortality rates. This comprehensive approach would not only save millions of children’s lives but also ensure healthcare services are readily available within local communities. Integrated management of childhood illnesses, particularly targeting prevalent conditions like acute respiratory infections, diarrhea, and malaria, is imperative to enhance child health outcomes and overall survival rates.
“This year’s report is an important milestone showing that less children die before their fifth birthday,” said Dr. Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank & Director, Global Financing Facility for Women, Children and Adolescents. “But this is simply not enough. We need to accelerate progress with more investments, collaboration and focus to end preventable child deaths and honor our global commitment. We owe it to all children to ensure they have access to the same health care and opportunities, regardless of where they are born.”
While there is evident progress in global child survival rates, significant threats and disparities persist, posing challenges to child well-being worldwide. These threats include escalating inequality and economic instability, prolonged conflicts, the escalating effects of climate change, and the repercussions of the COVID-19 pandemic. These factors not only endanger existing progress but also have the potential to stall or reverse advancements, resulting in unnecessary loss of children’s lives.
Children born into impoverished households face a disproportionately higher risk of mortality compared to those from affluent households, with the likelihood of death before age 5 being twice as high. Moreover, children residing in fragile or conflict-affected regions are nearly three times more susceptible to mortality before reaching their fifth birthday than those in stable areas. These disparities underscore the urgent need for targeted interventions and concerted efforts to address systemic inequalities and ensure the well-being of all children worldwide.
“The new estimates show that strengthening access to high-quality health care, especially around the time of birth, helps to reduce mortality among children under age 5,” said Li Junhua, United Nations Under-Secretary-General for Economic and Social Affairs. “While the milestones in the reduction of child mortality are important to track progress, they should also remind us that further efforts and investments are needed to reduce inequities and end preventable deaths among newborns, children and youth worldwide.”
At the current trajectory, it is projected that 59 countries will fail to meet the Sustainable Development Goal (SDG) target for under-5 mortality, while 64 countries will not achieve the goal for reducing newborn mortality. This unfortunate reality implies that approximately 35 million children will lose their lives before reaching the age of five by the year 2030. Tragically, the brunt of this mortality burden will disproportionately affect families residing in sub-Saharan Africa and Southern Asia, as well as those living in low- and lower-middle-income countries.
Furthermore, the report highlights significant data gaps, particularly in regions such as sub-Saharan Africa and Southern Asia, where child mortality rates are notably high. It underscores the urgent need for improvements in data collection and statistical systems to effectively track and monitor child survival and health outcomes.
This includes enhancing indicators related to mortality and health through comprehensive household surveys, strengthening Health Management Information Systems (HMIS) for birth and death registration, and bolstering Civil Registration and Vital Statistics (CRVS) mechanisms. Such enhancements are crucial for informed decision-making and targeted interventions to address child mortality disparities worldwide.
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