World Development Indicators 2005

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Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.

Saving children

     Every year almost 11 million children in developing countries die before the age of five, most from causes that are readily preventable in rich countries: acute respiratory infections, diarrhea, measles, and malaria. Rapid improvements before 1990 gave hope that mortality rates for infants and children under five could be cut by two-thirds in the following 25 years. But progress slowed almost everywhere in the 1990s.

     Only two regions, Latin America and the Caribbean and Europe and Central Asia, may be on track to achieve the target.

     Progress has been particularly slow in Sub-Saharan Africa, where civil disturbances and the HIV/AIDS epidemic have driven up rates of infant and child mortality. By the most recent data available, only 33 countries are making enough progress to reduce under-five mortality rates to one-third of their 1990 level and save the lives of millions of children.

Improving the odds for children

Under-five mortality rate (deaths per 1,000)

The gap between goal and reality is greatest in Sub-Saharan Africa, but millions of children are also at risk in populous South Asia.

Sub-Saharan Africa	South Asia

The pace of mortality reduction in East Asia and Pacific is slowing. The regional average in Latin America and the Caribbean disguises wide variations.

East Asia & Pacific	Latin America & Caribbean

Although Europe and Central Asia appears to be on track, questions remain about the quality and comparability of data over time.

Europe & Central Asia	Middle East & North Africa

Source: World Bank staff estimates.

To reduce child deaths, infants must survive

Infant mortality rate (deaths per 1,000 live births)

Source: World Bank staff estimates.

A large proportion of child deaths occur among children in their first year, many of them among newborns. Inequalities within and across countries mean that a disproportionate burden of infant deaths is borne by the poorest people within the poorest countries. Greater efforts are needed so that health care and other public services reach poor mothers and children.

Many children’s deaths are preventable

Causes of deaths, children under age five, developing countries, 2000–03

Source: World Health Organization.

Five diseases—pneumonia, diarrhea, malaria, measles, and HIV/AIDS—account for more than half of all deaths of children under age five. Antibiotics, immunization, and oral rehydration therapy for diarrhea could save the lives of many of these children. So would access to safe water and improved sanitation facilities. Good nutrition is also needed, because malnutrition increases the risk of dying from many of these diseases.

Unequal risks

Under-five mortality rate, by family wealth quintile and location (deaths per 1,000)

Mortality rates are generally higher in rural areas, where modern health care is less available. Higher mortality rates among the urban poor in Egypt are an exception.

Egypt, 2000

In India and many other countries mortality rates are 3 or 4 times as high in the poorest population quintile as in the richest.

India, 1998-99

Indonesia has reduced under-five mortality rates from 91 to 41 since 1990, but large differences remain between rich and poor.

Indonesia, 1997

Even among the more wealthy in Mali in 1995–96, 15 percent of children were expected to die before age five. There has been little improvement since.

Mali, 1995-96

Source: World Bank staff estimates based on Demographic and Health Survey data.


	Improving the odds for children Sub-Saharan Africa South Asia East Asia & Pacific Latin America & Caribbean Europe & Central Asia Middle East & North Africa


	To reduce child deaths, infants must survive




	Many children’s deaths are preventable




	Unequal risks Egypt, 2000 India, 1998-99 Indonesia, 1997 Mali, 1995-96