Global Decline in Child Mortality Rate Faces New Challenges

The global child mortality rate has declined significantly since 2000, falling by over 50%, according to new estimates by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). In 2023, the under-five mortality rate (U5MR) dropped to 37 deaths per 1,000 live births, down from 77 in 2000. This remarkable progress reflects decades of investment in child health, access to essential services, and improved global health policies.

Despite this advancement, disparities remain stark. A child born in sub-Saharan Africa is, on average, 18 times more likely to die before age five than a child born in Australia or New Zealand. These inequities in the child mortality rate by country 2023 highlight the urgent need to target support toward vulnerable regions.

Slower Gains in Neonatal Death Statistics

While progress has been made in reducing overall child deaths, neonatal death statistics show a slower rate of improvement. In 2023, nearly 48% of under-five deaths occurred during the neonatal period (the first 28 days of life). Between 2000 and 2023, neonatal deaths decreased by 45%, compared to a 58% drop in deaths among children aged 1–59 months.

This slower pace is due to several factors. Addressing neonatal mortality often requires complex medical interventions to treat complications from preterm births, infections, or birth trauma. These interventions are harder to deliver consistently in low-resource settings, particularly in conflict-affected and fragile areas.

Understanding the Under-Five Mortality Trends

The under-five mortality trends show that while the Millennium Development Goal (MDG) era (2000–2015) saw rapid improvements, the pace of progress has slowed in the Sustainable Development Goal (SDG) era (2015–2023). The annual rate of reduction in under-five mortality dropped by 42% in the SDG period. If current trends continue, an estimated 30 million children could die before their fifth birthday by 2030.

Sub-Saharan Africa and Southern Asia continue to carry the highest burden. In fact, more than 80% of global under-five deaths occurred in these two regions in 2023. Countries in fragile and conflict-affected situations account for nearly half of all under-five deaths despite representing only 25% of global live births.

The Impact of Funding Cuts on Child Health

New data emphasizes the severe impact of funding cuts on child health systems. Reductions in financing for essential maternal, newborn, and child health programs have led to staff shortages, disruptions in routine vaccinations, and the closure of healthcare facilities. These setbacks are particularly harmful in high-mortality areas, where any interruption can mean the difference between life and death.

Funding cuts are also affecting the ability to track and respond to child health needs. In many of the most vulnerable countries, the latest available child mortality data is over five years old. Reduced funding for household surveys and national data systems makes it harder for governments and organizations to identify emerging issues and allocate resources effectively.

Investing in Life-Saving Interventions

Despite current setbacks, the path to ending preventable child deaths is well understood. Proven, low-cost interventions such as skilled birth attendance, antenatal and postnatal care, vaccinations, and proper nutrition have saved millions of lives. To ensure continued progress, these services must be maintained and expanded, especially in countries with high mortality rates.

Strengthening health systems, improving healthcare access, and building robust data systems are essential to ensure that interventions reach the children who need them most. Renewed international cooperation, political will, and domestic investment will be critical to achieving SDG targets and saving millions of lives.

A Call to Action

The global decline in the child mortality rate is one of the great public health achievements of the 21st century. But that progress is fragile. Without renewed commitment and increased funding, the world risks backsliding and losing hard-won gains.

Investing in child health today means investing in future generations. Governments, donors, NGOs, and communities must work together to ensure that no child dies from a preventable cause. Continued focus on high-impact regions, improved data collection, and expanded health coverage are all key steps toward a healthier, more equitable world for children.

You can download the report here.