Levels and trends in child mortality

United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME), Report 2021

December 2021

While the world was gripped by the unfolding COVID-19 pandemic in 2020, children continued to face the same crisis they have for decades: intolerably high mortality rates and vastly inequitable chances at life. In total, more than 5.0 million children under age 5, including 2.4 million newborns, along with 2.2 million children and youth aged 5 to 24 years – 43 per cent of whom are adolescents – died in 2020. This tragic and massive loss of life, most of which was due to preventable or treatable causes, is a stark reminder of the urgent need to end preventable deaths of children and young people.

Data gaps remain a serious challenge to child mortality estimation and monitoring. Almost two thirds of low and middle income countries (97 out of 135) have no reliable mortality data in the past three years. And just 40 countries had high-quality national data for 2020 included in the estimation model, though national or subnational data were available for more than 80 countries or areas to help analyse excess mortality due to COVID-19.


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Under-five mortality and the Sustainable Development Goals assessment

Many countries remain off track to meet the Sustainable Development Goals (SDGs) on ending the preventable deaths of newborns and children under age 5. If current trends continue, 54 countries will not meet the under-five mortality target by 2030, and 61 countries will miss the neonatal mortality target. The SDGs call for an end to preventable deaths of newborns and children under age 5, with all countries aiming to have a neonatal mortality rate of 12 or fewer deaths per 1,000 live births, and an under-five mortality rate of 25 or fewer deaths per 1,000 live births, by 2030.

Geographic and economic disparities heighten the risk of death for children and threaten universal achievement of the SDGs

On current trends, more than 48 million children younger than 5 will die before 2030, half of them newborns. Well over half of these deaths – 57 per cent – will take place in sub-Saharan Africa (28 million), with another 25 per cent occurring in Southern Asia (12 million). Meeting the SDG target in the 54 countries that are off track would avert 8 million under-five deaths between 2021 and 2030 and reduce the annual number of under-five deaths to 2.5 million in 2030.


Mortality among children, adolescents and youth

Number of deaths among children and youth aged 5–24 years and among adolescents aged 10–19 years by SDG region, 2020

Globally, about 43 per cent of the deaths among those aged 5–24 years occurred among adolescents. Over 70 per cent of all deaths among 5–24-year-olds occurred in sub-Saharan Africa (45 per cent) and Central and Southern Asia (27 per cent). If current trends continue, nearly 21 million children and youth aged 5–24 years will die between 2021 and 2030.

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Almost everywhere in the world, a child born today has a better chance at surviving to age 5 than in 1990, but inequities persist among and within countries

Under-five mortality rates, 1990-2020

While progress has been made, newborn mortality is not decreasing as quickly as mortality among children aged 1 to 59 months

Neonatal mortality rates, 1990-2020

Adolescent mortality, ages 10–19, has declined by nearly 40 per cent since 1990, yet almost a million adolescents died in 2020

Mortality rate of adolescents aged 10-19, 1990-2020