Levels and trends in child mortality
United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME), Report 2024
The world has made remarkable progress in reducing child mortality. Since 2000, the global under-five mortality rate has fallen by 52 per cent, reflecting decades of investment and collaboration by governments, communities and partners. Millions of children have survived and gone on to thrive thanks to proven, life-saving interventions. Yet, this year’s United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) estimates also make clear that progress is slowing – and that millions of children are still dying from preventable causes. In 2023, an estimated 4.8 million children died before the age of five, including 2.3 million newborns. These deaths are not inevitable. They are the result of unequal access to health care, nutrition, and protection, especially in the most fragile and underserved settings.
The report’s findings highlight the urgent need to accelerate action. The path to ending preventable child deaths is well understood, but continued success depends on strong national commitment, sustained investments, and robust data systems. Without renewed focus, an estimated 30 million children could die before their fifth birthday by 2030 – lives that can, and must, be saved.
More children are surviving today than ever before
In 2023, the global under-five mortality rate was half of what it was in 2000 – a remarkable achievement that reflects decades of sustained investment and collaboration by governments, donors, health professionals, communities and families. Still, the journey toward ending all preventable child deaths is far from complete. An estimated 4.8 million children died before reaching their fifth birthday in 2023—deaths that were overwhelmingly preventable. This includes 2.3 million newborns who died within the first 28 days of life and 2.5 million children aged 1–59 months. Beyond early childhood, an additional 2.1 million children, adolescents and youth aged 5–24 also lost their lives.
While the overall decline in under-five mortality is encouraging, progress has not been uniform across all age groups. Since 2000, deaths among children aged 1–59 months have fallen by 58 per cent, compared to a 44 per cent decline in neonatal deaths. Nearly half of all under-five deaths in 2023 occurred within the first 28 days of life, underscoring the heightened vulnerability of newborns and the need for greater investment in targeted interventions during this critical period.
Children face unequal chances of survival based on where they live, their socio-economic status and if they live in a fragile or conflict-affected setting
Even as global averages improve, the reality for many children is shaped by where they are born and the conditions into which they are born. A child born in sub-Saharan Africa is, on average, 18 times more likely to die before the age of 5 than one born in Australia and New Zealand. The risk of under-five death in the highest-mortality country is 80 times greater than in the lowest. Children living in rural areas, from the poorest households, or born to mothers with the least education face significantly higher mortality risks. Fragility and conflict further compound these inequities: in 2023, countries classified as fragile and conflict-affected accounted for just a quarter of all live births but nearly half of all under-five deaths. Within countries, disparities tied to maternal education, wealth and urban-rural residence highlight the urgent need to prioritize the most vulnerable and ensure every child has an equal chance to survive.
Hard-won progress in reducing child mortality must be sustained
The global effort to reduce child mortality has yielded extraordinary results over the last 30 years. The decline in the global U5MR since 2000 is an achievement that underscores the power of sustained commitment, investment and coordinated action. It also signals the global community’s commitment to upholding its promise to protecting every child’s right to survive. This progress not only means millions of children’s lives saved – it also demonstrates that ending preventable child deaths is an achievable goal. Yet, these hard-won gains are in peril. The advances made are at risk of stagnation or even reversal due to a convergence of growing threats: crises, conflict, economic instability, fragile health systems and shrinking donor funding. Unless these challenges are addressed with decisive action, millions of newborns and young children will continue to die from causes we know how to prevent and treat. The path forward is clear – what is needed now is the political will and financial commitment to reach the children at greatest risk.
