Children in developing countries are 10 times more likely to die before the age of 5 than in developed countries

KEY FACTS

• Nearly 9 million children under the age of five die every year, according to 2007 figures.
• Around 70% of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.
• Leading causes of death in under-five children are pneumonia, diarrhoea and health problems during the first month of life.
• Over one third of all child deaths are linked to malnutrition.
• Children in developing countries are ten times more likely to die before the age of five than children in developed countries.

A child's risk of dying is highest in the neonatal period, the first 28 days of life. Safe childbirth and effective neonatal care are essential to prevent these deaths. About 40% of child deaths under the age of five take place during the neonatal period.

Preterm birth, birth asphyxia (lack of breathing at birth), and infections cause most neonatal deaths. From the end of the neonatal period and through the first five years of life, the main causes of death are pneumonia, diarrhoea, malaria, measles and HIV/AIDS. Malnutrition is the underlying contributing factor in over one third of all child deaths, making children more vulnerable to severe disease.

Who is most at risk?

Geographically

About three quarters of all child deaths occur in Africa and South-East Asia. Within countries, child mortality is higher in rural areas, and among poorer and less educated families.

Neonates

About four million babies die every year in their first month of life and a similar number are stillborn. Within the first month, one quarter to one half of all deaths occur within the first 24 hours of life, and 75% occur in the first week. The week immediately following birth is the most crucial period for newborn survival. This is when the mother and child should receive follow-up care to prevent and treat illness.

Prior to birth, the mother can increase her child's chance of survival and good health by attending antenatal care consultations, being immunized against tetanus, and avoiding smoking and use of alcohol.

At the time of birth, a baby's chance of survival increases significantly with the presence of a skilled birth attendant. After birth, essential care of a newborn should include: ensuring that the baby is breathing, starting the newborn on exclusive breastfeeding right away; keeping the baby warm and washing hands before touching the baby. Identifying and caring for illnesses in a newborn are also very important, as a baby can become very ill and die quickly if an illness is not recognized and treated appropriately. Sick babies must be taken immediately to a trained health care provider.

Children under age five

Over two thirds of under-five child deaths are due to diseases that are preventable and treatable through simple, affordable interventions. Strengthening health systems to provide such interventions to all children will save many young lives.

About 20 million children worldwide suffer from severe acute malnutrition, which leaves them more vulnerable to serious illness and early death. Exclusive breastfeeding for the first six months of life, followed by a combination of breastfeeding and complementary feeding up to age two years or beyond, helps to prevent malnutrition. For children who suffer from severe acute malnutrition, most can be treated successfully with ready-to-use therapeutic foods (RUTF). These highly fortified and energy-rich foods provide the required nutrients for malnourished children starting from age six months to older children, so they can be treated at home.

Leading causes of death in children: risk factors and response

	Risk factors	Prevention	Treatment
Pneumonia, or other acute respiratory infections	Low birth weight Malnutrition Non-breastfed children Overcrowded conditions	Vaccination Exclusive breastfeeding	Appropriate care by a trained health provider Antibiotics Oxygen for severe illness
Childhood diarrhoea	Non-breastfed children Unsafe drinking water and food Poor hygiene practices Malnutrition	Exclusive breastfeeding Safe water and food Adequate sanitation and hygiene Measles vaccination	Low-osmolarity oral rehydration salts (ORS) Zinc supplements

Prevention with vaccines

For some of the most deadly childhood diseases, such as measles, polio, diphtheria, tetanus, pertussis, and Haemophilius Influenzae type B, vaccines are available and can protect children from illness and death.

Global response: Millennium Development Goals 4 and 5

Millennium Development Goals adopted by the United Nations in 2000 aim to decrease child and maternal deaths worldwide by 2015. The fourth Millennium Development Goal (MDG) is to reduce the 1990 mortality rate among under-five children by two thirds. Child mortality is also closely linked to MDG 5 to improve maternal health.

Since more than one third of all child deaths occur within the first month of life, providing skilled care to mothers during pregnancy, as well as during and after birth, greatly contributes to child survival. Member Countries have set targets and developed specific strategies to reduce child mortality and monitor progress.