neonatal, infant, and under-5 mortality during 1990—2013

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990—2013: a systematic analysis for the Global Burden of Disease Study 2013

Dr Haidong Wang PhD a  * et al.

Findings

We estimated that 6·3 million (95% UI 6·0—6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1—18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6—177·4) in Guinea-Bissau to 2·3 (1·8—2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000—13 than during 1990—2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone.