The rate of child deaths around the world has dropped by more than half since 1990, but not enough to reach the UN goal of a two-thirds reduction by 2015, according to a new report.
New estimates show that deaths of under-5s fell from 12.7m per year in 1990 to 5.9m this year, the first time the figure has gone below 6m.
Despite the decline, 16,000 children under the age of five still die every day, according to the report by the UN children’s agency Unicef, the World Health Organisation, the World Bank Group, and the UN’s Population Division.
Based on the data, Unicef reported that 48m lives of under-5s have been saved since governments committed to achieve the UN goal in 2000.
World leaders are expected to adopt a new set of goals for the next 15 years at a UN summit this month.
Unicef said 38m more lives can be saved if progress to reduce child mortality is accelerated.
Deputy executive director Geeta Rao Gupta said that since 2000 many countries tripled the rate of reduction of under-5s mortality.
“But the far too large number of children still dying from preventable causes before their fifth birthday, and indeed within their first month of life, should impel us to redouble our efforts to do what we know needs to be done,” she said.
According to the report, the biggest challenge remains the first 28 days of life, when 45% of under-5s deaths occur.
The leading causes of deaths of under-5s are premature birth, pneumonia, complications during labour and delivery, malaria, and sepsis, a life-threatening complication of an infection, the report said, and nearly half the deaths are associated with “under-nutrition”.
The report highlights that a child’s chance of survival is vastly different based on birthplace.
In sub-Saharan Africa, one child in 12 dies before his or her fifth birthday, the highest rate in the world and more than 12 times higher than the one in 147 average for under-5s deaths in high-income countries, the report said.
Some 1m babies are dying per year on the first day of life.
“In order to get that further down, we need to focus on neonatal mortality, said Flavia Bustreo, WHO assistant director general.
This means early interventions to tackle killers like asphyxia and sepsis critical, as well as encouraging breastfeeding and early immunisations, Bustreo said.
The report came as leaders prepare to meet in New York this month to adopt the Sustainable Development Goals, a new plans of action to cover the next 15 years.
Nearly half of all under-5s deaths are associated with malnutrition, said the study, which added that the rate of improvement is accelerating, with child mortality falling quicker since the millennium than it did in the 1990s.
Under-5s in sub-Saharan Africa are 12 times more likely to die than those in rich countries.
Nevertheless many poor African countries, including Ethiopia, Uganda and Tanzania, hit the two-thirds target.
“We know how to prevent unnecessary newborn mortality,” said the WHO’s Bustreo.
“Quality care around the time of childbirth... can save thousands of lives every year.”
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