The number of children dying before their fifth birthday worldwide declined to 4.8 million in 2023, while stillbirths saw a slight reduction but remained high at approximately 1.9 million, according to two new reports from the United Nations Inter-agency Group for Child Mortality Estimation released on Tuesday.
Despite this progress, the reports caution that years of advancement in child survival are now at risk as several major donors plan to scale back funding for child health initiatives.
The World Health Organization noted that global efforts since 2000 have led to a dramatic decrease in child deaths by over half and a reduction in stillbirths by more than a third, thanks to sustained investments in child survival programs.
A historic milestone was reached in 2022 when global child mortality fell below five million for the first time.
However, the pace of progress has slowed, and preventable child deaths remain a significant concern.
UNICEF Executive Director Catherine Russell highlighted the importance of global interventions, stating, “Millions of children are alive today because of global commitments to proven interventions such as vaccines, nutrition, and access to clean water and sanitation.”
She further warned that despite reaching a record low in preventable child deaths, a lack of sustained investment could jeopardize these hard-won gains.
The reports reveal that reduced international funding for child health programs is already causing critical challenges, including healthcare worker shortages, clinic closures, disruptions in vaccination campaigns, and a lack of essential medical supplies, such as malaria treatments.
Regions grappling with high child mortality rates—especially those experiencing humanitarian crises and economic instability, are being hit the hardest.
WHO Director-General Dr. Tedros Ghebreyesus stressed the need for continued collaboration in protecting children’s health, stating, “From tackling malaria to preventing stillbirths and ensuring life-saving care for newborns, we have the tools to make a difference. But as funding declines, now more than ever, we must strengthen collaboration to protect children’s health.”
Even before the current funding crisis, progress in reducing child deaths had begun to slow.
The reports indicate that since 2015, the annual rate of under-five mortality reduction has dropped by 42 per cent, while progress in lowering stillbirths has declined by 53 per cent compared to the 2000–2015 period.
Causes of Child Mortality and Stillbirths
Nearly half of all deaths among children under five occur within the first month of life, primarily due to complications from premature birth and difficulties during labour.
Beyond the neonatal stage, infectious diseases such as pneumonia, malaria, and diarrhoea remain the top causes of preventable child deaths.
Stillbirths also remain a significant challenge, with 45 per cent occurring during labour due to maternal infections, prolonged or obstructed labour, and inadequate medical intervention.
The reports emphasize the importance of improving maternal, newborn, and child healthcare at all levels to save more lives. This includes ensuring early prenatal care, skilled birth attendance, routine immunizations, nutrition programs, and effective treatment of childhood illnesses.
The UN findings highlight glaring disparities in child mortality between high- and low-income nations.
A child born in a country with the highest mortality rate is 80 times more likely to die before their fifth birthday than one born in the country with the lowest rate.
A child born in sub-Saharan Africa faces an 18 times greater risk of dying before age five compared to one born in Australia or New Zealand.
Within countries, children from the poorest households, rural communities, and those whose mothers have lower education levels face the highest risks.
Stillbirth rates also reveal significant inequalities, with nearly 80 per cent occurring in sub-Saharan Africa and Southern Asia. Women in these regions are six to eight times more likely to experience stillbirth than those in Europe or North America.
UN DESA Under-Secretary-General Li Junhua underscored the need to close these gaps, stating, “Reducing these disparities is not just a moral imperative but a fundamental step toward sustainable development and global equity. Every child deserves a fair chance at life, and it is our collective responsibility to ensure that no child is left behind.”
The UN IGME is urging governments, donors, and private-sector partners to safeguard the progress made in reducing child mortality and intensify efforts to prevent further deaths.
Increased investments, service integration, and innovative solutions are necessary to expand access to life-saving healthcare, nutrition, and social protection services for children and pregnant mothers.
As funding cuts threaten years of progress, global leaders are being called upon to reinforce their commitments and prevent a reversal of the strides made in child survival.
