In 2023, 4.8 million children died in the world before they turn five, most of them for preventable causes, according to a report by the UN inter -institutional group for the estimation of childhood mortality (, for its acronym in English) published on Tuesday. Almost half of these deaths (2.3 million) occurred in the first 28 days of life.
In addition, in 2023 there were 1.9 million prenatal deaths in 2023, according to another report by the group also released this Tuesday and investigates that it occurs after 28 weeks of pregnancy, but before delivery or during this. “Two out of five babies died during childbirth, a time when most fetal deaths can be prevented,” explains the document, which provides that, if no measures are taken, 30 million deaths of children under five years before 2030, and 13 million morinates until that year are produced.
Since 2000, the world rate of mortality of children under five years of age has been reduced by half and has gone from 77 deaths per 1,000 live births, to 37 per 1,000 in 2023, the last year studied. However, these progress have slowed 42% between 2015 and 2023, compared to the improvements achieved between 2000 and 2015.
A child from a low income country has a ten -time risk of dying in the first month of life than a high rental one
The UN underlines that these advances are now even more in danger due to the financing cuts of the main donors, of which the consequences in child health programs are already being seen. Shortage of health personnel, clinic closure, lack of supplies, interruption of vaccination programs and treatments such as malaria are impacting territories where these infant mortality rates are already high. “The trend has been worrisome in recent years. The available funds of the governments donors and partners for some of the developing countries, which are far from meeting the health objectives of the, have been reduced and the recent cuts that have announced several governments have made the perspectives quite terrifying,” explains by videoconference to El País Fouzia Shafique, associate director of Health of UNICEF and one of the author.
The document warns that, if the current trend continues, 60 countries will not meet the goal collected in the SDGs to reduce the mortality of children under five to 25 deaths per 1,000 live births. And 65 countries are at risk of not fulfilling the objective of reducing the neonatal mortality rate to 12 deaths per 1,000 live births by 2030. “Now, these are figures a year ago and they were based on the assumption that, at least the financial situation would not change drastically,” explains Shafique, who adds that there are now countries in which the fiscal margin has been reduced drastically. “Therefore, unless the governments and other donors intervene and ensure that investments in maternal, neonatal and childish health are maintained, we will begin to see a reversal in the mortality rate,” he says. “We are in a situation in which perhaps within a year we are talking about an increase in figures and not a new decrease,” he adds.
The deaths of children, affect the report, “are especially tragic”, since the means to prevent them are well known and range from access to essential health services, births served by qualified health personnel, prenatal and postnatal quality of quality, specialized care for sick newborns, vaccinations, prevention and nutrition programs, among others. “The calculation is tragically simple: if these interventions come to an end, so much hope, aspirations and,” they warn in the introduction.
Unequal advances
Despite progress worldwide, a child born in Sub -Saharan Africa has a 18 -time probability of dying before turning five years old in Australia and New Zealand. This region concentrates with the south of Asia 80% of the deaths of children under five years. That is, four out of five deaths happened in these two territories. However, the causes are very different. In Sub -Saharan Africa is responsible for 15% of deaths of children under five in the region. In southern Asia, “deaths are largely due to causes related to childbirth complications,” the report mentions.
Children born in low and medium-low income countries face death risks significantly greater than those born in high-income countries. A child from a low income country has a 10 -time risk of dying in the first month of life than a high rent. And regarding the mortality of children under five years, we would be talking about 62 deaths per 1,000 live births in low -income countries, compared to 4.9 deaths per 1,000 live births in high -income countries. “Only four countries – no, Nigeria, Somalia and Chad – had in 2023 a mortality rate of children under five greater than 100 deaths per 1,000 live births, but all of them are in sub -Saharan Africa,” says the analysis. In addition, in this region there are also countries with the 20 mortality rates of children under five highest in the world, with more than 60 deaths per 1,000 live births.
During the first 28 days of life, an especially vulnerable period, the main threats are premature births, childbirth complications and congenital anomalies
On the other hand, the childhood that lives in countries classified as “fragile situations and affected by conflicts” are almost three times more likely to die before they turn five years than children born in countries not affected by these conditions.
The risks not only depend on the territory. Those children who live in poorer homes are almost double probabilities to die before turning five than those of richer homes, the report points out. And those who live in rural areas have a risk 1.5 times greater than those of urban environments. Other factors, such as the educational level of the mother or her age, also influence.
As for the causes, during the first 28 days of life, an especially vulnerable period, the main threats are premature births, complications in childbirth and congenital anomalies. For children who survive beyond that first month, “pneumonia, malaria and diarrhea represented almost a third of all deaths.”
As indicated at the beginning of this article, since 2000 the world mortality of children under five years of age has been reduced. A milestone that some countries have led further, with even greater decreases. The report highlights four success, Nepal, Senegal, Ghana and Burundi cases, in which financial and geographical challenges have not been an impediment in the decrease in children’s deaths. Senegal, for example, has achieved “one of the greatest reductions in mortality of children under five years throughout the world”, with 70% since 2000 and has also decreased neonatal mortality by 41%. Nepal has had a 67% and 59% decrease, respectively. In Ghana and Burundi the reductions have also been significant.
Better data and continue with the measures that save lives
In approximately two out of five countries, the most recent data available on infant mortality are over five years old. “Without better data, and efforts to reduce mortality will be hindered by uncertainty and delays, especially in countries with greater mortality, where data systems are weaker,” says the report.
As the report is influenced, “now it is not time to reduce proven interventions that save children’s lives, but to strengthen systems and platforms through which children receive these interventions. Letting these children die when the means are available to avoid their deaths is a fundamental violation of our duty for the childhood of the whole world.”
