In a significant development reported by the United Nations, child mortality rates have seen a promising decline. According to two new reports published by the UN Inter-agency Group for Child Mortality Estimation (UN IGME), the global child mortality rate fell to 4.8 million children under the age of five in 2023, marking a notable achievement in global health efforts. Yet, despite these milestone achievements, the number of stillbirths remains stagnated at 1.9 million, raising concerns about the ongoing challenges in maternal and child health.
Over the past two decades, the number of children dying before their fifth birthdays has decreased by over 50%, a commendable accomplishment attributed to sustainable investments aimed at improving child survival worldwide. 2022 marked a historical low, with the figures dropping below five million for the first time ever. However, this progress is threatened as the reports reveal a troubling stagnation due to substantial cuts in vital funding. UNICEF Executive Director, Catherine Russell, remarked on the dual nature of this development: “Millions of children are alive today because of global commitment to proven interventions like vaccinations, nutrition programs, and access to clean water and sanitation. It’s a remarkable achievement to drive child mortality to record lows. But without the right political decisions and adequate investments, we risk undoing these hard-won gains. Millions more children could die from preventable causes. We must not allow this to happen.”
The cuts in donor funding present a grave risk, jeopardizing decades of progress in reducing child mortality rates. UNICEF reported that reduced global funding for life-saving programs for children and mothers has led to critical shortages of medical personnel, clinic closures, interruptions in vaccination programs, and scarcities of vital supplies, such as those essential in combating malaria. The impact has been particularly severe in humanitarian crisis regions, heavily indebted countries, and areas already featuring the highest child mortality rates. In addition to immediate health services, the funding cuts threaten data collection efforts, complicating the challenges of reaching particularly vulnerable children. Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stressed the need for continued collaboration, stating, “We can improve the lives of millions of families, from tackling malaria to preventing stillbirths and ensuring evidence-based care for our youngest babies. Given the global cuts in aid, it is more important than ever to enhance collaboration to protect and improve children’s health.”
A concerning statistic from the reports indicates that around 50% of all deaths in children under five years of age occurred within the first month of life, primarily from complications related to prematurity and birth. Similarly, around 45% of stillbirths happen during labor, often due to prolonged or obstructed labor and infections that prevent timely medical intervention. The UN reports suggest that better access to high-quality health care for mothers, newborns, and children at all levels of the health system will save many more lives. Essential services cited in the reports include preventive health care in communities, timely visits to health facilities, skilled birth attendants during labor, quality prenatal and postnatal care, routine vaccinations, pediatric disease diagnosis and treatment, and specialized care for low-birth-weight and sick newborns.
According to Dr. Juan Pablo Uribe, Global Director of Health, Nutrition, and Population at the World Bank, the continuity of these essential services is critical: “Most avoidable deaths among children occur in low-income countries where essential services, vaccinations, and treatments are often unavailable. Investments in children's health secure their survival, education, and future contributions to the workforce. With strategic investments and strong political will, we can further reduce child mortality and create economic growth and job opportunities that benefit the entire world.”
The place of birth has also been highlighted as a crucial factor affecting survival chances. The risk of a child dying before their fifth birthday is 80 times higher in the country with the highest mortality rate compared to the country with the lowest mortality rate. A child born in sub-Saharan Africa is, on average, 18 times more likely to die before the age of five than a child born in Australia or New Zealand. Within countries, children from poorer backgrounds or those living in rural areas or whose mothers have lower educational levels face a higher risk of mortality. The discrepancies in stillbirth rates are equally alarming: nearly 80% occur in sub-Saharan Africa and South Asia, where the probability of a stillbirth is six to eight times higher than in Europe or North America. Furthermore, the likelihood of stillbirth in low-income countries is eight times greater than in high-income countries. Li Junhua, the UN Under-Secretary-General for Economic and Social Affairs, commented on the ongoing disparities: “The differences in child mortality between and within nations remain one of the greatest challenges of our time. Reducing these disparities is not only a moral imperative but also a fundamental step towards sustainable development and global justice. Every child deserves a fair chance in life, and it is our collective responsibility to ensure that no child is left behind.”
In light of these findings, the members of the UN Inter-agency Group for Child Mortality Estimation urge governments, donors, and partners from both the private and public sectors to maintain the hard-fought gains of the past decades and intensify their efforts to protect children. Urgent investments, service integration, and innovative approaches are needed to enhance access to proven life-saving interventions in health, nutrition, and social protection for children and pregnant women. The road ahead demands persistence and emphasis on equitable access to health care services to ensure that every child can thrive in healthy and nurturing environments.
