About five million children died before their fifth birthday and another 2.1 million children and young people lost their lives in 2021 – one every 4.4 seconds, according to new United Nations estimates published today.
The UN Inter-agency Group for Child Mortality Estimation (UN IGME) also found that 1.9 million babies were stillborn during the same period – many could have been saved with equitable access and high-quality maternal, newborn, adolescent and child health care, according to the report.
Vidhya Ganesh, UNICEF director of the division of data analytics, planning and monitoring, said: “Every day, far too many parents are facing the trauma of losing their children, sometimes even before their first breath.
“Such widespread, preventable tragedy should never be accepted as inevitable. Progress is possible with stronger political will and targeted investment in equitable access to primary health care for every woman and child.”
The reports show the global under-five mortality rate fell by 50% since 2000, while mortality rates in older children and youth dropped by 36% and the stillbirth rate decreased by 35%.
However, gains have slowed significantly since 2010 and the UN IGME reports warn 54 countries will fall short of meeting the Sustainable Development Goals (SDGs) target for under-five mortality.
If action is not taken to improve health services, almost 59 million children and youth will die before 2030, and nearly 16 million babies will be stillborn, they warn.
Children born in sub-Saharan Africa have the highest risk of childhood death in the world – 15 times higher than the risk for children in Europe and Northern America – and while the region had just 29% of global live births, it accounted for 56% of all under-five deaths in 2021. In Southern Asia, under-five deaths accounted for 26% of the total.
The two regions also bear the heaviest burden for stillbirth, with 77% in 2021 occurring in sub-Saharan Africa and South Asia. Nearly half of all stillbirths happened in sub-Saharan Africa.
Juan Pablo Uribe, global director for health, nutrition and population, world bank and director of the global financing facility, said: “Behind these numbers are millions of children and families who are denied their basic rights to health.
“We need political will and leadership for sustained financing for primary health care which is one of the best investments countries and development partners can make.”
While COVID-19 has not directly increased childhood mortality, the pandemic may have increased future risks to their survival.
The reports highlight concerns around disruptions to nutrition services, and access to primary health care. The pandemic has also fuelled the largest continued drop in vaccinations in three decades.
John Wilmoth, director of the UN DESA population division, said: “The new estimates highlight the remarkable global progress since 2000 in reducing mortality among children under age five.
“Despite this success, more work is needed to address persistent large differences in child survival across countries and regions, especially in sub-Saharan Africa.
“Only by improving access to quality health care, especially around the time of childbirth, will we be able to reduce these inequities and end preventable deaths of newborns and children worldwide.”
The two reports – *Levels & Trends in Child Mortality* and *Never Forgotten* – are the first of a series of data sets to be published in 2023. UN maternal mortality figures are to be published later this year.
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