Global Health Observatory (GHO)

Causes of child mortality, by region, 2000-2011


The four major killers of children under age five in 2011 were pneumonia
(17.5%: 4.7% during the neonatal period and 12.8% at 1-59 months),
prematurity (16.9%: 14.5% during the neonatal period and 2.4% at 1-59 months),
birth asphyxia and birth trauma (11.3%: 10.1% during the neonatal period and 1.1% at 1-59 months), and diarrhoeal diseases (9.3%: 0.8% during the neonatal period and 8.5% at 1-59 months). Malaria was still a major killer in Sub-Saharan Africa, causing about 14 percent of under-five deaths in the region.

The majority of child deaths due to infectious diseases can be prevented by known, simple, affordable and low cost interventions such as exclusive breastfeeding up to 6 months of age, immunization, appropriate use of antibiotics, oral rehydration therapy and zinc, insecticide treated bed nets, and anti-malarials.

About 43% of deaths in children younger than 5 years in 2011 occurred
before 28 days of life – the neonatal period. The most important cause of death was prematurity, which was responsible for one-third of all deaths during this period. Birth asphyxia and birth trauma were the second major causes of death in this early period of life, causing over 700 000 deaths, while neonatal sepsis caused
360 000 deaths.


In high-income countries, over one quarter (26%) of all child deaths was due to congenital abnormalities, and nearly a quarter (23%) was due to prematurity. In low- and middle-income countries, congenital abnormalities caused 1 in 15 under-five deaths, while prematurity caused 1 in 6 under-five deaths.

The lowest proportion of neonatal deaths (one-third of all under-five deaths) in 2011 occurred in the African Region. On the other hand, 95% of all under-five deaths due to malaria and 89% of all under-five deaths due to HIV/AIDS worldwide happened in the African Region. The proportion of under-five deaths from pneumonia in 2011 was highest in the WHO South East Asian region (20%), and lowest in the WHO Region of the Americas (10%).


The number of under-five deaths worldwide dropped from 12 million in 1990 to
6.9 million in 2011. Deaths due to diarrhoea have been nearly halved in the past decade, from 1.2 million in 2000 to 645 000 in 2011. The world has achieved nearly a three-quarter reduction in measles deaths in children under the age of five: from 480 000 deaths in 2000 to 130 000 in 2011. There were 510 000 fewer child deaths due to pneumonia and 175 000 fewer deaths due to malaria in 2011, compared to in the year 2000. The four infectious diseases, however, still accounted for more than one-third of all under-five deaths in 2011 collectively.

The proportion of under-five deaths occurring during the neonatal period rose from 38% in 2000 to 43% in 2011. The risk of dying during this period can be reduced with quality care during pregnancy, safe and clean delivery by a skilled attendant, and immediate postnatal care, including neonatal resuscitation, extra care of low birth weight babies, attention to baby warmth, treatment of neonatal sepsis and early initiation of breastfeeding.

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