Just under 7 million under-five children died in 2011; nearly 800 children every hour.
The risk of a child dying before completing five years of age was highest in the WHO African Region (106 per 1000 live births), about 8 times higher than that in the WHO European Region (13 per 1000 live births). Some 80% of the world’s under-five deaths in 2011 occurred in only 25 countries, and about half in only five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and China. India (24%) and Nigeria (11%) together account for more than a third of under-five deaths worldwide.
Overall, substantial progress has been made towards achieving MDG4.
About 14 000 fewer children died every day in 2011 than in 1990, the baseline year for measuring progress.
Improvement in child survival is evident in all regions. The number of countries with under-five mortality rates of 100 deaths per 1000 live births or higher has been more than halved from 53 in 1990 to 24 in 2011. In addition, no country had an under-five mortality rate above 200 deaths per 1000 live births in 2011, compared with 13 in 1990.
Globally, under-five mortality has decreased by 41%, from an estimated rate of 87 deaths per 1000 live births in 1990 to 51 deaths per 1000 live births in 2011. This decline translates into an average annual decrease in child mortality of 2.5%, which remains insufficient to achieve the MDG4 target of reducing under-five mortality rates by two-thirds between 1990 and 2015. Numbers of under-five deaths have declined from nearly 12 million in 1990 to 6.9 million in 2011. While progress has been made, it is unequally distributed. At the regional level, the decline in under-five mortality rates between 1990 and 2011 were 60% or higher in two regions: the Americas and the Western Pacific. The highest observed average annual rates of reduction were seen in the Western Pacific Region (5.2%), over two times higher than the rates observed in the African (2.4%) and in the Eastern Mediterranean (2.5%) regions.
As under-five mortality rates have fallen more sharply in richer developing regions, the disparity between Sub-Saharan Africa and other regions has grown. In 1990, a child born in Sub-Saharan Africa faced a probability of dying before age 5 that was 1.5 times higher than in Southern Asia, 3.4 times higher than in Latin America and the Caribbean, 3.7 times higher than in Eastern Asia and 12.1 times higher than in developed regions. By 2011 that probability was 1.8 times higher than in Southern Asia, 5.7 times higher than in Latin America and the Caribbean, 7.4 times higher than in Eastern Asia and 16.5 times higher than in developed regions. The disparity between Southern Asia and richer regions has also grown, though not as much.