Substantial global progress has been made in reducing childhood mortality since 1990. The total number of under-5 deaths worldwide has declined from 12.8 million in 1990 to 4.8 million in 2023. Since 1990, the global under-5 mortality rate has dropped by 59%, from 93 deaths per 1000 live births in 1990 to 37 in 2023. Globally, the number of neonatal deaths also declined, from 5.2 million in 1990 to 2.3 million in 2023. However, the decline in neonatal mortality from 1990 to 2023 has been slower than that of post-neonatal under-5 mortality.

Unfortunately, survival gains have stalled significantly since 2015, and 60 countries will fall short of meeting the SDG target for under-5 mortality and 65 countries will not achieve the SDG target for neonatal mortality. Unless swift action is not taken to improve health services and quality of care for newborns and children under-5, many young lives will be unnecessarily lost.

Globally, infectious diseases, including acute respiratory infections, diarrhoea, and malaria, along with pre-term birth complications, birth asphyxia and trauma and congenital anomalies remain the leading causes of death for children under 5.  Access to basic lifesaving interventions such as skilled delivery at birth, quality postnatal care, breastfeeding and adequate nutrition, vaccinations, and treatment for common childhood diseases can save many young lives.

Finally, children continue to face tragically differing chances of survival based on where they are born. In fact, two regions, sub-Saharan Africa and southern Asia, account for more than 80% of the 4.9 million under-5 deaths in 2022. In addition, Sub-Saharan Africa had the highest neonatal mortality rate in 2023 at 26 deaths per 1 000 live births, followed by Central and Southern Asia with 21 deaths per 1 000 live births. In fact, a child born in sub-Saharan Africa is 14 times more likely to die in the first month of life than a child born in the region of Australia and New Zealand.