In 2010 over 7.5 million children died before their 5th birthday: 3.1 million were newborns

Written by Bob Black, Li Liu and Joy Lawn

Our new global estimates are published this week in The Lancet giving the first ever trend analysis for child causes of death over the last decade. The good news is that 2 million fewer children under the age of 5 died in 2010 than in 2000. The bad news is that the overall rate of reduction is not fast enough to reach Millennium Development Goal 4 and that some regions, and some causes of death are being left further behind.

Preterm birth complications are now 2nd leading cause of all childhood deaths. Photo: Jane Hahn Getty Images/Save the Children.

For newborns, progress in reducing deaths has been especially slow. Over 3 million newborns died in 2010. This was only down by 600,000 from 10 years earlier. Newborn deaths now account for 40% of all under five childhood deaths, up from 38% in 2000.

Now preterm birth complications is the second leading cause of death among all children (14%),following pneumonia (18%), with diarrhea the third highest cause at 11%.

Causes of death for newborns (first 4 weeks) and children under 5 years, worldwide for the year 2010,
Li Liu et al Lancet 2012.

The leading causes of newborn deaths are:

• preterm birth complications (1.1 million, 35% of all neonatal deaths)
• intrapartum-related conditions (previously called “birth asphyxia’) (0.7 million, 23%), and 
• sepsis or meningitis (0.4 million, 13%).

No neonatal cause of death—except for tetanus—declined at a rate fast enough to meet MDG 4. Preterm birth complications only dropped by 2% per year from 2000 to 2010. The rate would have to more than double to be on track.

Regional and national estimates are also available. As expected there is a lot of variation in the causes of death. In 2010 the fraction of all under-five deaths that are newborn varied across regions, ranging between 30% in Africa to 54% in Western Pacific. In Africa, malaria causes 15% of all childhood deaths, second only to pneumonia. Of the ~ 159,000 deaths in children under five due to HIV/AIDS, almost all were in Africa.

The regions with the highest burden of child and newborn deaths have the least data. For instance in 2010, less than 4% of neonatal deaths were in countries with nationally reliable death certificates for most deaths. Registering every baby at birth gives identity, improves the data and enable better accountability for survival.

Our analysis was done by the Child Health Epidemiology Reference Group (CHERG), which is an expert panel formed by the WHO and UNICEF. CHERG.org gives a complete list of past global estimates and cause specific analysis.

Learn more:

• Read the full paper available for free at the Lancet
• Visit CHERG's website
• Born Too Soon: 5 points for action on preterm birth
• Newborn survival - grounds for optimism?
• If you were born as an African baby...