Progress against child mortality has been a recent achievement. Child mortality rates were very high throughout most of human history.

As recently as two centuries ago, around 1 in 2 children died before reaching the end of puberty. Researchers made this observation across many societies, as you can see in the chart. Our ancestors were largely powerless against poverty, famine, and disease, and these calamities were especially devastating for children.

Since then, child mortality has plummeted across the world. By 2020, the global average had declined to 4.3%.

This dramatic decline has resulted from better nutrition, clean water, sanitation, neonatal healthcare, vaccinations, medicines, and reductions in poverty, conflicts, and famine.

The chart also shows that in some wealthy countries – such as Iceland, Japan, and Norway – the share is 0.4%, ten times lower than the global average.

This historical experience, and the lower rates in wealthy countries today, shows us that much more progress is possible.

In this article, we cover this historical development in more detail:

Mortality in the past: every second child died

The chances that a newborn survives childhood have increased from 50% to 96% globally. This article asks how we know about the mortality of children in the past and what we can learn from it for our future.

Child mortality rates are much higher in some parts of the world than others. The map shows the share of children who die before they are fifteen years old.

As you can see, countries in Africa, South America, and South Asia have much higher rates.

In Nigeria in 2020, for example, 13% of children die before they are fifteen. In Pakistan, that share was 7%.

In other parts of the world, it was much lower. In Italy, for example, it was 0.4%.

Declines in mortality rates have also varied around the world. In countries in Southern Africa, such as South Africa and Zimbabwe, child mortality increased in the 1990s and 2000s – largely due to theHIV/AIDS epidemic.³

The scale of child mortality is immense and can be hard to grasp. Around 5 million children under five years old die annually.

That’s around 14,000 deaths every day, or ten every minute. Or, thinking of it another way, 5 million is the population of Ireland or Norway.⁵

This enormous loss of life is also a tragedy felt by people around the children – their parents, siblings, friends, and communities.

Over time, child deaths have declined, even as the global population hasrisen. But there is still much more progress to be made.

In this article, we cover this in more detail:

Child mortality: an everyday tragedy of enormous scale that we can make progress against

We live in a world in which ten children die every minute.

To make progress against child mortality, we need to know what children are dying from.

In the chart, you can see global estimates from the publication of the Institute for Health Metrics and Evaluation in 2019. The size of each box corresponds to the number of children under five years old who die from each cause.

Infectious diseases, shown on the left, were most common, killing an estimated 2.17 million children annually. This includes respiratory infections, diarrheal diseases, malaria and meningitis.

Next were birth disorders, such as preterm birth, neonatal asphyxia (suffocation), and trauma, which together caused an estimated 1.88 million deaths.

Several other causes such as heart abnormalities and malnutrition were also responsible for hundreds of thousands of deaths.

These figures are astonishing because many of these causes are preventable. With vaccination, basic medication, rehydration treatment, nutrition supplementation, and neonatal healthcare, a large share of child deaths could be prevented.

The day a child is born is the most dangerous day of life.

In the chart, you can see how the risk of death changes across the first year of life.

The top panel shows the daily death rate per 1,000 infants in the United States.

As you can see, the risk of death is highest just after birth – when they are introduced into a new environment. In the first hours of their lives, some children die from birth complications, suffocation and trauma, sepsis, and other conditions.

Over the following days and weeks, their risks remain high but decline sharply. Months later, the risks continue to decline, although at a slower rate.

There are several reasons for this reduction. One is that infants who are most vulnerable tend to die earlier. Another reason is that infantsʼ vital organs – such as their immune system and lung capacity – become more developed over time, which makes them more capable of survival.⁶

In the lower panel, the chart shows how the daily deaths accumulate across the year – you can see that most infant deaths occurred in the first few months.

In this article, we cover this in more detail:

How does the risk of death change as we age – and how has this changed over time?

Death rates decline rapidly after birth but rise again in adolescence. From adulthood onwards, they rise exponentially.