More than 10 million children die each year in the developing world, the vast majority from causes preventable through a combination of good care, nutrition, and medical treatment. Mortality rates for children under five dropped by 15 percent since 1990, but the rates remain high in developing countries. 

In developing countries, one child in 10 dies before its fifth birthday, compared with 1 in 143 in high-income countries. Child deaths have dropped rapidly in the past 25 years, but progress everywhere slowed in the 1990s, and a few countries have experienced increases in the same period. At current rates of progress, only a few countries are likely to achieve the Millennium Development Goal of reducing child mortality to one-third of their 1990 levels.                                                                     

Target 5  Reduce by two thirds, between 1990 and 2015, the under-five mortality rate

Under-five mortality charts Chart on causes of death among children Child mortality map

Child mortality is closely linked to poverty. In 2002 the average under-five mortality rate was 121 deaths per 1,000 live births in low-income countries, 40 in lower-middle-income countries, and 22 in upper-middle-income countries. In high-income countries, the rate was less than 7. For approximately 70 percent of the deaths before age five, the cause is a disease or a combination of diseases and malnutrition that would be preventable in a high-income country: acute respiratory infections, diarrhea, measles, and malaria.
.	Past trend and future progress needed to achieve under-five mortality target   No region, except possibly Latin America and the Caribbean, is on track to achieve the target of reducing, by 2015, the under-five mortality rates by two thirds of their 1990 levels. Progress has been particularly slow in Sub-Saharan Africa, where civil disturbances and the HIV/AIDS epidemic have driven up rates of infant and child mortality in several countries

Just as child deaths are the result of many causes, reducing child mortality will require multiple, complementary interventions. Raising incomes will help. So will increasing public spending on health services. But more is needed. Access to safe water, better sanitation facilities, and improvements in education, especially for girls and mothers, are closely linked to reduced mortality. Also needed are roads to improve access to health facilities and modern forms of energy to reduce dependence on traditional fuels, which cause damaging indoor air pollution.

	Causes of death among children In 2002, 48 countries had child mortality rates greater than 100 per 1,000 live births. 15 countries – 14 in Sub-Saharan Africa – had mortality rates of more than 200. A major factor contributing to child mortality is malnutrition, which weakens children and reduces their resistance to disease. Malnutrition plays a role in more than half of all child deaths.

Immunization is an essential component in reducing under 5 mortality rates Among the childhood vaccine-preventable diseases measles is the leading cause of child mortality, over half a million deaths in 2000. Increased routine measles immunization to at least 90 per cent coverage in all countries combined with a ‘second opportunity’ for measles vaccination either through a second dose in the routine immunization schedule or the supplemental immunization activities are the main strategies to reduce measles deaths.