Beyond the Headlines: The Slowing Progress and Persistent Inequalities in Global Child Mortality

By UNICEF UK's Senior Policy Advisor for Child Health, Sian Williams .

Last week, the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) launched new data for child mortality and still birth rates for 2023. The headline is great news. Fewer children than ever before in history are dying before their 5th birthday.

This is a testament to the amazing progress made to scale-up and improve access to proven lifesaving health services for children around the world. These services include routine immunisation, comprehensive nutrition programmes, and quality antenatal and postnatal care.

However, beneath the headline is a far more concerning picture. Five key statistics stand out that point to the precarious situation faced by young children around the world, putting their futures at risk.

1. In 2023, 4.8 million children died before turning 5 years old

In absolute terms, this number is still far too high. But it is also important to remember that every one of these deaths is a tragedy for a family, and represents a huge amount of potential that has been lost.

2. Millions of children continue to die every year of preventable causes

Most under-5 deaths are caused by conditions related to neonatal mortality and infectious diseases (figure 1). It is unacceptable that so many of these deaths could have been easily prevented by improving access to well-known solutions like immunisation and skilled birth attendance.

3. Reduction in the under-5 mortality rate was 42% slower between 2015 and 2023 than it was between 2000 and 2015

Since 2000, the global under-5 mortality rate has declined by 52%. This is an amazing achievement, but progress isn’t as fast as it used to be – the number of children who died before their 5th birthday in 2023 was just 100,000 fewer than in 2022, dropping from 4.9 million to just 4.8 million.

Every additional life saved is a success story, but this slowing decline shows a worrying trend towards stagnation. And as countries around the world make major cuts to aid budgets and programmes, there is a real potential for backsliding. We know life-saving child survival programmes are already suffering at the hands of cuts, facing healthcare worker shortages, clinic closures, and vaccination programme disruptions.

4. Children living in the highest-risk country are 80 times more likely to die before the age of 5 than those in the lowest-risk country

The most vulnerable children around the world continue to suffer the most. Factors like lower household wealth, lower levels of maternal education, and living in a rural area also increase risk. As does living in fragile and conflict-affected settings, where children are nearly three times more likely to die before reaching 5.

It is also these children who will face the worst impacts of aid cuts, expected to hit hardest in regions facing humanitarian crises, debt-stricken countries, and areas with already high child mortality rates.

5. If current trends continue, 30 million more children under 5 will die before 2030

There is still time to change this picture. Recommitting to simple, cost-effective, and scalable solutions that we know work to prevent child deaths could make a difference to millions of children and families around the world. But we need to move faster and further, working to reach the most vulnerable and reverse the huge inequalities that we see persisting.

What UNICEF UK want to see

Millions of children’s futures are at risk, and donors like the UK have a major role to play. These stark numbers sit badly against the recently announced cuts to UK Overseas Development Assistance (ODA). Especially when we know the last time the UK made cuts to ODA, programmes targeted at children were disproportionately affected. This cannot happen again.

UNICEF UK are asking the UK government to restore the ODA budget, protect spending on children, and commit to allocate at least 25% of the ODA budget to child-sensitive programmes. This must include investment in high-impact health interventions like immunisation and nutrition services, ensuing these reach the most vulnerable children and mothers facing the highest risks.

There is still time to reverse these trends, reinvigorate progress on child health and wellbeing, and support even more children around the world to not just survive, but to thrive.