Levels and Causes of Mortality under Age Five Years

This chapter reviews recent estimates of levels and distributions by cause of death of children under age five years, including stillbirths. We focus on 2000–15 and present results by World Bank region. We introduce an innovation by including information on stillbirths, defined as deaths from the 28th week of gestation. The standard convention has been to use live birth as the starting point of risk measurement, as in Millennium Development Goal 4 (MDG 4) to reduce mortality under age five years by two-thirds from 1990 to 2015 (UN 2000). However, substantial proportions of stillbirths are preventable given adequate obstetric care, and would, if prevented, increase the number of live births. We argue that including stillbirths in summary measures of child mortality provides a more inclusive assessment of health service provision than the standard convention. Data on levels and trends of mortality before age five years are taken from the 2015 report by the United Nations Inter-Agency Group on Mortality Estimation (IGME) (You and others 2015). Data on levels and trends of causes of mortality under age five years are taken from the latest estimates produced by the World Health Organization (WHO) and UNICEF’s (United Nations Children’s Fund) Child Health Epidemiology Reference Group (Liu and others, forthcoming). LEVELS AND TRENDS OF MORTALITY UNDER AGE FIVE YEARS, 2000–15

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