According to UNICEF The under-five mortality rate is a key indicator of child well-being, including health and nutrition status. It is also a key indicator of the coverage of child survival interventions and, more broadly, of social and economic development. Millennium Development Goal 4 (MDG 4) calls for reducing the under-five mortality rate by two-thirds between 1990 and 2015. The world has made substantial progress, reducing the rate 49 percent, from 90 (89, 92) deaths per 1,000 live births in 1990 to 46 (44, 48) in 2013. Since 1990 almost 100 million children under age five—roughly the current population of the Philippines—have been saved.
The world is also reducing under-five mortality faster than at any other time during the past two decades. The global annual rate of reduction has steadily accelerated since 1990–1995—more than tripling from 1.2 percent to 4.0 percent in 2005–2013. Despite these gains, child survival remains an urgent concern. The toll of under-five deaths over the past two decades is staggering: between 1990 and 2013, 223 million children worldwide died before their fifth birthday—more than today’s population of Brazil, the world’s fifth most populous country. Progress has been insufficient, and the MDG 4 target risks being missed at the global level. To achieve MDG 4 on time, the global annual rate of reduction in under-five mortality would need to rise to 20.8 percent for 2013–2015, much higher than the 4.0 percent achieved over 2005–2013. At the country level, historical trends show that progress for most countries has been too slow and that only 12 of the 60 countries with high under-five mortality rates (at least 40 deaths per 1,000 live births) are on track to achieve MDG 4 if current trends continue.