Around 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns, according to new estimates released by the United Nations, which stated that most of these deaths are preventable.
On the other hand, Bangladesh, a South Asian country, has made major gains in child survival over the past two decades, as the under-five mortality rate (U5MR) dropped sharply from 85.5 deaths per 1,000 live births in 2000 to 30.5 in 2024.
Neonatal mortality also declined substantially, from 43.4 to 17.9 deaths per 1,000 live births over the same period.
The Report jointly produced by UNICEF, WHO, World Bank, and UN Population divisions on Wednesday noted that under-five deaths globally have halved since 2000, but since 2015, the reduction in child mortality has slowed by more than 60 per cent.
The report estimates deaths directly caused by severe acute malnutrition (SAM), finding that more than 100,000 children aged 1-59 months – or 5 per cent – died from it in 2024.
The toll is far greater when indirect effects are considered, as malnutrition weakens children’s immunity and increases their risk of dying from common childhood diseases.
Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth.
Beyond the first month, infectious diseases such as malaria, diarrhoea, and pneumonia were major killers.
“No child should die from diseases that we know how to prevent. But we see worrying signs that progress in child survival is slowing – and at a time where we’re seeing further global budget cuts,” said UNICEF Executive Director Catherine Russell.
Global trends in the child mortality rate
Since 2000, around 174 million children have died before age five, including 76 million newborns, a total nearly equal to the population of Bangladesh, highlighting the vast scale of global child mortality.
In 2024, sub-Saharan Africa accounted for 58 per cent of all under-five deaths, as in that region, the leading infectious diseases were responsible for 54 per cent of all under-five deaths.
In Europe and North America, this proportion drops to 9 per cent, and in Australia and New Zealand, it drops further to 6 per cent.
In Southern Asia, which accounted for 25 per cent of all under-five deaths, mortality was driven largely by complications in the first month of life – including preterm delivery, birth asphyxia/ trauma, congenital anomalies, and neonatal infections.
“The world has made remarkable progress in saving children’s lives, but many still die from preventable causes,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“Children living amid conflict and crisis are nearly three times more likely to die before their fifth birthday. We must protect essential health and nutrition services and reach the most vulnerable families so every child has the chance not only to survive, but to thrive.”
These largely preventable conditions underscore the urgent need for investing in quality antenatal care, skilled health-care personnel at birth, care of small and sick newborns, and essential newborn services.
The report also finds that an estimated 2.1 million children, adolescents and youth aged 5–24 died in 2024.
Infectious diseases and injuries remain leading causes among younger children, while risks shift in adolescence: self-harm is the leading cause of death among girls aged 15–19, and road traffic injuries among boys.
Shifts in the global development financing landscape are placing critical maternal, newborn, and child health programmes under growing pressure.
“The latest estimates from the United Nations Inter-agency Group for Child Mortality Estimation are a stark reminder that progress on child survival is slowing and too many countries are off track to meet the Sustainable Development Goals,” said Under-Secretary-General for Economic and Social Affairs Mr. Li Junhua.
Evidence shows that investments in child health remain among the most cost-effective development measures, the report suggested.
“The science is clear: targeted investments in primary health care, maternal and newborn health services, routine immunization, nutrition programmes, and quality and timely data systems can save millions of lives,” says Li Liu, PhD, an associate professor at the Johns Hopkins Bloomberg School of Public Health and co-PI of CA-CODE.
The report is based on UN data as well as estimates from the Johns Hopkins Bloomberg School of Public Health.
Bangladesh makes major gains in child survival
Bangladesh has made significant progress in reducing child and neonatal mortality over the past two decades, driven by targeted health interventions and system-wide reforms, according to the report.
The under-five mortality rate (U5MR) dropped sharply from 85.5 deaths per 1,000 live births in 2000 to 30.5 in 2024. Neonatal mortality also declined substantially, from 43.4 to 17.9 deaths per 1,000 live births over the same period.
Health experts attribute this progress largely to the nationwide expansion of Special Care Newborn Units (SCANUs), which address leading causes of newborn deaths, including prematurity, low birth weight, birth asphyxia and infections.
Recognizing that nearly 60% of under-five deaths occur during the neonatal period, the Ministry of Health and Family Welfare prioritized newborn care through the National Neonatal Health Strategy introduced in 2009, followed by a dedicated National Newborn Health Program aligned with Sustainable Development Goals (SDGs).
With support from UNICEF and development partners, the Directorate General of Health Services expanded SCANUs from just 16 units in 2011 to 62 units across 51 districts by 2025.
The government has also strengthened a continuum of care by expanding kangaroo mother care services to over 450 health facilities and establishing newborn stabilization units at the subdistrict level.
Integration of digital tools, including DHIS2 and case tracking systems, has further improved real-time monitoring and patient outcomes, with early data indicating declining fatality rates.
To address persistent gaps in primary healthcare access, Bangladesh launched the Reaching Every Mother and Newborn (REMN) strategy in 2023.
The initiative focuses on improving antenatal care, safe deliveries, postnatal services and community engagement through data-driven planning.
By 2025, REMN had been rolled out in 56 subdistricts across 10 districts, strengthening more than 1,500 health facilities to deliver integrated maternal and newborn care.
Experts say the combined impact of SCANU expansion and REMN implementation highlights how sustained policy commitment, improved healthcare quality and data-driven interventions are helping Bangladesh move closer to ending preventable child and newborn deaths.
“We know how to prevent these deaths. What is needed now is renewed political commitment, sustained investment in primary health care, and stronger data systems to ensure no child is left behind,” said Li Junhua, UN Under-Secretary-General for Economic and Social Affairs.