Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals

Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019. We updated cause-specific mortality estimates for neonat...

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Bibliographic Details
Published in:The lancet child & adolescent health Vol. 6; no. 2; p. 106
Main Authors: Perin, Jamie, Mulick, Amy, Yeung, Diana, Villavicencio, Francisco, Lopez, Gerard, Strong, Kathleen L, Prieto-Merino, David, Cousens, Simon, Black, Robert E, Liu, Li
Format: Journal Article
Language:English
Published: England 01.02.2022
Subjects:
Cause of Death - trends
Child Mortality - trends
Child, Preschool
Female
Global Health
Humans
Infant
Infant Mortality - trends
Male
Models, Statistical
Sustainable Development
World Health Organization
ISSN:2352-4650, 2352-4650
Online Access:Get more information
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Summary:Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019. We updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis. In 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality. Progress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death. Bill & Melinda Gates Foundation; WHO.
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ISSN:2352-4650
2352-4650
DOI:10.1016/S2352-4642(21)00311-4