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A Child Survival Report Card: Number 1, 2004 View All Reports >
Key risk factors in selected countries
Despite relatively low rates of child mortality, there is room for improvement.

At present, only 43 children out of every 1,000 live births do not reach their fifth birthday.

Unlike Latin America and the Caribbean, however, the momentum of reduction has slowed sharply over the past two decades. Between 1980 and 2000, the annual reduction rate averaged just 2.8 per cent, compared with almost 5 per cent in 1960s and 1970s.

The slowdown mostly reflects trends in China. At 39 per 1,000 live births, China’s child mortality rate is half of the global average and below any regional average apart from Latin America and the Caribbean. However, in the past two decades progress on reducing child mortality has slowed sharply, and was less than 2 per cent during the 1990s.

In contrast, under-five mortality has fallen rapidly in Indonesia, the second most populous country in the region. Indonesia managed to halve its infant mortality from 91 per 1,000 live births in 1990 to just 45 in 2002, a level approaching China’s rate for the same year. Indonesia remains on schedule to meet MDG 4.

Other than Indonesia, the best performing countries in the region over the past decade are those that enjoyed the lowest levels of child mortality in 1990: Brunei Darussalam, Malaysia, Republic of Korea and Singapore.

Their success is all the more impressive given the relatively low starting base and the sharp constraints on public finances imposed by the Asian financial crisis of 1997-1999. All four countries have managed to reduce their child mortality rates to levels comparable to those in industrialized countries. The Philippines also remains on schedule to meet MDG 4, having cut its child mortality rate by 40 per cent.

But greater efforts to lower child mortality are required in the Pacific, as all the islands are falling behind.

Cambodia, where one in every seven children does not reach the age of five, is, sadly, the only country in the region that has seen an increase in child mortality since 1990. Progress has been slow in other countries with high child mortality rates, such as Myanmar and Papua New Guinea, and has stagnated in the Democratic People’s Republic of Korea.

EAST ASIA AND PACIFIC
CountryU5MR 1990U5MR 2002MDG target(a) 2015Progress(b) 1990-2002Requirement 2002-2015
Cambodia 115 138 38 -1.5 9.9
Korea, Dem. People's Rep. of 55 55 18 0.0 8.5
Papua New Guinea 101 94 34 0.6 7.9
Tuvalu 56 52 19 0.6 7.9
Palau 34 29 11 1.3 7.2
Myanmar 130 109 43 1.5 7.1
China 49 39 16 1.9 6.7
Timor-Leste 160 126 53 2.0 6.6
Kiribati 88 69 29 2.0 6.6
Micronesia (Federated States of) 31 24 10 2.1 6.5
Viet Nam 51 39 17 2.2 6.4
Tonga 27 20 9 2.5 6.1
Marshall Islands 92 66 31 2.8 5.9
Cook Islands 32 23 11 2.8 5.9
Thailand 40 28 13 3.0 5.7
Fiji 31 21 10 3.2 5.5
Mongolia 104 71 35 3.2 5.5
Solomon Islands 36 24 12 3.4 5.3
Lao People's Dem. Republic 163 100 54 4.1 4.7
Vanuatu 70 42 23 4.3 4.5
Samoa 42 25 14 4.3 4.5
Philippines 66 38 22 4.6 4.2
Korea, Rep. of 9 5 3 4.9 3.9
Brunei Darussalam 11 6 4 5.1 3.7
Indonesia 91 45 30 5.9 3.0
Singapore 8 4 3 5.8 3.0
Malaysia 21 8 7 8.0 1.0
Niue - - - - -
Nauru - 30 - - -
 

Countries whose AARR has matched or exceeded the implied MDG target in 1990-2002 are shown as shaded.


(a)

Millennium Development Goal 4 set each country the task of reducing the under-five child mortality rate by two thirds between 1990 and 2015.


(b)

The speed of progress in reducing the U5MR is measured here by calculating the average annual reduction rate (AARR). Unlike the comparison of absolute changes, the AARR reflects the fact that the lower limits to U5MR are approached only with increasing difficulty. The AARR is calculated on an exponential basis, which assumes a continuous, exponential reduction between two points in time. It does not take into account the intermediate values of the series. To achieve a two-thirds reduction between 1990 and 2015 requires a progress rate of 4.4 per cent or higher.

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Child Survival
Sub-Saharan Africa
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