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Cited by 3,167Global Maternal and Child HealthMaternal and Neonatal HealthcareChild Nutrition and Water Access

Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis

Open access
Liu, Li, Oza, Shefali, Hogan, Daniel, Perin, Jamie, Rudan, Igor, Lawn, Joy E, Cousens, Simon, Mathers, Colin +1 more·2015·The Lancet
DOI 10.1016/s0140-6736(14)61698-6
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Abstract

Background Trend data for causes of child death are crucial to inform priorities for improving child survival by and beyond 2015. We report child mortality by cause estimates in 2000-13, and cause-specific mortality scenarios to 2030 and 2035.Methods We estimated the distributions of causes of child mortality separately for neonates and children aged 1-59 months. To generate cause-specific mortality fractions, we included new vital registration and verbal autopsy data. We used vital registration data in countries with adequate registration systems. We applied vital registration-based multicause models for countries with low under-5 mortality but inadequate vital registration, and updated verbal autopsy-based multicause models for high mortality countries. We used updated numbers of child deaths to derive numbers of deaths by causes. We applied two scenarios to derive cause-specific mortality in 2030 and 2035.Findings Of the 6·3 million children who died before age 5 years in 2013, 51·8% (3·257 million) died of infectious causes and 44% (2·761 million) died in the neonatal period. The three leading causes are preterm birth complications (0·965 million [15·4%, uncertainty range (UR) 9·8-24·5]; UR 0·615-1·537 million), pneumonia (0·935 million [14·9%, 13·0-16·8]; 0·817-1·057 million), and intrapartum-related complications (0·662 million [10·5%, 6·7-16·8]; 0·421-1·054 million). Reductions in pneumonia, diarrhoea, and measles collectively were responsible for half of the 3·6 million fewer deaths recorded in 2013 versus 2000. Causes with the slowest progress were congenital, preterm, neonatal sepsis, injury, and other causes. If present trends continue, 4·4 million children younger than 5 years will still die in 2030. Furthermore, sub-Saharan Africa will have 33% of the births and 60% of the deaths in 2030, compared with 25% and 50% in 2013, respectively.Interpretation Our projection results provide concrete examples of how the distribution of child causes of deaths could look in 15-20 years to inform priority setting in the post-2015 era. More evidence is needed about shifts in timing, causes, and places of under-5 deaths to inform child survival agendas by and beyond 2015, to end preventable child deaths in a generation, and to count and account for every newborn and every child.Funding Bill & Melinda Gates Foundation.

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Authors
Liu, L., Oza, S., Hogan, D., Perin, J., Rudan, I., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E.
Affiliations
  • Johns Hopkins University (US)
  • London School of Hygiene & Tropical Medicine (GB)
  • World Health Organization (CH)
  • University of Edinburgh (GB)
Corresponding author
Black, Robert E
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2015-01
Volume
385
Issue
9966
Pages
430-440
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(14)61698-6
OpenAlex
W2150069228
Semantic Scholar
b9cf3b47bb9cdcc470b720ae319035966a334c0e
Cited by
3,167
References
7
Citations by year
2026: 62 · 2025: 126 · 2024: 208 · 2023: 222 · 2022: 266 · 2021: 297 · 2020: 365 · 2019: 319 · 2018: 315 · 2017: 408 · 2016: 355 · 2015: 203 · 2014: 16 · 2012: 1
FWCI
308.06
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (acceptedVersion)
  • PubMed (publishedVersion)
Funders
  • WHO
  • UNICEF
  • Bill & Melinda Gates Foundation
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Keywords
child mortality, causes of death, neonatal mortality, preterm birth complications, neonatal pneumonia, neonatal sepsis, verbal autopsy, civil registration, multicausality, mortality projections, sub-Saharan Africa, diarrhea, measles, injuries, congenital malformations, child survival, global burden of disease
MeSH terms
Cause of Death, Child, Preschool, Forecasting, Humans, Infant, Infant, Newborn, Models, Statistical, Child Mortality

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