schliessen

Filtern

 

Bibliotheken

Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, fi nancial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, high... Full description

Journal Title: http://hdl.handle.net/10044/1/5385610044/1/53856Lancet 08 October 2016
Main Author: Wang, H
Other Authors: Bhutta, Za , Coates, Mm , Coggeshall, M , Dandona, L , Diallo, K , Franca, Eb , Fraser, M , Fullman, N , Gething, Pw , Hay, Si , Kinfu, Y , Kita, M , Kulikoff, Xr , Larson, Hj , Liang, J , Liang, X , Lind, M , Lopez, Ad , Lozano, R , Mensah, Ga , Mikesell, Jb , Mokdad, Ah , Mooney, Md , Nguyen, G , Rakovac, I , Salomon, Ja , Silpakit, N , Sligar, A , Sorensen, Rjd , Vos, T , Zhu, J , Abajobir, Aa , Abate, Kh , Abbas, Km , Abd - Allah, F , Abdulle, Am , Abera, Sf , Aboyans, V , Abraham, B , Abubakar, I , Abu - Raddad, Lj , Abu - Rmeileh, Nme , Abyu, Gy , Achoki, T , Adebiyi, Ao , Adedeji, Ia , Adelekan, Al , Adou, Ak , Agarwal, A , Ajala, On , Akinyemiju, Tf , Akseer, N , Alam, K , Alam, Nkm , Alasfoor, D , Aldridge, Rw , Alegretti, Ma , Alemu, Za , Ali, R , Alkerwi, A , Alla, F , Al - Raddadi, R , Alsharif, U , Altirkawi, Ka , Martin, Ea , Alvis - Guzman, N , Amare, At , Amberbir, A , Amegah, Ak , Ameh, Ea , Ammar, W , Amrock, Sm , Andersen, Hh , Anderson, Gm , Antonio, Cat , Arnlov, J , Al, A , Asayesh, H , Asghar, Rj , Assadi, R , Atique, S , Avokpaho, Efga , Awasthi, A , Quintanilla, Bpa , Bacha, U , Badawi, A , Balakrishnan, K , Banerjee, A , Banigbe, Bf , Barac, A , Barber, Rm , Barker - Collo, Sl , Barnighausen, T , Barrero, Lh , Bayou, Ta , Bayou, Yt , Bazargan - Hejazi, S , Beardsley, J , Bedi, N , Bekele, T , Bell, Ml , Bello, Ak , Bennett, Da , Bensenor, Im , Berhane, A , Bernabe, E , Betsu, Bd , Bhatt, S , Biadgilign, S , Bikbov, B , Birlik, Sm , Bisanzio, D , Bjertness, E , Blore, Jd , Bourne, Rra , Brainin, M , Brazinova, A , Breitborde, Njk , Brown, A , Buckle, Gc , Burch, M , Butt, Za , Campos - Nonato, Ir , Campuzano, Jc , Cardenas, R , Carpenter, D , Carrero, Jj , Carter, A , Casey, Dc , Castaneda - Oquela, Ca , Rivas, Jc , Castro, Re , Catala - Lopez, F , Cercy, K , Chang, H - Y , Chang, J - C , Chibueze, Ce , Chisumpa, Vh , Choi, J - Yj , Chowdhury, R , Christopher, Dj , Ciobanu, Lg , Colquhoun, Sm , Cooper, C , Cornaby, L , Damtew, Sa , Danawi, H , Dandona, R , Das Neves, J , Davis, Ac , De Jager, P , De Leo, D , Degenhardt, L , Deribe, K , Deribew, A , Jarlais, Dcd , Deveber, Ga , Dharmaratne, Sd , Dhillon, Pk , Ding, El , Doshi, Pp , Doyle, Ke , Duan, L , Dubey, M , Ebrahimi, H , Ellingsen, Cl , Elyazar, I , Endries, Ay , Ermakov, Sp , Eshrati, B , Esteghamati, A , Faraon, Eja , Farid, Ta , Farinha, Cses , Faro, A , Farvid, Ms , Farzadfar, F , Fereshtehnejad, S - M , Fernandes, Jc , Fischer, F , Fitchett, Jra , Foigt, N , Franklin, Rc , Friedman, J , Furst, T , Gambashidze, K , Gamkrelidze, A , Ganguly, P , Gebre, T , Gebrehiwot, Tt , Gebremedhin, At , Gebru, Aa , Gelefinse, Jm , Gessner, Bd , Ginawi, Iam , Giref, Az , Gishu, Md , Gomez - Dantes, H , Gona, P , Goodridge, A , Gopalani, Sv , Goto, A , Gouda, Hn , Gugnani, Hc , Guo, Y , Gupta, R , Gupta, R , Gupta, V , Gyawali, B , Haagsma, Ja , Hafezi - Nejad, N , Haile, D , Hailu, Ad , Hailu, Gb , Hamadeh, Rr , Hancock, J , Handal, Aj , Hankey, Gj , Harb, Hl , Harikrishnan, S , Harun, Km , Havmoeller, R , Hay, Rj , Heredia - Pi, Ib , Hoek, Hw , Horino, M , Horita, N , Hosgood, Hd , Hotez, Pj , Hoy, Dg , Hsairi, M , Hu, G , Huang, C , Huang, Jj , Huang, H , Huiart, L , Iburg, Km , Idrisov, Bt , Innos, K , Jacobsen, Kh , Jahanmehr, N , Javanbakht, M , Jayatilleke, Au , Jee, Sh , Jeemon, P , Jha, V , Jiang, G , Jiang, Y , Jibat, T
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Elsevier
ID: ISSN: 0140-6736 DOI: 10.1016/S0140-6736(16)31575-6
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: imperial10044/1/58721
title: Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
format: Article
creator:
  • Wang, H
  • Bhutta, Za
  • Coates, Mm
  • Coggeshall, M
  • Dandona, L
  • Diallo, K
  • Franca, Eb
  • Fraser, M
  • Fullman, N
  • Gething, Pw
  • Hay, Si
  • Kinfu, Y
  • Kita, M
  • Kulikoff, Xr
  • Larson, Hj
  • Liang, J
  • Liang, X
  • Lind, M
  • Lopez, Ad
  • Lozano, R
  • Mensah, Ga
  • Mikesell, Jb
  • Mokdad, Ah
  • Mooney, Md
  • Nguyen, G
  • Rakovac, I
  • Salomon, Ja
  • Silpakit, N
  • Sligar, A
  • Sorensen, Rjd
  • Vos, T
  • Zhu, J
  • Abajobir, Aa
  • Abate, Kh
  • Abbas, Km
  • Abd - Allah, F
  • Abdulle, Am
  • Abera, Sf
  • Aboyans, V
  • Abraham, B
  • Abubakar, I
  • Abu - Raddad, Lj
  • Abu - Rmeileh, Nme
  • Abyu, Gy
  • Achoki, T
  • Adebiyi, Ao
  • Adedeji, Ia
  • Adelekan, Al
  • Adou, Ak
  • Agarwal, A
  • Ajala, On
  • Akinyemiju, Tf
  • Akseer, N
  • Alam, K
  • Alam, Nkm
  • Alasfoor, D
  • Aldridge, Rw
  • Alegretti, Ma
  • Alemu, Za
  • Ali, R
  • Alkerwi, A
  • Alla, F
  • Al - Raddadi, R
  • Alsharif, U
  • Altirkawi, Ka
  • Martin, Ea
  • Alvis - Guzman, N
  • Amare, At
  • Amberbir, A
  • Amegah, Ak
  • Ameh, Ea
  • Ammar, W
  • Amrock, Sm
  • Andersen, Hh
  • Anderson, Gm
  • Antonio, Cat
  • Arnlov, J
  • Al, A
  • Asayesh, H
  • Asghar, Rj
  • Assadi, R
  • Atique, S
  • Avokpaho, Efga
  • Awasthi, A
  • Quintanilla, Bpa
  • Bacha, U
  • Badawi, A
  • Balakrishnan, K
  • Banerjee, A
  • Banigbe, Bf
  • Barac, A
  • Barber, Rm
  • Barker - Collo, Sl
  • Barnighausen, T
  • Barrero, Lh
  • Bayou, Ta
  • Bayou, Yt
  • Bazargan - Hejazi, S
  • Beardsley, J
  • Bedi, N
  • Bekele, T
  • Bell, Ml
  • Bello, Ak
  • Bennett, Da
  • Bensenor, Im
  • Berhane, A
  • Bernabe, E
  • Betsu, Bd
  • Bhatt, S
  • Biadgilign, S
  • Bikbov, B
  • Birlik, Sm
  • Bisanzio, D
  • Bjertness, E
  • Blore, Jd
  • Bourne, Rra
  • Brainin, M
  • Brazinova, A
  • Breitborde, Njk
  • Brown, A
  • Buckle, Gc
  • Burch, M
  • Butt, Za
  • Campos - Nonato, Ir
  • Campuzano, Jc
  • Cardenas, R
  • Carpenter, D
  • Carrero, Jj
  • Carter, A
  • Casey, Dc
  • Castaneda - Oquela, Ca
  • Rivas, Jc
  • Castro, Re
  • Catala - Lopez, F
  • Cercy, K
  • Chang, H - Y
  • Chang, J - C
  • Chibueze, Ce
  • Chisumpa, Vh
  • Choi, J - Yj
  • Chowdhury, R
  • Christopher, Dj
  • Ciobanu, Lg
  • Colquhoun, Sm
  • Cooper, C
  • Cornaby, L
  • Damtew, Sa
  • Danawi, H
  • Dandona, R
  • Das Neves, J
  • Davis, Ac
  • De Jager, P
  • De Leo, D
  • Degenhardt, L
  • Deribe, K
  • Deribew, A
  • Jarlais, Dcd
  • Deveber, Ga
  • Dharmaratne, Sd
  • Dhillon, Pk
  • Ding, El
  • Doshi, Pp
  • Doyle, Ke
  • Duan, L
  • Dubey, M
  • Ebrahimi, H
  • Ellingsen, Cl
  • Elyazar, I
  • Endries, Ay
  • Ermakov, Sp
  • Eshrati, B
  • Esteghamati, A
  • Faraon, Eja
  • Farid, Ta
  • Farinha, Cses
  • Faro, A
  • Farvid, Ms
  • Farzadfar, F
  • Fereshtehnejad, S - M
  • Fernandes, Jc
  • Fischer, F
  • Fitchett, Jra
  • Foigt, N
  • Franklin, Rc
  • Friedman, J
  • Furst, T
  • Gambashidze, K
  • Gamkrelidze, A
  • Ganguly, P
  • Gebre, T
  • Gebrehiwot, Tt
  • Gebremedhin, At
  • Gebru, Aa
  • Gelefinse, Jm
  • Gessner, Bd
  • Ginawi, Iam
  • Giref, Az
  • Gishu, Md
  • Gomez - Dantes, H
  • Gona, P
  • Goodridge, A
  • Gopalani, Sv
  • Goto, A
  • Gouda, Hn
  • Gugnani, Hc
  • Guo, Y
  • Gupta, R
  • Gupta, R
  • Gupta, V
  • Gyawali, B
  • Haagsma, Ja
  • Hafezi - Nejad, N
  • Haile, D
  • Hailu, Ad
  • Hailu, Gb
  • Hamadeh, Rr
  • Hancock, J
  • Handal, Aj
  • Hankey, Gj
  • Harb, Hl
  • Harikrishnan, S
  • Harun, Km
  • Havmoeller, R
  • Hay, Rj
  • Heredia - Pi, Ib
  • Hoek, Hw
  • Horino, M
  • Horita, N
  • Hosgood, Hd
  • Hotez, Pj
  • Hoy, Dg
  • Hsairi, M
  • Hu, G
  • Huang, C
  • Huang, Jj
  • Huang, H
  • Huiart, L
  • Iburg, Km
  • Idrisov, Bt
  • Innos, K
  • Jacobsen, Kh
  • Jahanmehr, N
  • Javanbakht, M
  • Jayatilleke, Au
  • Jee, Sh
  • Jeemon, P
  • Jha, V
  • Jiang, G
  • Jiang, Y
  • Jibat, T
subjects:
  • Science & Technology
  • Life Sciences & Biomedicine
  • Medicine, General & Internal
  • General & Internal Medicine
  • Development Goal 4
  • CHILD-Mortality
  • Developing-Countries
  • Integrated Approach
  • LIFE Expectancy
  • Newborn Babies
  • Health
  • Interventions
  • Death
  • Survival
  • Child Mortality
  • Communicable Diseases
  • Global Health
  • Humans
  • Infant
  • Infant Mortality
  • Malaria
  • Stillbirth
  • Gbd 2015 Child Mortality Collaborators
  • Humans
  • Communicable Diseases
  • Malaria
  • Child Mortality
  • Infant Mortality
  • Infant
  • Stillbirth
  • Global Health
  • Science & Technology
  • Life Sciences & Biomedicine
  • Medicine, General & Internal
  • General & Internal Medicine
  • Development Goal 4
  • CHILD-Mortality
  • Developing-Countries
  • Integrated Approach
  • LIFE Expectancy
  • Newborn Babies
  • Health
  • Interventions
  • Death
  • Survival
  • 11 Medical And Health Sciences
  • General & Internal Medicine
ispartof: http://hdl.handle.net/10044/1/5385610044/1/53856Lancet, 08 October 2016
description: Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, fi nancial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specifi c and cause-specifi c mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refi ned in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specifi c mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-eff ects model, which accounted for variable stillbirth defi nitions and data source-specifi c biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as diff erences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent
language: eng
source:
identifier: ISSN: 0140-6736 DOI: 10.1016/S0140-6736(16)31575-6
fulltext: fulltext_linktorsrc
issn:
  • 01406736
  • 0140-6736
url: Link


@attributes
ID1568903385
RANK0.06999999
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
LOCALfalse
PrimoNMBib
record
control
sourcerecordid10044/1/58721
sourceidimperial
recordidTN_imperial10044/1/58721
sourcesystemPC
pqid1828270177
galeid470763694
display
typearticle
titleGlobal, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
creatorWang, H ; Bhutta, Za ; Coates, Mm ; Coggeshall, M ; Dandona, L ; Diallo, K ; Franca, Eb ; Fraser, M ; Fullman, N ; Gething, Pw ; Hay, Si ; Kinfu, Y ; Kita, M ; Kulikoff, Xr ; Larson, Hj ; Liang, J ; Liang, X ; Lind, M ; Lopez, Ad ; Lozano, R ; Mensah, Ga ; Mikesell, Jb ; Mokdad, Ah ; Mooney, Md ; Nguyen, G ; Rakovac, I ; Salomon, Ja ; Silpakit, N ; Sligar, A ; Sorensen, Rjd ; Vos, T ; Zhu, J ; Abajobir, Aa ; Abate, Kh ; Abbas, Km ; Abd - Allah, F ; Abdulle, Am ; Abera, Sf ; Aboyans, V ; Abraham, B ; Abubakar, I ; Abu - Raddad, Lj ; Abu - Rmeileh, Nme ; Abyu, Gy ; Achoki, T ; Adebiyi, Ao ; Adedeji, Ia ; Adelekan, Al ; Adou, Ak ; Agarwal, A ; Ajala, On ; Akinyemiju, Tf ; Akseer, N ; Alam, K ; Alam, Nkm ; Alasfoor, D ; Aldridge, Rw ; Alegretti, Ma ; Alemu, Za ; Ali, R ; Alkerwi, A ; Alla, F ; Al - Raddadi, R ; Alsharif, U ; Altirkawi, Ka ; Martin, Ea ; Alvis - Guzman, N ; Amare, At ; Amberbir, A ; Amegah, Ak ; Ameh, Ea ; Ammar, W ; Amrock, Sm ; Andersen, Hh ; Anderson, Gm ; Antonio, Cat ; Arnlov, J ; Al, A ; Asayesh, H ; Asghar, Rj ; Assadi, R ; Atique, S ; Avokpaho, Efga ; Awasthi, A ; Quintanilla, Bpa ; Bacha, U ; Badawi, A ; Balakrishnan, K ; Banerjee, A ; Banigbe, Bf ; Barac, A ; Barber, Rm ; Barker - Collo, Sl ; Barnighausen, T ; Barrero, Lh ; Bayou, Ta ; Bayou, Yt ; Bazargan - Hejazi, S ; Beardsley, J ; Bedi, N ; Bekele, T ; Bell, Ml ; Bello, Ak ; Bennett, Da ; Bensenor, Im ; Berhane, A ; Bernabe, E ; Betsu, Bd ; Bhatt, S ; Biadgilign, S ; Bikbov, B ; Birlik, Sm ; Bisanzio, D ; Bjertness, E ; Blore, Jd ; Bourne, Rra ; Brainin, M ; Brazinova, A ; Breitborde, Njk ; Brown, A ; Buckle, Gc ; Burch, M ; Butt, Za ; Campos - Nonato, Ir ; Campuzano, Jc ; Cardenas, R ; Carpenter, D ; Carrero, Jj ; Carter, A ; Casey, Dc ; Castaneda - Oquela, Ca ; Rivas, Jc ; Castro, Re ; Catala - Lopez, F ; Cercy, K ; Chang, H - Y ; Chang, J - C ; Chibueze, Ce ; Chisumpa, Vh ; Choi, J - Yj ; Chowdhury, R ; Christopher, Dj ; Ciobanu, Lg ; Colquhoun, Sm ; Cooper, C ; Cornaby, L ; Damtew, Sa ; Danawi, H ; Dandona, R ; Das Neves, J ; Davis, Ac ; De Jager, P ; De Leo, D ; Degenhardt, L ; Deribe, K ; Deribew, A ; Jarlais, Dcd ; Deveber, Ga ; Dharmaratne, Sd ; Dhillon, Pk ; Ding, El ; Doshi, Pp ; Doyle, Ke ; Duan, L ; Dubey, M ; Ebrahimi, H ; Ellingsen, Cl ; Elyazar, I ; Endries, Ay ; Ermakov, Sp ; Eshrati, B ; Esteghamati, A ; Faraon, Eja ; Farid, Ta ; Farinha, Cses ; Faro, A ; Farvid, Ms ; Farzadfar, F ; Fereshtehnejad, S - M ; Fernandes, Jc ; Fischer, F ; Fitchett, Jra ; Foigt, N ; Franklin, Rc ; Friedman, J ; Furst, T ; Gambashidze, K ; Gamkrelidze, A ; Ganguly, P ; Gebre, T ; Gebrehiwot, Tt ; Gebremedhin, At ; Gebru, Aa ; Gelefinse, Jm ; Gessner, Bd ; Ginawi, Iam ; Giref, Az ; Gishu, Md ; Gomez - Dantes, H ; Gona, P ; Goodridge, A ; Gopalani, Sv ; Goto, A ; Gouda, Hn ; Gugnani, Hc ; Guo, Y ; Gupta, R ; Gupta, R ; Gupta, V ; Gyawali, B ; Haagsma, Ja ; Hafezi - Nejad, N ; Haile, D ; Hailu, Ad ; Hailu, Gb ; Hamadeh, Rr ; Hancock, J ; Handal, Aj ; Hankey, Gj ; Harb, Hl ; Harikrishnan, S ; Harun, Km ; Havmoeller, R ; Hay, Rj ; Heredia - Pi, Ib ; Hoek, Hw ; Horino, M ; Horita, N ; Hosgood, Hd ; Hotez, Pj ; Hoy, Dg ; Hsairi, M ; Hu, G ; Huang, C ; Huang, Jj ; Huang, H ; Huiart, L ; Iburg, Km ; Idrisov, Bt ; Innos, K ; Jacobsen, Kh ; Jahanmehr, N ; Javanbakht, M ; Jayatilleke, Au ; Jee, Sh ; Jeemon, P ; Jha, V ; Jiang, G ; Jiang, Y ; Jibat, T
publisherElsevier
ispartofhttp://hdl.handle.net/10044/1/5385610044/1/53856Lancet, 08 October 2016
identifier ISSN: 0140-6736 DOI: 10.1016/S0140-6736(16)31575-6
subject
descriptionBackground Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, fi nancial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specifi c and cause-specifi c mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refi ned in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specifi c mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-eff ects model, which accounted for variable stillbirth defi nitions and data source-specifi c biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as diff erences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95% uncertainty interval [UI] 5·7–6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7–53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3–43·6) to 2·6 million (2·6–2·7) neonatal deaths and 47·0% (35·1–57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6–3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional defi ciencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as diff erences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-eff ective intervention packages to innovative fi nancing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030.
languageeng
source
version15
lds50peer_reviewed
links
openurl$$Topenurl_article
linktorsrc$$Uhttp://hdl.handle.net/10044/1/58721$$EView_full_text_in_Spiral_(Access_may_be_restricted)
openurlfulltext$$Topenurlfull_article
search
creatorcontrib
0Wang, H
1Bhutta, Za
2Coates, Mm
3Coggeshall, M
4Dandona, L
5Diallo, K
6Franca, Eb
7Fraser, M
8Fullman, N
9Gething, Pw
10Hay, Si
11Kinfu, Y
12Kita, M
13Kulikoff, Xr
14Larson, Hj
15Liang, J
16Liang, X
17Lind, M
18Lopez, Ad
19Lozano, R
20Mensah, Ga
21Mikesell, Jb
22Mokdad, Ah
23Mooney, Md
24Nguyen, G
25Rakovac, I
26Salomon, Ja
27Silpakit, N
28Sligar, A
29Sorensen, Rjd
30Vos, T
31Zhu, J
32Abajobir, Aa
33Abate, Kh
34Abbas, Km
35Abd - Allah, F
36Abdulle, Am
37Abera, Sf
38Aboyans, V
39Abraham, B
40Abubakar, I
41Abu - Raddad, Lj
42Abu - Rmeileh, Nme
43Abyu, Gy
44Achoki, T
45Adebiyi, Ao
46Adedeji, Ia
47Adelekan, Al
48Adou, Ak
49Agarwal, A
50Ajala, On
51Akinyemiju, Tf
52Akseer, N
53Alam, K
54Alam, Nkm
55Alasfoor, D
56Aldridge, Rw
57Alegretti, Ma
58Alemu, Za
59Ali, R
60Alkerwi, A
61Alla, F
62Al - Raddadi, R
63Alsharif, U
64Altirkawi, Ka
65Martin, Ea
66Alvis - Guzman, N
67Amare, At
68Amberbir, A
69Amegah, Ak
70Ameh, Ea
71Ammar, W
72Amrock, Sm
73Andersen, Hh
74Anderson, Gm
75Antonio, Cat
76Arnlov, J
77Al, A
78Asayesh, H
79Asghar, Rj
80Assadi, R
81Atique, S
82Avokpaho, Efga
83Awasthi, A
84Quintanilla, Bpa
85Bacha, U
86Badawi, A
87Balakrishnan, K
88Banerjee, A
89Banigbe, Bf
90Barac, A
91Barber, Rm
92Barker - Collo, Sl
93Barnighausen, T
94Barrero, Lh
95Bayou, Ta
96Bayou, Yt
97Bazargan - Hejazi, S
98Beardsley, J
99Bedi, N
100...
titleGlobal, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
descriptionBackground Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, fi nancial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specifi c and cause-specifi c mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refi ned in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specifi c mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-eff ects model, which accounted for variable stillbirth defi nitions and data source-specifi c biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as diff erences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95% uncertainty interval [UI] 5·7–6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7–53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3–43·6) to 2·6 million (2·6–2·7) neonatal deaths and 47·0% (35·1–57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6–3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional defi ciencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as diff erences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-eff ective intervention packages to innovative fi nancing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030.
subject
0Science & Technology
1Life Sciences & Biomedicine
2Medicine, General & Internal
3General & Internal Medicine
4Development Goal 4
5CHILD-Mortality
6Developing-Countries
7Integrated Approach
8LIFE Expectancy
9Newborn Babies
10Health
11Interventions
12Death
13Survival
14Child Mortality
15Communicable Diseases
16Global Health
17Humans
18Infant
19Infant Mortality
20Malaria
21Stillbirth
22Gbd 2015 Child Mortality Collaborators
2311 Medical And Health Sciences
general
0English
1Elsevier
2Spiral (Imperial College London)
310.1016/S0140-6736(16)31575-6
sourceidimperial
recordidimperial10044/1/58721
issn
001406736
10140-6736
rsrctypearticle
addtitlehttp://hdl.handle.net/10044/1/53856
searchscope
0imperial
1spiral_ir
scope
0imperial
1spiral_ir
creationdate2016
startdate20161008
enddate20161008
lsr30VSR-Enriched:[orcidid, pqid, vol, galeid, issue, pages, eissn]
sort
titleGlobal, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
authorWang, H ; Bhutta, Za ; Coates, Mm ; Coggeshall, M ; Dandona, L ; Diallo, K ; Franca, Eb ; Fraser, M ; Fullman, N ; Gething, Pw ; Hay, Si ; Kinfu, Y ; Kita, M ; Kulikoff, Xr ; Larson, Hj ; Liang, J ; Liang, X ; Lind, M ; Lopez, Ad ; Lozano, R ; Mensah, Ga ; Mikesell, Jb ; Mokdad, Ah ; Mooney, Md ; Nguyen, G ; Rakovac, I ; Salomon, Ja ; Silpakit, N ; Sligar, A ; Sorensen, Rjd ; Vos, T ; Zhu, J ; Abajobir, Aa ; Abate, Kh ; Abbas, Km ; Abd - Allah, F ; Abdulle, Am ; Abera, Sf ; Aboyans, V ; Abraham, B ; Abubakar, I ; Abu - Raddad, Lj ; Abu - Rmeileh, Nme ; Abyu, Gy ; Achoki, T ; Adebiyi, Ao ; Adedeji, Ia ; Adelekan, Al ; Adou, Ak ; Agarwal, A ; Ajala, On ; Akinyemiju, Tf ; Akseer, N ; Alam, K ; Alam, Nkm ; Alasfoor, D ; Aldridge, Rw ; Alegretti, Ma ; Alemu, Za ; Ali, R ; Alkerwi, A ; Alla, F ; Al - Raddadi, R ; Alsharif, U ; Altirkawi, Ka ; Martin, Ea ; Alvis - Guzman, N ; Amare, At ; Amberbir, A ; Amegah, Ak ; Ameh, Ea ; Ammar, W ; Amrock, Sm ; Andersen, Hh ; Anderson, Gm ; Antonio, Cat ; Arnlov, J ; Al, A ; Asayesh, H ; Asghar, Rj ; Assadi, R ; Atique, S ; Avokpaho, Efga ; Awasthi, A ; Quintanilla, Bpa ; Bacha, U ; Badawi, A ; Balakrishnan, K ; Banerjee, A ; Banigbe, Bf ; Barac, A ; Barber, Rm ; Barker - Collo, Sl ; Barnighausen, T ; Barrero, Lh ; Bayou, Ta ; Bayou, Yt ; Bazargan - Hejazi, S ; Beardsley, J ; Bedi, N ; Bekele, T ; Bell, Ml ; Bello, Ak ; Bennett, Da ; Bensenor, Im ; Berhane, A ; Bernabe, E ; Betsu, Bd ; Bhatt, S ; Biadgilign, S ; Bikbov, B ; Birlik, Sm ; Bisanzio, D ; Bjertness, E ; Blore, Jd ; Bourne, Rra ; Brainin, M ; Brazinova, A ; Breitborde, Njk ; Brown, A ; Buckle, Gc ; Burch, M ; Butt, Za ; Campos - Nonato, Ir ; Campuzano, Jc ; Cardenas, R ; Carpenter, D ; Carrero, Jj ; Carter, A ; Casey, Dc ; Castaneda - Oquela, Ca ; Rivas, Jc ; Castro, Re ; Catala - Lopez, F ; Cercy, K ; Chang, H - Y ; Chang, J - C ; Chibueze, Ce ; Chisumpa, Vh ; Choi, J - Yj ; Chowdhury, R ; Christopher, Dj ; Ciobanu, Lg ; Colquhoun, Sm ; Cooper, C ; Cornaby, L ; Damtew, Sa ; Danawi, H ; Dandona, R ; Das Neves, J ; Davis, Ac ; De Jager, P ; De Leo, D ; Degenhardt, L ; Deribe, K ; Deribew, A ; Jarlais, Dcd ; Deveber, Ga ; Dharmaratne, Sd ; Dhillon, Pk ; Ding, El ; Doshi, Pp ; Doyle, Ke ; Duan, L ; Dubey, M ; Ebrahimi, H ; Ellingsen, Cl ; Elyazar, I ; Endries, Ay ; Ermakov, Sp ; Eshrati, B ; Esteghamati, A ; Faraon, Eja ; Farid, Ta ; Farinha, Cses ; Faro, A ; Farvid, Ms ; Farzadfar, F ; Fereshtehnejad, S - M ; Fernandes, Jc ; Fischer, F ; Fitchett, Jra ; Foigt, N ; Franklin, Rc ; Friedman, J ; Furst, T ; Gambashidze, K ; Gamkrelidze, A ; Ganguly, P ; Gebre, T ; Gebrehiwot, Tt ; Gebremedhin, At ; Gebru, Aa ; Gelefinse, Jm ; Gessner, Bd ; Ginawi, Iam ; Giref, Az ; Gishu, Md ; Gomez - Dantes, H ; Gona, P ; Goodridge, A ; Gopalani, Sv ; Goto, A ; Gouda, Hn ; Gugnani, Hc ; Guo, Y ; Gupta, R ; Gupta, R ; Gupta, V ; Gyawali, B ; Haagsma, Ja ; Hafezi - Nejad, N ; Haile, D ; Hailu, Ad ; Hailu, Gb ; Hamadeh, Rr ; Hancock, J ; Handal, Aj ; Hankey, Gj ; Harb, Hl ; Harikrishnan, S ; Harun, Km ; Havmoeller, R ; Hay, Rj ; Heredia - Pi, Ib ; Hoek, Hw ; Horino, M ; Horita, N ; Hosgood, Hd ; Hotez, Pj ; Hoy, Dg ; Hsairi, M ; Hu, G ; Huang, C ; Huang, Jj ; Huang, H ; Huiart, L ; Iburg, Km ; Idrisov, Bt ; Innos, K ; Jacobsen, Kh ; Jahanmehr, N ; Javanbakht, M ; Jayatilleke, Au ; Jee, Sh ; Jeemon, P ; Jha, V ; Jiang, G ; Jiang, Y ; Jibat, T
creationdate20161008
lso0120161008
facets
frbrgroupid-209991632103300805
frbrtype5
newrecords20180508
languageeng
topic
0Science & Technology
1Life Sciences & Biomedicine
2Medicine, General & Internal
3General & Internal Medicine
4Development Goal 4
5CHILD-Mortality
6Developing-Countries
7Integrated Approach
8LIFE Expectancy
9Newborn Babies
10Health
11Interventions
12Death
13Survival
14Child Mortality
15Communicable Diseases
16Global Health
17Humans
18Infant
19Infant Mortality
20Malaria
21Stillbirth
22Gbd 2015 Child Mortality Collaborators
2311 Medical And Health Sciences
collectionSpiral (Imperial College London)
prefilterarticles
rsrctypearticles
creatorcontrib
0Wang, H
1Bhutta, Za
2Coates, Mm
3Coggeshall, M
4Dandona, L
5Diallo, K
6Franca, Eb
7Fraser, M
8Fullman, N
9Gething, Pw
10Hay, Si
11Kinfu, Y
12Kita, M
13Kulikoff, Xr
14Larson, Hj
15Liang, J
16Liang, X
17Lind, M
18Lopez, Ad
19Lozano, R
20Mensah, Ga
21Mikesell, Jb
22Mokdad, Ah
23Mooney, Md
24Nguyen, G
25Rakovac, I
26Salomon, Ja
27Silpakit, N
28Sligar, A
29Sorensen, Rjd
30Vos, T
31Zhu, J
32Abajobir, Aa
33Abate, Kh
34Abbas, Km
35Abd - Allah, F
36Abdulle, Am
37Abera, Sf
38Aboyans, V
39Abraham, B
40Abubakar, I
41Abu - Raddad, Lj
42Abu - Rmeileh, Nme
43Abyu, Gy
44Achoki, T
45Adebiyi, Ao
46Adedeji, Ia
47Adelekan, Al
48Adou, Ak
49Agarwal, A
50Ajala, On
51Akinyemiju, Tf
52Akseer, N
53Alam, K
54Alam, Nkm
55Alasfoor, D
56Aldridge, Rw
57Alegretti, Ma
58Alemu, Za
59Ali, R
60Alkerwi, A
61Alla, F
62Al - Raddadi, R
63Alsharif, U
64Altirkawi, Ka
65Martin, Ea
66Alvis - Guzman, N
67Amare, At
68Amberbir, A
69Amegah, Ak
70Ameh, Ea
71Ammar, W
72Amrock, Sm
73Andersen, Hh
74Anderson, Gm
75Antonio, Cat
76Arnlov, J
77Al, A
78Asayesh, H
79Asghar, Rj
80Assadi, R
81Atique, S
82Avokpaho, Efga
83Awasthi, A
84Quintanilla, Bpa
85Bacha, U
86Badawi, A
87Balakrishnan, K
88Banerjee, A
89Banigbe, Bf
90Barac, A
91Barber, Rm
92Barker - Collo, Sl
93Barnighausen, T
94Barrero, Lh
95Bayou, Ta
96Bayou, Yt
97Bazargan - Hejazi, S
98Beardsley, J
99Bedi, N
100...
creationdate2016
jtitle
0http://hdl.handle.net/10044/1/53856
110044/1/53856
2Lancet
toplevelpeer_reviewed
delivery
delcategoryRemote Search Resource
fulltextfulltext_linktorsrc
addata
au
0Wang, H
1Bhutta, Za
2Coates, Mm
3Coggeshall, M
4Dandona, L
5Diallo, K
6Franca, Eb
7Fraser, M
8Fullman, N
9Gething, Pw
10Hay, Si
11Kinfu, Y
12Kita, M
13Kulikoff, Xr
14Larson, Hj
15Liang, J
16Liang, X
17Lind, M
18Lopez, Ad
19Lozano, R
20Mensah, Ga
21Mikesell, Jb
22Mokdad, Ah
23Mooney, Md
24Nguyen, G
25Rakovac, I
26Salomon, Ja
27Silpakit, N
28Sligar, A
29Sorensen, Rjd
30Vos, T
31Zhu, J
32Abajobir, Aa
33Abate, Kh
34Abbas, Km
35Abd - Allah, F
36Abdulle, Am
37Abera, Sf
38Aboyans, V
39Abraham, B
40Abubakar, I
41Abu - Raddad, Lj
42Abu - Rmeileh, Nme
43Abyu, Gy
44Achoki, T
45Adebiyi, Ao
46Adedeji, Ia
47Adelekan, Al
48Adou, Ak
49Agarwal, A
50Ajala, On
51Akinyemiju, Tf
52Akseer, N
53Alam, K
54Alam, Nkm
55Alasfoor, D
56Aldridge, Rw
57Alegretti, Ma
58Alemu, Za
59Ali, R
60Alkerwi, A
61Alla, F
62Al - Raddadi, R
63Alsharif, U
64Altirkawi, Ka
65Martin, Ea
66Alvis - Guzman, N
67Amare, At
68Amberbir, A
69Amegah, Ak
70Ameh, Ea
71Ammar, W
72Amrock, Sm
73Andersen, Hh
74Anderson, Gm
75Antonio, Cat
76Arnlov, J
77Al, A
78Asayesh, H
79Asghar, Rj
80Assadi, R
81Atique, S
82Avokpaho, Efga
83Awasthi, A
84Quintanilla, Bpa
85Bacha, U
86Badawi, A
87Balakrishnan, K
88Banerjee, A
89Banigbe, Bf
90Barac, A
91Barber, Rm
92Barker - Collo, Sl
93Barnighausen, T
94Barrero, Lh
95Bayou, Ta
96Bayou, Yt
97Bazargan - Hejazi, S
98Beardsley, J
99Bedi, N
100...
atitleGlobal, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
jtitle
0http://hdl.handle.net/10044/1/53856
110044/1/53856
2Lancet
risdate20161008
issn0140-6736
formatjournal
genrearticle
ristypeJOUR
abstractBackground Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, fi nancial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specifi c and cause-specifi c mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refi ned in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specifi c mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-eff ects model, which accounted for variable stillbirth defi nitions and data source-specifi c biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as diff erences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95% uncertainty interval [UI] 5·7–6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7–53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3–43·6) to 2·6 million (2·6–2·7) neonatal deaths and 47·0% (35·1–57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6–3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional defi ciencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as diff erences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-eff ective intervention packages to innovative fi nancing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030.
pubElsevier
doi10.1016/S0140-6736(16)31575-6
urlhttp://hdl.handle.net/10044/1/58721$$EView_full_text_in_Spiral_(Access_may_be_restricted)
oafree_for_read
orcidid0000-0002-6933-4637
volume388
issue10053
pages1725-1774
eissn1474547X
date2016-10-08