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MDG Goal 4: Reduce child mortality

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The key to making progress towards attaining MDG 4 is to reach every newborn and every child in every district with a limited set of priority interventions. These interventions are antenatal care, newborn care, appropriate infant feeding, immunization, management of common childhood illnesses including pneumonia and diarrhoea and use of insecticide-treated nets (ITNs).[1] Between 1990 and 2009, the average coverage of infants immunized against measles in the Region increased from 57% to 69%. In 2010, it was estimated that 35% of children under-five years of age slept under an insecticide-treated net (ITN). In the Region, coverage of pneumonia care seeking remains low at 43%, pneumonia cases receiving antibiotic treatment remains at 23%, diarrhoea cases receiving ORT are only 41% and only 34% of children with malaria receive antimalarial treatment. Several African countries are making encouraging progress in the treatment of children with severe acute malnutrition through Community Management of Acute Malnutrition (CMAM) programmes.

Progress on Target 4A.[2]

Under-five mortality dropped from 179 per 1000 live births in 1990 to 127 per 1000 live births in 2009.[3] Seven countries[4] are on track to achieve this target; 27 countries are making progress, although it is insufficient; and 12 countries have made no progress (Figure 1).

Figure 1 : Under-five mortality rate (per 1000 live births) in 2009 and MDG target in the African Region[5] MDG5-U5MRb-26032012.jpg


  1. WHO, Child Survival: A strategy for the African Region (AFR/RC56/13). Brazzaville, World Health Organization, Regional Office for Africa, 2006.
  2. MDG Target 4A: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.
  3. Levels and Trends in child mortality, Report 2010, Estimates Developed by the UN Interagency Group for child mortality estimation; UNICEF 2010.
  4. Algeria, Cape Verde, Eritrea, Liberia, Madagascar, Mauritius and Seychelles.
  5. Data Source: WHO, World Health Statistics 2011, Geneva, World Health Organization, 2011. Country and regional assessments of progress towards MDG 4 are based on average annual rates of reduction (AARR) in U5MR observed for 1990–2008 and required during 2009–2015 in order to reach the MDG target of reducing U5MR by two thirds by 2015, according to the following thresholds: On track: U5MR is less than 40, or U5MR is 40 or more and AARR observed for 1990–2008 is 4.0 per cent or more. Insufficient progress: U5MR is 40 or more and AARR observed for 1990–2008 is between 1.0 per cent and 3.9 per cent. No progress: U5MR is 40 or more and AARR observed for 1990–2008 is less than 1.0 per cent.