Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Wang, Haidong, Liddell, Chelsea A., Coates, Matthew M., Mooney, Meghan D., Levitz, Carly E., Schumacher, Austin E., Apfel, Henry, Iannarone, Marissa, Phillips, Bryan, Lofgren, Katherine T., Sandar, Logan, Dorrington, Rob E., Rakovac, Ivo, Jacobs, Troy A., Liang, Xiaofeng, Zhou, Maigeng, Zhu, Jun, Yang, Gonghuan, Wang, Yanping, Liu, Shiwei, Li, Yichong, Ozgoren, Ayse Abbasoglu, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Alemu, Zewdie Aderaw, Allen, Peter J., AlMazroa, Mohammad AbdulAziz, Alvarez, Elena, Amankwaa, Adansi A., Amare, Azmeraw T., Ammar, Walid, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Asad, Majed Masoud, Assadi, Reza, Banerjee, Amitava, Basu, Sanjay, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Bhutta, Zulfiqar, Blore, Jed, Basara, Berrak Bora, Boufous, Soufiane, Breitborde, Nicholas, Bruce, Nigel G., Bui, Linh Ngoc, Carapetis, Jonathan R., Cardenas, Rosario, Carpenter, David O., Caso, Valeria, Castro, Ruben Estanislao, Catala-Lopez, Ferran, Calvin, Alanur, Che, Xuan, Chiang, Peggy Pei-Chia, Chowdhury, Rajiv, Christopi, Costas, Chuang, Ting-Wu, Cirillo, Massimo, da Costa Leite, Iuri, Courville, Karen J., Dandona, Lalit, Dandona, Rakhi, Davist, Adrian, Dayama, Anand, Deribe, Kebede, Dharmaratne, Samath D., Dherani, Mukesh K., Dilmen, Ugur, Ding, Eric L., Edmond, Karen M., Ermakov, Sergei Petrovich, Farzadfart, Farshad, Fereshtehnejad, Seye-Mohammad, Fijabi, Daniel Obadare, Foigt, Nataliya, Forouzanfar, Mohammad H., Garcia, Ana C., Geleijnse, Johanna M., Gessner, Bradford D., Goginashvili, Ketevan, Gona, Philimon, Goto, Atsushi, Gouda, Hebe N., Green, Mark A., Greenwell, Karen Fern, Gugnani, Harish Chander, Gupta, Rahul, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Harb, Hilda L., Hay, Simon, Hedayati, Mohammad, Hosgood, H. Dean, Hoy, Damian G., Idrisov, Bulat T., Islami, Farhad, Ismayilova, Samaya, Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kabagambe, Edmond Kato, Kazi, Dhruv S., Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khang, Young-Ho, Kim, Daniel, Kinfu, Yohannes, Kinge, Jonas M., Kokubo, Yoshihiro, Kosen, Soewarta, Kuate Defo, Barthelemy, Kumar, G. Anil, Kumar, Kaushalendra, Kumar, Ravi B., Lai, Taavi, Lan, Qing, Larsson, Anders, Lee, Jong-Tae, Leinsalu, Mall, Lim, Stephen S., Lipshultz, Steven E., Logroscino, Giancarlo, Lotufo, Paulo A., Lunevicius, Raimundas, Lyons, Ronan Anthony, Ma, Stefan, Mahdi, Abbas Ali, Marzan, Melvin Barrientos, Mashal, Mohammad Taufiq, Mazorodze, Tasara T., McGrath, John J., Memish, Ziad A., Mendoza, Walter, Mensah, George A., Meretoja, Atte, Miller, Ted R., Mills, Edward, Mohammad, Karzan Abdulmuhsin, Mokdad, Ali H., Monasta, Lorenzo, Motico, Marcella, Moore, Ami R., Moschandreas, Joanna, Msemburi, William T., Mueller, Ulrich O., Muszynska, Magdalena, Naghavi, Mohsen, Naidoo, Kovin, Narayan, K. M. Venkat, Nejjari, Chakib, Ng, Marie, Ngiarabega, Jean de Dieu, Nieuwenhuijsen, Mark J., Nyakarahuka, Luke, Ohkubo, Takayoshi, Omer, Saad B., Paternina Caicedo, Angel J., Pillay-van Wyk, Victoria, Pope, Dan, Prabhakaran, Dorairaj, Rahman, Sajjad U. R., Rana, Saleem M., Reilly, Robert Quentin, Rojas-Rueda, David, Ronfani, Luca, Rushton, Lesley, Saeedit, Mohammad Yahya, Salomon, Joshua, Sampson, Uchechukwu, Santos, Itamar S., Sawhney, Monika, Schmidt, Jurgen C., Shakh-Nazarova, Marina, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shishani, Kawkab, Shiuet, Ivy, Sigfusdottir, Inga Dora, Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S., Sposato, Luciano A., Stathopoulou, Vasiliki Kalliopi, Stroumpoulis, Konstantinos, Tabb, Karen M., Talongwa, Roberto Tchio, Teixeira, Carloina Maria, Terkawi, Abdullah Sulieman, Thomson, Alan J., Thorne-Lyman, Andrew L., Toyoshima, Hideaki, Tsala Dimbuene, Zacharie, Uwaliraye, Parfait, Uzun, Selen Begum, Vasankari, Tommi J., Vasconcelos, Ana Maria Nogales, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vost, Theo, Waller, Stephen, Wan, Xia, Weichenthal, Scott, Weiderpass, Eliabete, Weintraub, Robert G., Westerman, Ronny, Wilkinson, James D., William, Hywel C., Yang, Yang C., Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Younis, Mustafa, Yu, Chuahua, Yun Jin, Kim, Zaki, Maysaa El Sayed, Zhu, Shankuan, Lopez, Alan D. and Murray, Christopher J. L. (2014) Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 384 9947: 957-979. doi:10.1016/S0140-6736(14)60497-9


Author Wang, Haidong
Liddell, Chelsea A.
Coates, Matthew M.
Mooney, Meghan D.
Levitz, Carly E.
Schumacher, Austin E.
Apfel, Henry
Iannarone, Marissa
Phillips, Bryan
Lofgren, Katherine T.
Sandar, Logan
Dorrington, Rob E.
Rakovac, Ivo
Jacobs, Troy A.
Liang, Xiaofeng
Zhou, Maigeng
Zhu, Jun
Yang, Gonghuan
Wang, Yanping
Liu, Shiwei
Li, Yichong
Ozgoren, Ayse Abbasoglu
Abera, Semaw Ferede
Abubakar, Ibrahim
Achoki, Tom
Adelekan, Ademola
Ademi, Zanfina
Alemu, Zewdie Aderaw
Allen, Peter J.
AlMazroa, Mohammad AbdulAziz
Alvarez, Elena
Amankwaa, Adansi A.
Amare, Azmeraw T.
Ammar, Walid
Anwari, Palwasha
Cunningham, Solveig Argeseanu
Asad, Majed Masoud
Assadi, Reza
Banerjee, Amitava
Basu, Sanjay
Bedi, Neeraj
Bekele, Tolesa
Bell, Michelle L.
Bhutta, Zulfiqar
Blore, Jed
Basara, Berrak Bora
Boufous, Soufiane
Breitborde, Nicholas
Bruce, Nigel G.
Bui, Linh Ngoc
Carapetis, Jonathan R.
Cardenas, Rosario
Carpenter, David O.
Caso, Valeria
Castro, Ruben Estanislao
Catala-Lopez, Ferran
Calvin, Alanur
Che, Xuan
Chiang, Peggy Pei-Chia
Chowdhury, Rajiv
Christopi, Costas
Chuang, Ting-Wu
Cirillo, Massimo
da Costa Leite, Iuri
Courville, Karen J.
Dandona, Lalit
Dandona, Rakhi
Davist, Adrian
Dayama, Anand
Deribe, Kebede
Dharmaratne, Samath D.
Dherani, Mukesh K.
Dilmen, Ugur
Ding, Eric L.
Edmond, Karen M.
Ermakov, Sergei Petrovich
Farzadfart, Farshad
Fereshtehnejad, Seye-Mohammad
Fijabi, Daniel Obadare
Foigt, Nataliya
Forouzanfar, Mohammad H.
Garcia, Ana C.
Geleijnse, Johanna M.
Gessner, Bradford D.
Goginashvili, Ketevan
Gona, Philimon
Goto, Atsushi
Gouda, Hebe N.
Green, Mark A.
Greenwell, Karen Fern
Gugnani, Harish Chander
Gupta, Rahul
Hamadeh, Randah Ribhi
Hammami, Mouhanad
Harb, Hilda L.
Hay, Simon
Hedayati, Mohammad
Hosgood, H. Dean
Hoy, Damian G.
Idrisov, Bulat T.
Islami, Farhad
Ismayilova, Samaya
Jha, Vivekanand
Jiang, Guohong
Jonas, Jost B.
Juel, Knud
Kabagambe, Edmond Kato
Kazi, Dhruv S.
Kengne, Andre Pascal
Kereselidze, Maia
Khader, Yousef Saleh
Khalifa, Shams Eldin Ali Hassan
Khang, Young-Ho
Kim, Daniel
Kinfu, Yohannes
Kinge, Jonas M.
Kokubo, Yoshihiro
Kosen, Soewarta
Kuate Defo, Barthelemy
Kumar, G. Anil
Kumar, Kaushalendra
Kumar, Ravi B.
Lai, Taavi
Lan, Qing
Larsson, Anders
Lee, Jong-Tae
Leinsalu, Mall
Lim, Stephen S.
Lipshultz, Steven E.
Logroscino, Giancarlo
Lotufo, Paulo A.
Lunevicius, Raimundas
Lyons, Ronan Anthony
Ma, Stefan
Mahdi, Abbas Ali
Marzan, Melvin Barrientos
Mashal, Mohammad Taufiq
Mazorodze, Tasara T.
McGrath, John J.
Memish, Ziad A.
Mendoza, Walter
Mensah, George A.
Meretoja, Atte
Miller, Ted R.
Mills, Edward
Mohammad, Karzan Abdulmuhsin
Mokdad, Ali H.
Monasta, Lorenzo
Motico, Marcella
Moore, Ami R.
Moschandreas, Joanna
Msemburi, William T.
Mueller, Ulrich O.
Muszynska, Magdalena
Naghavi, Mohsen
Naidoo, Kovin
Narayan, K. M. Venkat
Nejjari, Chakib
Ng, Marie
Ngiarabega, Jean de Dieu
Nieuwenhuijsen, Mark J.
Nyakarahuka, Luke
Ohkubo, Takayoshi
Omer, Saad B.
Paternina Caicedo, Angel J.
Pillay-van Wyk, Victoria
Pope, Dan
Prabhakaran, Dorairaj
Rahman, Sajjad U. R.
Rana, Saleem M.
Reilly, Robert Quentin
Rojas-Rueda, David
Ronfani, Luca
Rushton, Lesley
Saeedit, Mohammad Yahya
Salomon, Joshua
Sampson, Uchechukwu
Santos, Itamar S.
Sawhney, Monika
Schmidt, Jurgen C.
Shakh-Nazarova, Marina
She, Jun
Sheikhbahaei, Sara
Shibuya, Kenji
Shin, Hwashin Hyun
Shishani, Kawkab
Shiuet, Ivy
Sigfusdottir, Inga Dora
Singh, Jasvinder A.
Skirbekk, Vegard
Sliwa, Karen
Soshnikov, Sergey S.
Sposato, Luciano A.
Stathopoulou, Vasiliki Kalliopi
Stroumpoulis, Konstantinos
Tabb, Karen M.
Talongwa, Roberto Tchio
Teixeira, Carloina Maria
Terkawi, Abdullah Sulieman
Thomson, Alan J.
Thorne-Lyman, Andrew L.
Toyoshima, Hideaki
Tsala Dimbuene, Zacharie
Uwaliraye, Parfait
Uzun, Selen Begum
Vasankari, Tommi J.
Vasconcelos, Ana Maria Nogales
Vlassov, Vasiliy Victorovich
Vollset, Stein Emil
Vost, Theo
Waller, Stephen
Wan, Xia
Weichenthal, Scott
Weiderpass, Eliabete
Weintraub, Robert G.
Westerman, Ronny
Wilkinson, James D.
William, Hywel C.
Yang, Yang C.
Yentur, Gokalp Kadri
Yip, Paul
Yonemoto, Naohiro
Younis, Mustafa
Yu, Chuahua
Yun Jin, Kim
Zaki, Maysaa El Sayed
Zhu, Shankuan
Lopez, Alan D.
Murray, Christopher J. L.
Title Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Journal name The Lancet   Check publisher's open access policy
ISSN 0140-6736
1474-547X
Publication date 2014-01-01
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/S0140-6736(14)60497-9
Open Access Status DOI
Volume 384
Issue 9947
Start page 957
End page 979
Total pages 23
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Language eng
Subject 2700 Medicine
Abstract Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.
Formatted abstract
Background
Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.

Methods
We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030.

Findings

We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone.

Interpretation
Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030.
Keyword Bill & Melinda Gates Foundation
US Agency for International Development
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 095066
RG/08/014/24067
201900
MR/L003120/1
MR/K023233/1
MR/K006525/1
Institutional Status UQ
Additional Notes Published online ahead of print 2 May 2014.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Queensland Brain Institute Publications
Official 2015 Collection
School of Public Health Publications
School of Medicine Publications
 
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Created: Tue, 27 May 2014, 22:14:35 EST by Hebe Gouda on behalf of School of Public Health