Haidong Wang1, Chelsea A Liddell2, Matthew M Coates2, Meghan D Mooney2, Carly E Levitz2, Austin E Schumacher2, Henry Apfel2, Marissa Iannarone2, Bryan Phillips2, Katherine T Lofgren2, Logan Sandar2, Rob E Dorrington3, Ivo Rakovac4, Troy A Jacobs5, Xiaofeng Liang6, Maigeng Zhou6, Jun Zhu7, Gonghuan Yang8, Yanping Wang7, Shiwei Liu6, Yichong Li6, Ayse Abbasoglu Ozgoren9, Semaw Ferede Abera10, Ibrahim Abubakar11, Tom Achoki12, Ademola Adelekan13, Zanfina Ademi14, Zewdie Aderaw Alemu15, Peter J Allen16, Mohammad AbdulAziz AlMazroa17, Elena Alvarez18, Adansi A Amankwaa19, Azmeraw T Amare20, Walid Ammar21, Palwasha Anwari22, Solveig Argeseanu Cunningham23, Majed Masoud Asad24, Reza Assadi25, Amitava Banerjee26, Sanjay Basu27, Neeraj Bedi28, Tolesa Bekele29, Michelle L Bell30, Zulfiqar Bhutta31, Jed D Blore14, Berrak Bora Basara32, Soufiane Boufous33, Nicholas Breitborde34, Nigel G Bruce35, Linh Ngoc Bui36, Jonathan R Carapetis37, Rosario Cárdenas38, David O Carpenter39, Valeria Caso40, Ruben Estanislao Castro41, Ferrán Catalá-Lopéz42, Alanur Cavlin9, Xuan Che43, Peggy Pei-Chia Chiang44, Rajiv Chowdhury45, Costas A Christophi46, Ting-Wu Chuang47, Massimo Cirillo48, Iuri da Costa Leite49, Karen J Courville50, Lalit Dandona51, Rakhi Dandona52, Adrian Davis53, Anand Dayama54, Kebede Deribe55, Samath D Dharmaratne56, Mukesh K Dherani35, Uğur Dilmen32, Eric L Ding57, Karen M Edmond58, Sergei Petrovich Ermakov59, Farshad Farzadfar60, Seyed-Mohammad Fereshtehnejad61, Daniel Obadare Fijabi62, Nataliya Foigt63, Mohammad H Forouzanfar2, Ana C Garcia64, Johanna M Geleijnse65, Bradford D Gessner66, Ketevan Goginashvili67, Philimon Gona68, Atsushi Goto69, Hebe N Gouda70, Mark A Green71, Karen Fern Greenwell72, Harish Chander Gugnani73, Rahul Gupta74, Randah Ribhi Hamadeh75, Mouhanad Hammami76, Hilda L Harb21, Simon Hay77, Mohammad T Hedayati78, H Dean Hosgood79, Damian G Hoy80, Bulat T Idrisov81, Farhad Islami82, Samaya Ismayilova83, Vivekanand Jha84, Guohong Jiang85, Jost B Jonas86, Knud Juel87, Edmond Kato Kabagambe88, Dhruv S Kazi89, Andre Pascal Kengne90, Maia Kereselidze91, Yousef Saleh Khader92, Shams Eldin Ali Hassan Khalifa93, Young-Ho Khang94, Daniel Kim95, Yohannes Kinfu96, Jonas M Kinge97, Yoshihiro Kokubo98, Soewarta Kosen99, Barthelemy Kuate Defo100, G Anil Kumar52, Kaushalendra Kumar101, Ravi B Kumar52, Taavi Lai102, Qing Lan103, Anders Larsson104, Jong-Tae Lee105, Mall Leinsalu106, Stephen S Lim2, Steven E Lipshultz107, Giancarlo Logroscino108, Paulo A Lotufo109, Raimundas Lunevicius110, Ronan Anthony Lyons111, Stefan Ma112, Abbas Ali Mahdi113, Melvin Barrientos Marzan114, Mohammad Taufiq Mashal115, Tasara T Mazorodze116, John J McGrath70, Ziad A Memish17, Walter Mendoza117, George A Mensah118, Atte Meretoja14, Ted R Miller119, Edward J Mills120, Karzan Abdulmuhsin Mohammad121, Ali H Mokdad2, Lorenzo Monasta122, Marcella Montico122, Ami R Moore123, Joanna Moschandreas124, William T Msemburi90, Ulrich O Mueller125, Magdalena M Muszynska126, Mohsen Naghavi2, Kovin S Naidoo127, K M Venkat Narayan23, Chakib Nejjari128, Marie Ng2, Jean de Dieu Ngirabega129, Mark J Nieuwenhuijsen130, Luke Nyakarahuka131, Takayoshi Ohkubo132, Saad B Omer23, Angel J Paternina Caicedo133, Victoria Pillay-van Wyk90, Dan Pope35, Farshad Pourmalek134, Dorairaj Prabhakaran135, Sajjad U R Rahman136, Saleem M Rana137, Robert Quentin Reilly138, David Rojas-Rueda130, Luca Ronfani122, Lesley Rushton139, Mohammad Yahya Saeedi17, Joshua A Salomon57, Uchechukwu Sampson88, Itamar S Santos109, Monika Sawhney140, Jürgen C Schmidt53, Marina Shakh-Nazarova91, Jun She141, Sara Sheikhbahaei60, Kenji Shibuya142, Hwashin Hyun Shin143, Kawkab Shishani144, Ivy Shiue145, Inga Dora Sigfusdottir146, Jasvinder A Singh147, Vegard Skirbekk97, Karen Sliwa148, Sergey S Soshnikov149, Luciano A Sposato150, Vasiliki Kalliopi Stathopoulou151, Konstantinos Stroumpoulis152, Karen M Tabb153, Roberto Tchio Talongwa154, Carolina Maria Teixeira155, Abdullah Sulieman Terkawi156, Alan J Thomson157, Andrew L Thorne-Lyman158, Hideaki Toyoshima159, Zacharie Tsala Dimbuene160, Parfait Uwaliraye161, Selen Begüm Uzun32, Tommi J Vasankari162, Ana Maria Nogales Vasconcelos163, Vasiliy Victorovich Vlassov164, Stein Emil Vollset97, Stephen Waller165, Xia Wan166, Scott Weichenthal143, Elisabete Weiderpass167, Robert G Weintraub168, Ronny Westerman125, James D Wilkinson169, Hywel C Williams170, Yang C Yang171, Gokalp Kadri Yentur32, Paul Yip172, Naohiro Yonemoto173, Mustafa Younis174, Chuanhua Yu175, Kim Yun Jin176, Maysaa El Sayed Zaki177, Shankuan Zhu178, Theo Vos2, Alan D Lopez14, Christopher J L Murray2. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. Electronic address: haidong@uw.edu. 2. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. 3. University of Cape Town, Cape Town, South Africa. 4. WHO Regional Office for Europe, Copenhagen, Denmark. 5. MCH Division, USAID - Global Health Bureau, HIDN, Washington, DC, USA. 6. National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 7. National Office for Maternal and Child's Health Surveillance, Chengdu, China. 8. Peking Union Medical College, Beijing, China; Peking Union Medical College, Beijing, China. 9. Hacettepe University Institute of Population Studies, Ankara, Turkey. 10. Mekelle University, Tigray, Ethiopia. 11. University College London, London, United Kingdom. 12. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana. 13. Public Health Promotion Alliance, Osogpb, Nigeria. 14. University of Melbourne, Melbourne, VIC, Australia. 15. Debre Markos Univerity, Debre Markos, Ethiopia. 16. Ministry of Health, Belmopan, Cayo, Belize. 17. Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia. 18. Government, Madrid, Spain. 19. Albany State University, Albany, GA, USA. 20. Department of Epidemiology, University of Groningen, Groningen, Netherlands. 21. Ministry of Public Health, Beirut, Lebanon. 22. UNFPA, Kabul, Afghanistan. 23. Emory University, Atlanta, GA, USA. 24. Ministry of Health, Amman, Jordan. 25. Mashhad University of Medical Sciences, Mashhad, Khorasan, Iran. 26. University of Birmingham, Birmingham, West Midlands, United Kingdom. 27. Stanford University, Stanford, CA, USA. 28. College of Public Health and Tropical Medicine, Jazan, Saudi Arabia. 29. Madawalabu University, Bale Goba, Oromia, Ethiopia. 30. Yale University, New Haven, CT, USA. 31. Aga Khan University Medical Center, Karachi, Pakistan. 32. Ministry of Health, General Directorate of Health Research, Ankara, Turkey. 33. Transport and Road Safety (TARS) Research, University of New South Wales, Sydney, NSW, Australia. 34. University of Arizona, Tucson, AZ, USA. 35. University of Liverpool, Merseyside, United Kingdom. 36. Hanoi School of Public Health, Hanoi, Vietnam. 37. Telethon Institute for Child Health Research, Subiaco, WA, Australia. 38. Universidad Autonoma Metropolitana, Mexico, DF, Mexico. 39. University at Albany, Rensselaer, NY, USA. 40. Stroke Unit, University of Perugia, Perugia, Italy. 41. Universidad Diego Portales, Santiago, Chile. 42. Division of Pharmacology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain. 43. National Institutes of Health, Bethesda, MD, USA. 44. General Practice and Primary Health Care Academic Centre, Melbourne, VIC, Australia. 45. University of Cambridge, Cambridge, United Kingdom. 46. Cyprus University of Technology, Limassol, Cyprus. 47. Taipei Medical University, Taipei, Taiwan. 48. University of Salerno, Baronissi, SA, Italy. 49. National School of Public Health (ENSP/Fiocruz), Rio De Janeiro, Brazil. 50. Hospital Dr. Gustavo N. Collado, Chitre, Herrera, Panama. 51. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India. 52. Public Health Foundation of India, New Delhi, India. 53. Public Health England, London, United Kingdom. 54. School of Medicine, Atlanta, GA, USA. 55. Addis Ababa University, Addis Ababa, Ethiopia. 56. University of Peradeniya, Peradeniya, Sri Lanka. 57. Harvard School of Public Health, Harvard University, Boston, MA, USA. 58. University of Western Australia, Perth, WA, Australia. 59. The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia. 60. Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 61. Karolinska Institutet, Stockholm, Sweden. 62. Heller Graduate School, Waltham, MA, USA. 63. Institute of Gerontology, Academy of Medical Sciences, Kyiv, Ukraine. 64. Public Health Unit of Primary Health Care Group of Almada-Seixal (region of Lisbon), Almada, Portugal. 65. Wageningen University, Division of Human Nutrition, Wageningen, the Netherlands. 66. Agence de Medecine Preventive, Paris, France. 67. Ministry of Labour, Health, and Social Affairs, Tbilisi, Georgia. 68. University of Massachusetts Medical School, Worcester, MA, USA. 69. Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan. 70. University of Queensland, Brisbane, QLD, Australia. 71. University of Sheffield, Sheffield, South York, United Kingdom. 72. Stattis LLC, Chisinau, Moldova. 73. Saint James School of Medicine, Kralendijk, Bonaire, Netherlands Antilles. 74. Kanawha Charleston Health Department, Charleston, WV, USA. 75. Arabian Gulf University, Manama, Bahrain. 76. Wayne County Department of Health and Human Services, Detroit, MI, USA. 77. University of Oxford, Oxford, United Kingdom. 78. Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran. 79. Albert Einstein College of Medicine, Bronx, NY, USA. 80. School of Population Health, Brisbane, QLD, Australia; Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia. 81. Brandeis University, Waltham, MA, USA. 82. American Cancer Society, New York, NY, USA. 83. Self-Employed, Baku, Azerbaijan. 84. Postgraduate Institute of Medical Education and Research, Chandigarh, India. 85. Tianjin Centers for Disease Control and Prevention, Tianjin, China. 86. Department of Ophthalmology, Medical Faculty Mannheim, Mannheim, Germany. 87. The National Institute of Public Health, Copenhagen, Denmark. 88. Vanderbilt University, Nashville, TN, USA. 89. University of California San Francisco, San Francisco, CA, USA. 90. South African Medical Research Council, Cape Town, Western Cape, South Africa. 91. National Centre for Diseases Control and Public Health, Tbilisi, Georgia. 92. Jordan University of Science and Technology, AlRamtha, Irbid, Jordan. 93. Supreme Council of Health, Doha, Qatar. 94. Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea. 95. Northeastern University, Boston, MA, USA. 96. University of Canberra, Canberra, ACT, Australia. 97. The Norwegian Institute of Public Health, Oslo, Norway. 98. Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 99. Center for Community Empowerment, Health Policy & Humanities, NIHRD, Jakarta, Indonesia. 100. University of Montreal, Montreal, Quebec, Canada. 101. International Institute for Population Sciences, Mumbai, India. 102. Fourth View Consulting, Tallinn, Estonia. 103. National Cancer Institute, Bethesda, MD, USA. 104. Uppsala University, Uppsala, Sweden. 105. Korea University, Seoul, South Korea. 106. The National Institute for Health Development, Tallinn, Estonia. 107. Wayne State University, Miami, FL, USA. 108. University of Bari, Bari, Italy. 109. University of Sao Paulo, Sao Paulo, Brazil. 110. Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom. 111. Swansea University, Swansea, United Kingdom. 112. Ministry of Health Singapore, Singapore. 113. King George's Medical University, Lucknow, Uttar Pradesh, India. 114. University of the East Ramon Magsaysay Medical Center, Quezon City, Metro Manila, Philippines. 115. Ministry of Public Health, Kabul, Afghanistan. 116. AIDC EC, Port Elizabeth, Eastern Cape, South Africa. 117. UNFPA, Lima, Peru. 118. Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda, MD, USA. 119. Pacific Institute for Research & Evaluation, Calverton, MD, USA. 120. University of Ottawa, Ottawa, Ontario, Canada. 121. University of Salahaddin, Erbil, Iraq. 122. Institute for Maternal and Child Health - IRCCS "Burlo Garofolo," Trieste, Italy. 123. University of North Texas, Denton, TX, USA. 124. University of Crete, Crete, Greece. 125. Philipps-University Marburg, Marburg, Hessia, Germany. 126. Warsaw School of Economics, Warsaw, Poland. 127. University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa. 128. Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, University sidi Mohamed Ben Abdellah, Fez, Morocco. 129. Rwanda Biomedical Center, Kigali, Rwanda. 130. Centre of Research in Environmental Epidemiology (CREAL), Barcelona, Spain. 131. Makerere University, Kampala, Uganda. 132. Teikyo University School of Medicine, Tokyo, Japan. 133. Universidad de Cartagena, Cartagena, Bolivar, Colombia. 134. University of British Columbia, Vancouver, BC, Canada. 135. Centre for Chronic Disease Control, New Delhi, Delhi, India. 136. Hamad Medical Corporation, Doha, Qatar. 137. Department of Public Health, University of the Punjab, Lahore, Punjab, Pakistan. 138. Private Consultant, Cairns, QLD, Australia. 139. Imperial College London, London, United Kingdom. 140. Marshall University, Huntington, WV, USA. 141. Zhongshan Hospital, Fudan, University, Shanghai, China. 142. University of Tokyo, Tokyo, Japan. 143. Health Canada, Ottawa, Ontario, Canada. 144. Washington State University, Spokane, WA, USA. 145. Heriot-Watt University, Edinburgh, Scotland, United Kingdom. 146. Reykjavik University, Reykjavik, Iceland. 147. University of Alabama at Birmingham, Birmingham, AL, USA. 148. Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa. 149. Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia. 150. Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada. 151. Centre Hospitalier Nord Deux-Sevres, Bressuire, France. 152. KEELPNO (Center for Disease Control, Greece, dispatched to "Alexandra" General Hospital of Athens), Athens, Greece. 153. University of Illinois, Champaign, IL, USA. 154. Ministry of Health, Yaounde, Centre, Cameroon. 155. ARS Norte, Porto, Portugal. 156. Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia. 157. Adaptive Knowledge Management, Victoria, BC, Canada. 158. Columbia University and The Earth Institute, New York, NY, USA. 159. Health Care Center of Anjo Kosei Hospital, Anjo City, Aichi Prefecture, Japan. 160. Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, Rwanda, Kigali City, Rwanda. 161. Ministry of Health, Rwanda, Kigali City, Rwanda. 162. UKK Institute for Health Promotion Research, Tampere, Finland. 163. Universidade de Brasilia, Brasilia, Distrito Federal, Brazil. 164. National Research University Higher School of Economics, Moscow, Russia. 165. Uniformed Services University of Health Sciences, Bethesda, MD, USA. 166. Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China. 167. Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden. 168. University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia. 169. University of Miami, Miami, FL, USA. 170. University of Nottingham, Nottingham, United Kingdom. 171. University of North Carolina at Chapel Hill, Chapel Hill, NC. USA. 172. The University of Hong Kong, Hong Kong. 173. National Center of Neurology and Psychiatry, Kodira, Tokyo, Japan. 174. Jackson State University, Jackson, MS, USA. 175. Department of Epidemiology and Biostatistics, School of Public Health, and Global Health Institute, Wuhan University, Wuhan, Hubei, China. 176. TCM MEDICAL TK SDN BHD, Nusajaya, Johor Bahru, Malaysia. 177. Mansoura Faculty of Medicine, Mansoura, Egypt. 178. Zhejiang University School of Public Health, Hangzhou, Zhejiang, China.
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. FUNDING: Bill & Melinda Gates Foundation, US Agency for International Development.
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. FUNDING: Bill & Melinda Gates Foundation, US Agency for International Development.
Authors: Robert E Black; Simon Cousens; Hope L Johnson; Joy E Lawn; Igor Rudan; Diego G Bassani; Prabhat Jha; Harry Campbell; Christa Fischer Walker; Richard Cibulskis; Thomas Eisele; Li Liu; Colin Mathers Journal: Lancet Date: 2010-05-11 Impact factor: 79.321
Authors: Li Liu; Hope L Johnson; Simon Cousens; Jamie Perin; Susana Scott; Joy E Lawn; Igor Rudan; Harry Campbell; Richard Cibulskis; Mengying Li; Colin Mathers; Robert E Black Journal: Lancet Date: 2012-05-11 Impact factor: 79.321
Authors: Xing Lin Feng; Evropi Theodoratou; Li Liu; Kit Yee Chan; David Hipgrave; Robert Scherpbier; Hana Brixi; Sufang Guo; Wen Chunmei; Mickey Chopra; Robert E Black; Harry Campbell; Igor Rudan; Yan Guo Journal: J Glob Health Date: 2012-06 Impact factor: 4.413
Authors: Cary Ma; Lourdes Cynthia Gunaratnam; Austin Ericson; Andrea L Conroy; Sophie Namasopo; Robert O Opoka; Michael T Hawkes Journal: Am J Trop Med Hyg Date: 2019-01 Impact factor: 2.345
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