Infant and child mortality

Infant mortality – death among children not yet one year of age, reflects the effect of economic, social and environmental conditions on the health of mothers and infants, as well as the effectiveness of health systems. Child mortality – death among children not yet 5 years of age an indicator of child health as well as the overall development and well‐being of a population. As part of their Sustainable Development Goals, the United Nations has set a target of reducing under age 5 mortality to at least as low as 25 per 1 000 live births by 2030 (United Nations 2015).

Over the 2000-16 period, infant mortality rates have roughly halved in the Asia/Pacific region, but huge cross-national disparities exists across countries. Advanced economies have the lowest infant mortality rates, often lower than OECD average (4.0): Macau, China, Hong Kong, China, Japan, and Singapore record infant mortality rates of around two deaths per 1 000 live births (Figure 6.4). In contrast, low-income countries such as Lao PDR, Myanmar, Papua New Guinea, Pakistan and Timor-Leste have infant mortality rates exceeding 40 deaths per 1 000 live births.

Across the selected countries, the highest incidence of infant mortality is recorded for children with mothers who low educational attainment and little income who live in rural areas (Figure 6.5). While all the selected countries show similar trends, the infant mortality discrepancies upon socio-economic status of mothers were widest in Lao DPR (2011-12): the infant mortality rate was 95 among low-income wealth families and 27 for high-income families; 96 for mothers with low educational attainment and 32 for mothers with high educational attainment; and, 85 for mothers in rural areas and 39 for mothers in urban areas.

Child mortality rates have halved over the 2000-16 period. However, one-third of Asia/Pacific countries have not yet achieved the Sustainable Development Goal of a child mortality rate of 25 or less per 1 000 live births by 2030 (Figure 6.6). Lao PDR, Myanmar, Pakistan, and Papua New Guinea have child mortality rates exceeding 50 deaths per 1 000 live births though child mortality rates fell significantly over the past fifteen years. Boys are more likely than girls to die before their fifth birthday in all countries except Tonga, although the gender gap in child mortality has narrowed over the past fifteen years.

Definition and measurement

The infant mortality rate is defined as the number of children who die before reaching their first birthday in a given year, expressed per 1 000 live births. The child mortality rate (or under-five mortality rate – U5MR) is the probability – expressed as a rate per 1 000 live births, of a child born in a specified years dying before reaching the age of five when subject to current age-specific mortality rates.

Some countries base their infant mortality rates on estimates derived from censuses, surveys and sample registration systems, and not on accurate and complete registration of births and deaths. Differences among countries in registering practices for premature infants may also add slightly to international variations in rates.

Further reading

The UN inter-agency Group (UNICEF, WHO, World Bank Group, United Nations) for Child Mortality Estimation (2017), “Levels & Trends in Child Mortality”,

Figure 6.4. The infant mortality rate has halved, while huge disparities exist across countries
Infant mortality rate, per 1 000 live births, 2000 and 2016

UN Inter-agency Group for Child Mortality Estimation (IGME) Child Mortality Report 2017; Hong Kong annual digest of statistics 2017; Macau yearbook of Statistics, 2016.


Figure 6.5. Mothers experienced high incidence of infant mortality when they have low education and wealth and live in rural areas
Infant mortality rate by wealth, location, and mothers’ education, selected countries and years

Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) 2012-16.


Figure 6.6. The child mortality rate halved to 24.6 since 2000, but the gender gap still exists
Child (under 5) mortality, per 1 000 live births, by sex, 2000 and 2016

WHO Global Health Observatory data (2018), UN Inter-agency Group for Child Mortality Estimation (IGME) Child Mortality Report 2017.


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