Children in Key statistics on child survival, protection and development Key Statistics In, mortality rates among children under five decreased by 48 per cent between 199 and 13, but still half of the world's 6.3 million under-five deaths occur in. Pneumonia, malaria and diarrhoea account for % of all under-five deaths in. has the highest rate of stunting among under-fives; it is also the region with slowest progress in reducing stunting since 199. UNICEF/ETHA_14_248/Ose In 13, there were an estimated 2.9 million children under 15 years living with HIV in. Over half of the world s out-of-school children (33 million) live in. The population in with access to an improved drinking source more than doubled from 199 to 12. There has been major progress in the last decade in the use of insecticide-treated nets among children. The child population in is burgeoning; by 5, more than 1 in 3 children in the world will live in sub-saharan Number of births, by UNICEF region, 195-5 Births (millions) 1 8 CEE/CIS Rest of the world Middle East and North Sub-Saharan Arica East Asia and Pacific Latin America and Caribbean South Asia From 14 onwards, sub-saharan is the region with the highest number of births, and this trend will persist for the rest of the century. By mid-century sub-saharan will account for 39 per cent of all births. Between 15 and 3 the number of children under 18 in sub-saharan will rise from 487 million to 647 million. From 25 onwards sub-saharan will be the single region with the greatest number of children under 18. 195 197 199 1 3 5 Source: UNICEF analysis based on United Nations, Department of Economic and Social Affairs, Population Division, World Population Prospects: The 12 Revision, United Nations, New York, 13. Prepared by: UNICEF Data & Analytics Division of Data, Research and Policy February 15 Find the latest statistics on children in at the UNICEF Statistics website: data.unicef.org Notes: (1) Maps in this brochure are stylized and not to scale. They do not reflect a position by UNICEF on the legal status of any country or territory or the deliminatation of any frontiers. The final boundary between the Republic of the Sudan and the Republic of South Sudan has not yet been determined. (2) Regional aggregates are calculated according to the regional classification of the n Union, unless otherwise noted.
Child Mortality in Key Fact In, mortality rates among children under five (U5MR) have decreased by 48 per cent from 163 deaths per 1, live births in 199 to 85 in 13, but still half of the world's 6.3 million under-five deaths occur in. All regions in have experienced marked declines in under-five mortality since 199 Under-five mortality rate by country (deaths per 1, live births) and number of under five deaths by sub-region, 13 Under-five mortality rate, 199-13 26 73 199 13 16, 68 168 1,35, 9 151 547, 776, 18 112 169 7 65 66 89 9 125 126 185 429, World 46 85 9 5 1 15 25 163 Pneumonia, malaria and diarrhoea account for % of all under-five deaths in Distribution of under-five deaths in by cause, 13 Despite declining rates, neonatal deaths are growing as a share of under-five deaths, amid faster progress in reducing mortality from 1 to 59 months Age distribution of under-five deaths,, 199-13 Pneumonia (post-neonatal) (14%) Other (16%) Measles (1%) AIDS (3%) Meningitis (3%) Injuries (5%) Pneumonia (16%) All other causes of death (23%) Malaria (14%) Malaria (14%) Pneumonia (neonatal) (2%) Neonatal (35%) Diarrhoea (1%) Preterm birth complications (11%) Intrapartum-related events (1%) Sepsis (6%) Tetanus (1%) Congenital abnormalities (3%) Other neonatal (2%) Diarrhoea (neonatal) (%) Diarrhoea (post-neonatal) (1%) 27% Child deaths (12-59 months) Post-neonatal deaths (1-11 months) Neonatal deaths (first month) 35% Globally, almost half of all under-five deaths are attributable to malnutrition 199 1995 5 1 Source for all charts: UNICEF analysis based on IGME 14 and WHO & CHERG 14
Maternal Health in has the highest number of maternal deaths, despite steady declines since 199 Globally, the maternal mortality ratio (MMR) declined from maternal deaths per 1, live births in 199 to 21 in 13 In sub-saharan the MMR was 51 per 1, live births in 13, a 48% decline from 99 in 199. Sub-Saharan accounted for 179, maternal deaths in 13, 62 per cent of the global total, largely due to limited access to emergency obstetric care and insufficient maternal care during pregnancy and delivery. Most pregnant women access skilled antenatal care at least once, but only about half receive the recommended minimum of four antenatal care visits Antenatal care: Percentage of women aged 15-49 years attended at least once during pregnancy by skilled health personnel (doctor, nurse or midwife), and percentage attended by any provider at least four times 9-13* 1 8 73 51 74 81 67 85 45 94 64 ANC 1 ANC 4 77 49 82 51 Improvement in maternal health outcomes requires key interventions: A minimum of four visits for quality antenatal care in order to ensure the well-being of the mother and the baby Quality intra- and post-partum care with skilled health personnel Improved access to emergency obstetric care Expanded access to information, counseling and supplies for a wide range of contraceptive methods Antiretroviral therapy to all pregnant women who need it World In malaria endemic countries, provision of intermittent preventive treatment of malaria and ITNs to all pregnant women during antenatal visits Note: The World estimate for ANC 4 excludes China, for which comparable data are not available. Skilled delivery care coverage is higher in urban than in rural areas Skilled attendance at birth: Percentage of births attended by skilled health personnel by area of residence, 9-13* Only about half of babies in are born with assistance from skilled health personnel Skilled attendance at birth: Percentage of births attended by skilled health personnel (doctor, nurse or midwife), 9-13 1 Urban Rural 91 94 86 8 75 8 77 79 67 59 53 47 28 33 39 World Less than % 59% 79% 8% or higher Source for all charts: UNICEF global databases 14, based on DHS, MICS, and other national surveys. Note: *Some exceptions for earlier data years were made to ensure adequate population coverage for all sub-regions
Child nutrition in Stunting, or being too short for one s age, is linked with irreversible long term consequences; it diminishes chances of succeeding in school and of living healthy and productive lives. is the only region with very little change in the percentage (%) of stunted children since 199. Little progress towards stunting reduction in compared to other regions Percentage of children under age five stunted (moderate and severe), by region, 199-13 5 Asia Global Less than two-fifths of -5 month olds in are exclusively breastfed; but rapid progress is possible as evidenced in many countries. There are stark disparities between the richest and poorest in most sub-regions. 3 1 Latin America and Caribbean 199 1995 5 1 13 Less than half of n children are breastfed within an hour of birth, and even fewer infants -5 months of age are exclusively breastfed Percentage of infants put to the breast within one hour of birth; exclusively breastfed ( 5 months), 9-13* 1 8 24 42 32 55 55 48 5 51 Early initiation of breastfeeding (<1 hour) Exclusive breastfeeding (-5 mo.) 69 48 37 Stunting rates are on average nearly twice as high among the poorest Percentage of children under age five stunted (moderate and severe), by wealth quintile, 9-13* 5 3 1 48 28 Poorest quintile 47 47 25 Richest quintile 18 46 26 Gap 29 Recent advances in 6 n countries show that rapid progress in exclusive breastfeeding is possible Percentage of infants -5 months that are exclusively breastfed, in well-performing countries, 5-12 (%) 1 Well-performing countries Significant (> 15 percentage point) increases in the last 5 years Additional well-performing countries Current high (>5 per cent) achievement 88 85 8 27 23 1 8 11 4 Niger ('8, '9, '1, '12) 32 Sierra Leone ('5, '8, '1) 16 25 Burkina Faso ('9, '11, '12) 16 Guinea Bissau ('6, '1) 28 48 62 Togo ('6, '8, '1) 45 69 Burundi ('5, '1) 41 5 49 52 United Republic of Tanzania ('5, '1) Ethiopia ('5, '11) 63 Uganda ('6, '11) 57 71 Malawi ('6, '1) Rwanda ('5, '1) Source for all charts: UNICEF global databases 14, based on DHS, MICS, and other national surveys; UNICEF, World Bank, WHO Joint Malnutrition Estimates, 14. Note: *Some exceptions for earlier data years were made to ensure adequate population coverage for all sub-regions.
HIV/AIDS and Malaria in Although progress has been made in to increase the prevention of mother to child transmission (PMTCT) of HIV and increasing pediatric anti-retroviral therapy (ART) coverage, much more progress is needed. In 13, around 2, children were newly infected with HIV in. Across sub-saharan, about 3% of all under-five deaths are caused by AIDS, and in some n countries, nearly % of under-five deaths are attributed to AIDS. Although some progress has been made, ARV coverage for PMTCT ranged between 23% in and 83% in in 13. An estimated 2.9 million children under 15 years were living with HIV in as of 13; nearly 1 per cent of which were newly infected, mainly through mother-to-child transmission of HIV Percentage of pregnant women living with HIV receiving most effective ARVs for PMTCT and percentage of children aged -14 years living with HIV receiving ART, 13 1 8 37 45 68 83 67 32 All 23 29 11 7 19 22 PMTCT coverage Paediatric ART coverage Note: ART coverage is based on the estimated unrounded number of all children living with HIV receiving ART. UNAIDS recommends using the denominator of all children living with HIV and not just those eligible for ART based on 13 WHO eligibility HIV treatment criteria. Source: UNAIDS, UNICEF, WHO, 14 Global AIDS Response Progress Reporting; UNAIDS 13 estimates, 14. Major progress during the last decade in the use of Insecticide Treated Nets (ITNs) among children Percentage of children under age five sleeping under ITNs in, early s and around 13 Around Around 13 During the last decade, the proportion of children sleeping under ITNs in sub-saharan increased from less than 5 per cent to almost per cent. Less than 1% 1 19% 29% 3 49% 5 79% Not malaria endemic In Madagascar, Rwanda, and Tanzania, coverage increased from less than 5 per cent to over 7 per cent. Mass campaigns for distribution of ITNs are used to ensure that everyone is reached. Malaria case management in endemic countries Use of diagnostic tests to confirm malaria before starting antimalarial treatment is low. In most endemic countries, less than 5 per cent of febrile children under-five who receive anti-malarials are treated with artemisinin-based combination therapy (ACT), the recommended first line antimalarial drug. Source: UNICEF global databases 14, based on DHS, MICS, and other national surveys
Child marriage, birth registration and Female Genital Mutilation/Cutting (FGM/C) in Over a third of young women in were married or in union before age 18 Percentage of women aged -24 years who were first married or in union before ages 15 and 18, 5-13 Countries with high levels of child marriage tend to have high levels of early childbearing Percentage of women aged -24 years who were first married or in union before age 18, and who gave birth before age 18, n countries, 5-13 Married or in union before age 15 Married or in union after age 15 but before age 18 Each dot represents a country 15 27 2 9 1 11 12 1 26 25 31 29 Women who gave birth by age 18 World 8 19 (excluding China) 1 3 5 8 Women first married or in union by age 18 Levels of birth registration vary widely across the different regions of but also between countries within the same region Percentage of children under age five whose births are registered, and countries with the highest and lowest levels, 5-13 Percentage of children under age five whose births are registered, 5-13 1 Regional average Country with the lowest birth registration level Country with the highest birth registration level 8 Less than 25% 25 5% 51 75% 76 9% Above 9% FGM/C is concentrated in a swath of countries from the Atlantic Coast to the Horn of Percentage of girls and women aged 15-49 years who have undergone FGM/C, 4-13 In half of the countries, the majority of girls underwent FGM/C before age 5. In the rest of the countries, most cutting occurs between ages 5 and 14. Less than 1% 1 25% 26 5% 51 8% Above 8% FGM/C is not concentrated in these countries In most countries where FGM/C is concentrated, the majority of women and men think it should end. In nearly all countries where the practice is concentrated, traditional practitioners perform most of the procedures. Source for all charts: UNICEF global databases 14, based on DHS, MICS, other national surveys, censuses and vital registration systems.
Education in Over half of the world s out-of-school children (33 million) live in. Girls are more likely to be out of school than boys. The majority of n countries have not achieved universal primary education. Progress in reducing the out-of-school children population has slowed down since 7. Many children fail to complete a full primary education and fail to master basic literacy and numeracy skills. In, boys are more likely to be enrolled in primary school than girls Gender parity index of primary enrolment, girls as a percentage of boys, n countries, 9-12 1.2 1.1 1..9.8.7 Girls more likely to be enrolled Parity Boys more likely to be enrolled Each dot represents the GPI of one country.6 Only thirteen n countries are near achieving universal primary education Net enrolment/attendance rate, 8-13 Many n countries face the double challenge of non-completion and low learning performance Percentage of cohort who reached grade 4 and achieved a minimal level of learning in reading, 4-12 1 Did not reach grade 4 Reached grade 4 but did not learn the basics Reached grade 4 and learned the basics 8 Less than 85% 85 94% 95 or higher Swaziland U. R. Tanzania Mauritius Seychelles Botswana Namibia Kenya Gabon Lesotho Uganda Mozambique Cameroon Zambia Malawi Liberia Burundi Togo Senegal Congo Burkina Faso Côte d'ivoire Mali Benin Chad Madagascar Niger Progress in primary enrolment has stagnated in recent years Primary school adjusted net enrolment rate (%) and out-of-school population of primary school age (millions) in by sex, -12 Adjusted net enrolment rate (%) 1 9 8 7 5 3 1 Out-of-school girls of primary school age Out-of-school boys of primary school age Adjusted primary net enrolment rate for girls Adjusted primary net enrolment rate for boys Adjusted primary net enrolment rate total Progress needed to achieve the MDG target 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 1 9 8 7 5 3 1 Out-of-school population of primary school age (millions) Source for all charts: UNICEF global databases 14, based on DHS, MICS, and other national surveys; UNESCO Institute for Statistics databases 14; Education for All Global Monitoring Report 13/14.
Drinking Water and Sanitation in The population with access to an improved drinking water source in more than doubled, from 351 million in 199 to 746 million in 12 Improved drinking water coverage, n countries, 12 (%) 9 Gambia 1 Mauritius 97 Botswana 89 Cabo Verde 87 Ghana 82 Burkina Faso 8 Côte d'ivoire 76 Benin 75 Guinea 75 Liberia 74 Senegal 74 Guinea-Bissau 67 Mali 64 Nigeria 61 Togo 96 Seychelles 92 Djibouti 75 Uganda 71 Rwanda 62 Kenya 57 South Sudan 55 Sudan 53 Tanzania 52 Ethiopia 5 Madagas car ND Comoros ND Eritrea 95 South 92 Namibia 85 Malawi 81 Lesotho 8 Zimbabwe 74 Swaziland 63 Zambia 54 Angola 49 Mozambique 97 Sao Tome and Principe 92 Gabon 75 Congo 75 Burundi 74 Cameroon 68 51 Chad 46 n Republic Democratic Republic of the Congo ND Equatorial Guinea 99 Egypt 97 Tunisia 84 Algeria 84 Morocco 5 Mauritania ND Libya Drinking water coverage in increased from 56% in 199 to 69% in 12. This rate of progress is not sufficient to meet the continent s MDG drinking water target of 78% by 15. Just over a quarter (27%) of the n population enjoys the convenience and associated health benefits of a piped drinking water supply on premises. The population without access to an improved drinking water source increased from 279 million in 199 to 3 million in 12. Sierra Leone ND Somalia 52 Niger ND = No data In only 39% of the population uses an improved sanitation facility; the population without access grew by 239 million despite 214 million people gaining access since 199 Sanitation coverage trends in, by sub-region (bars) and by area of residence (area), 199-12 (Coverage %) 1 8 26 24 15 25 23 32 49 71 9 199 12 34 39 Open defecation rates in declined most from 45% in 199 to 27% in 12. and made the least progress on sanitation. In 18% of the population still practices open defecation. (Millions) (Millions) Urban 29 15 112 229 199 12 186 Rural 99 196 199 12 Improved facilities Shared facilities Unimproved facilities Open defecation 5 Malawi, Angola, Ethiopia and Benin registered declines in open defecation rates of 25 percentage points or more since 199. Sierra Leone, Sudan and Tanzania registered an increase in open defecation rates. Source for all charts: WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP)