In a comprehensive new analysis, researchers have charted the global trajectory of child mortality rates, revealing a pressing gap between current progress and the United Nations Sustainable Development Goal (SDG) 3.2 target for under-five mortality reduction. Despite significant advancements over past decades, the world remains on course to miss the critical 2030 deadline by at least five years, with stark regional disparities pointing to urgent public health challenges, particularly in Sub-Saharan Africa.
The study, conducted by Min Liu and colleagues at Peking University and published in the open-access journal PLOS One, harnesses decades of mortality data across 200 countries and territories, spanning from 1990 to 2023. By meticulously analyzing these trends, the researchers quantified annual under-five death rates and projected future trajectories, offering a robust forecast of when nations might achieve or fail the ambitious SDG child mortality benchmarks.
The United Nations’ SDG 3.2 explicitly targets reducing the mortality rate for children under five to fewer than 25 deaths per 1,000 live births by 2030. This goal embodies a global commitment to improving child survival through enhanced healthcare access, nutrition, and preventive measures. Yet, as the 2030 horizon nears, comprehensive assessments of global readiness to meet this target have been sparse — a gap this study strives to fill with empirical rigor.
Findings indicate a dramatic 63% reduction in global under-five deaths over the last three decades, from nearly 13 million deaths in 1990 down to approximately 4.78 million in 2023. This decline corresponds to an average annual mortality rate reduction of 3.18%, signaling sustained progress. Nevertheless, the current average global mortality rate remains at 36.72 deaths per 1,000 live births — significantly exceeding the SDG target and demonstrating that much ground remains to be covered.
Crucially, the study’s projections forecast that at the current rate of improvement, the global under-five mortality rate will not dip below the SDG threshold until about 2035, five years past the designated deadline. While 133 countries have already attained the goal, and an additional nine are deemed on track to meet it by 2030, 58 countries face grim prospects of missing this watershed moment. Among these, 25 will likely fail to reach the target until after 2050, while Dominica has registered an alarming increase in under-five deaths.
Geographic inequalities are profoundly pronounced. More than 80% of all under-five deaths worldwide are concentrated in just two regions: Sub-Saharan Africa and Central and Southern Asia. Sub-Saharan Africa remains the most afflicted, with under-five mortality rates still approximately 68.82 deaths per 1,000 live births. The projections suggest this region will not reach the SDG target until well into 2055, underscoring deep systemic health care and socioeconomic disparities that impede child survival.
The researchers emphasize caution regarding data limitations, especially from conflict-affected zones and some low-income countries, where data quality is often hampered. These limitations may obscure the true scale of child mortality challenges but also affirm the critical necessity for improved health information systems and surveillance to better target interventions.
To bridge the gap between current trends and global goals, the authors advocate for a strategic scaling up of proven interventions. These include expanding skilled birth attendance, enhancing postnatal care, strengthening immunization coverage, improving childhood nutrition, and ensuring access to effective treatments for common infectious diseases such as pneumonia and diarrhea. Such community-centric, evidence-based programs are vital to accelerating mortality declines, particularly in regions burdened by poverty and limited health infrastructure.
Beyond healthcare delivery, the study highlights the need for integrated policy responses that address broader determinants of child health, including maternal education, sanitation, and poverty alleviation. Addressing the social and economic roots of child mortality is essential for unlocking lasting improvements and achieving equity in child survival globally.
The findings of this extensive research underline a sobering reality: despite historical gains, significant efforts remain necessary to meet international child mortality targets within the stipulated timeframe. Without intensified global and local action, millions of children will continue to die unnecessarily, deepening inequities between regions and nations.
This study provides a critical evidence base for policymakers, international agencies, and health practitioners, outlining where intensified focus is required and offering a clear timeline for achievable progress. It underscores the urgency of sustained investments in health systems and community interventions to safeguard the lives and futures of the world’s most vulnerable population segment — children under five.
As global development agendas evolve, integrating these insights will be pivotal in refining strategies aimed at child survival, bolstering accountability, and galvanizing multisectoral partnerships that transcend health to embrace education, nutrition, and economic development.
The research also serves as a clarion call for international solidarity and innovation in public health, emphasizing that accelerated progress hinges on harnessing scientific advances, technological solutions, and collaborative frameworks to surmount entrenched obstacles to child survival.
Ultimately, this comprehensive tracking of under-five mortality trends underscores the imperative to reaffirm global commitments and reshape health priorities to achieve measurable, equitable, and sustainable reductions in child mortality by and beyond 2030.
Subject of Research: People
Article Title: Tracking under-five mortality from 1990 to 2023: Global, regional, and national trends, inequities, and projections toward achieving SDG Target 3.2 by 2030
News Publication Date: 1-Apr-2026
References: Cao G, Liu J, Liu M (2026) Tracking under-five mortality from 1990 to 2023: Global, regional, and national trends, inequities, and projections toward achieving SDG Target 3.2 by 2030. PLoS One 21(4): e0343745. DOI: 10.1371/journal.pone.0343745
Image Credits: Cao et al., 2026, PLOS One, CC-BY 4.0
Keywords: Sustainable development, Child welfare, Social welfare, Public health, Under-five mortality, Global health, SDG 3.2, Health disparities, Sub-Saharan Africa, Child survival, Mortality reduction Targets
