Monitoring development indicators has become a central interest of international agencies and countries for tracking progress towards the Millennium Development Goals. In this review, which also provides an introduction to a collection of articles, we describe the methodology used by the United Nations Inter-agency Group for Child Mortality Estimation to track country-specific changes in the key indicator for Millennium Development Goal 4 (MDG 4), the decline of the under-five mortality rate (the probability of dying between birth and age five, also denoted in the literature as U5MR and 5q0). We review how relevant data from civil registration, sample registration, population censuses, and household surveys are compiled and assessed for United Nations member states, and how time series regression models are fitted to all points of acceptable quality to establish the trends in U5MR from which infant and neonatal mortality rates are generally derived. The application of this methodology indicates that, between 1990 and 2010, the global U5MR fell from 88 to 57 deaths per 1,000 live births, and the annual number of under-five deaths fell from 12.0 to 7.6 million. Although the annual rate of reduction in the U5MR accelerated from 1.9% for the period 1990–2000 to 2.5% for the period 2000–2010, it remains well below the 4.4% annual rate of reduction required to achieve the MDG 4 goal of a two-thirds reduction in U5MR from its 1990 value by 2015. Thus, despite progress in reducing child mortality worldwide, and an encouraging increase in the pace of decline over the last two decades, MDG 4 will not be met without greatly increasing efforts to reduce child deaths.

IntroductionUnder-five mortality rate (U5MR) and maternal mortality rate (MMR) are important indicators for evaluating the quality of perinatal health and child health services in a country or region, and are research priorities for promoting maternal and infant safety and maternal and child health. This paper aimed to analysis and predict the trends of U5MR and MMR in China, to explore the impact of social health services and economic factors on U5MR and MMR, and to provide a basis for relevant departments to formulate relevant policies and measures.MethodsThe JoinPoint regression model was established to conduct time trend analysis and describe the trend of neonatal mortality rate (NMR), infant mortality rate (IMR), U5MR and MMR in China from 1991 to 2020. The linear mixed effect model was used to assess the fixed effects of maternal health care services and socioeconomic factors on U5MR and MMR were explored, with year as a random effect to minimize the effect of collinearity. Auto regressive integrated moving average models (ARIMA) were built to predict U5MR and MMR from 2021 to 2025.ResultsThe NMR, IMR, U5MR and MMR from 1991 to 2020 in China among national, urban and rural areas showed continuous downward trends. The NMR, IMR, U5MR and MMR were significantly negatively correlated with gross domestic product (GDP), the proportion of the total health expenditure (THE) to GDP, system management rate, prenatal care rate, post-natal visit rate and hospital delivery rate. The predicted values of national U5MR from 2021 to 2025 were 7.3 ‰, 7.2 ‰, 7.1 ‰, 7.1 ‰ and 7.2 ‰ and the predicted values of national MMR were 13.8/100000, 12.1/100000, 10.6/100000, 9.6/100000 and 8.3/100000.ConclusionChina has made great achievements in reducing the U5MR and MMR. It is necessary for achieving the goals of Healthy China 2030 by promoting the equalization of basic public health services and further optimizing the allocation of government health resources. China’s experience in reducing U5MR and MMR can be used as a reference for developing countries to realize the SDGs.

Under five mortality rate (U5MR) of Mtwara Region decreased by 1.89% from 175 deaths per 1000 population in 2012 to 171 deaths per 1000 population in 2013. Since the 8.56% slump in 2004, under five mortality rate (U5MR) plummeted by 21.40% in 2013.

UNICEF's country profile for Australia, including under-five mortality rates, child health, education and sanitation data.

149 (deaths per 1000 population) in 2013.

116 (deaths per 1000 population) in 2013.

131 (deaths per 1000 population) in 2013.

UNICEF's country profile for Indonesia, including under-five mortality rates, child health, education and sanitation data.

UNICEF's country profile for Nepal, including under-five mortality rates, child health, education and sanitation data.

UNICEF's country profile for Ethiopia, including under-five mortality rates, child health, education and sanitation data.

UNICEF's country profile for China, including under-five mortality rates, child health, education and sanitation data.

160 (deaths per 1000 population) в 2013.

113 (deaths per 1000 population) in 2013.

83 (deaths per 1000 population) in 2013.

126 (deaths per 1000 population) in 2013.

88 (deaths per 1000 population) in 2013.

164 (deaths per 1000 population) in 2013.

96 (deaths per 1000 population) in 2013.

UNICEF's country profile for Madagascar, including under-five mortality rates, child health, education and sanitation data.

Methods for estimating pneumonia child mortality in all countries (U5MR: under five mortality rate, GNI PPP: gross national income per capita at purchasing power parity, VR: vital registration, HIV ANC: index score for HIV prevalence based on the antenatal care surveillance; China U5MR in 2008 was 20.5/1000lb, however it was included in the Verbal autopsy model given that this country's profile is closer to the one of the high mortality countries and its GNI PPP was