Under-five deaths (millions)Region 1970 1975 1980 1985 1990 1995 2000 2005 2007 2008 2009Africa 3.6 3.6 3.8 4.0 4.2 4.4 4.4 4.2 4.2 4.1 4.1Sub-Saharan Africa 2.9 3.0 3.3 3.6 3.9 4.2 4.2 4.1 4.1 4.0 4.0Eastern and Southern Africa 1.3 1.3 1.4 1.5 1.7 1.7 1.7 1.6 1.6 1.5 1.5West and Central Africa 1.6 1.6 1.8 1.9 2.1 2.3 2.4 2.4 2.4 2.3 2.3Middle East and North Africa 1.3 1.2 1.1 0.9 0.8 0.6 0.5 0.4 0.4 0.4 0.4Asia 10.4 8.8 7.5 7.2 6.8 5.9 4.9 4.0 3.7 3.6 3.4South Asia 5.3 5.2 5.2 4.9 4.6 4.3 3.6 3.1 2.9 2.7 2.6East Asia and Pacific 5.0 3.5 2.3 2.2 2.2 1.6 1.3 0.9 0.9 0.8 0.8Latin America and Caribbean 1.2 1.1 0.9 0.8 0.6 0.5 0.4 0.3 0.3 0.3 0.2CEE/CIS 0.6 0.6 0.5 0.5 0.4 0.3 0.2 0.2 0.1 0.1 0.1Industrialized countries 0.3 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1Developing countries 15.9 14.3 13.0 12.6 12.2 11.2 10.0 8.9 8.4 8.2 8.0Least developed countries 3.3 3.5 3.6 3.6 3.7 3.8 3.6 3.5 3.4 3.4 3.3World 16.3 14.8 13.4 12.9 12.4 11.4 10.2 9.0 8.5 8.3 8.1Country-specific mortality indicators for 1970–2009, basedon the most recent IGME estimates, are presented in Table10 (for the years 1970, 1990, 2000 and 2009) and are alsoavailable at and , the IGME website.Multiple Indicator Cluster Surveys: For more than adecade, UNICEF has supported countries in collectingstatistically sound and internationally comparable datathrough MICS. Since 1995, nearly 200 surveys have beenconducted in approximately 100 countries and territories.The third round of MICS was conducted in more than 50countries during 2005–2006, allowing for a new and morecomprehensive assessment of the situation of children andwomen globally. The fourth round of surveys is now underway and will run until 2011. The UNICEF-supported MICSare among the largest sources of data for monitoringprogress towards internationally agreed developmentgoals for children, including the Millennium DevelopmentGoals (MDGs). Many of the MICS indicators have beenincorporated into the statistical tables appearing in thisreport. More information on these data is available at.Regional Classification: In the 2009 edition of TheState of the World’s Children, UNICEF added two newregional groupings: Africa and Asia. In addition, thenumber of countries classified in the sub-Saharan Africaregion increased with the inclusion of Djibouti and theSudan. As a result, regional estimates for sub-SaharanAfrica published in previous issues of The State of theWorld’s Children may not be comparable with thosepublished in this issue. All other regions remainunchanged.For details of the countries included in all UNICEFregions, please refer to the UNICEF RegionalClassification, page 124.Revisions to Statistical TablesTable 1. Basic Indicators:Neonatal mortality rates: The neonatal mortality ratespresented in this report were produced by WHO and areconsistent with the under-five mortality rates. Bothindicators are for the year 2009.Table 2. Nutrition:Underweight, stunting and wasting: Prevalence ofunderweight, stunting and wasting among childrenunder 5 years of age is estimated by comparing actualmeasurements with an international standard referencepopulation. In April 2006, WHO released the WHO ChildGrowth Standards to replace the widely used NationalCenter for Health Statistics/World Health Organization(NCHS/WHO) reference population, which was based ona limited sample of children from the United States. Thenew standards are the result of an intensive study projectinvolving more than 8,000 children from Brazil, Ghana,India, Norway, Oman and the United States.Overcoming the technical and biological drawbacks of theold reference population, the new standards confirm thatchildren born anywhere in the world and given the optimumstart in life have the potential to develop to withinthe same range of height and weight. Differences in children’sgrowth to age 5 are more influenced by nutrition,feeding practices, environment and health care thangenetics or ethnicity.84THE STATE OF THE WORLD’S CHILDREN 2011
In this report, all of the child anthropometry indicators arereported according to the WHO Child Growth Standards.An additional column displays underweight prevalence(moderate and severe) based on the NCHS/WHO standard.Owing to the differences between the old reference populationand the new standards, prevalence estimates ofchild anthropometry indicators published in consecutiveeditions of The State of the World’s Children may not befully comparable.Vitamin A supplementation: Only full coverage (twodoses) of vitamin A supplementation is presented inthis report, emphasizing the importance for childrenof receiving two annual doses of vitamin A, spaced4–6 months apart. In the absence of a direct methodto measure this indicator, full coverage is reported asthe lower coverage estimate from rounds 1 and 2 in agiven year.Table 3. Health:Water and Sanitation: The drinking water and sanitationcoverage estimates in this report come from theWHO/UNICEF Joint Monitoring Programme for WaterSupply and Sanitation (JMP). These are the official UnitedNations estimates for measuring progress towards theMDG target for drinking water and sanitation, and they arebased on a standard classification of what constitutescoverage. JMP estimates coverage using a linearregression line that is fitted to coverage data from allavailable household sample surveys and censuses. Fulldetails of the JMP methodology and country estimates canbe found at and .Table 4. HIV and AIDS:In 2010, the Joint United Nations Programme on HIV/AIDS(UNAIDS) released new global HIV and AIDS estimatesfor 2009 that reflect more reliable data available frompopulation-based surveys, expanded national sentinelsurveillance systems and programme service statisticsin a number of countries. As a result, UNAIDS hasretrospectively generated new estimates for HIVprevalence, the number of people living with HIV andthe number of children whose parents have died dueto all causes or AIDS for past years based on the refinedmethodology.Figures published in this report are not comparable to previousestimates and therefore do not reflect trends overtime. UNAIDS has published comparable estimates by applyingthe new methods to earlier HIV and AIDS estimates;these data can be accessed at . In additionto presenting the HIV prevalence among young malesand females aged 15–24, this year’s table presents the totalHIV prevalence among young people aged 15–24.Table 5. Education:Survival rate to the last grade of primary school: Thesurvival rate to Grade 5 (percentage of primary schoolentrants reaching Grade 5) was replaced in 2008 by thesurvival rate to the last grade of primary school (percentageof children entering the first grade of primary schoolwho are expected to reach the last grade). The survival rateto the last grade became an official indicator for MDG 2(Universal Primary Education) in January 2008.Table 6. Demographic Indicators:Population annual growth rate and average annual growthrate of urban population: These indicators have beenfurther disaggregated to include data for 1990–2000.Table 7. Economic Indicators:Proportion of the population living below US$1.25 per day:In 2008, the World Bank announced a new poverty line thatis based on revised estimates of purchasing power parity(PPP) price levels around the world. Table 7 reflects thisupdated poverty line and reports on the proportion of thepopulation living below US$1.25 per day at 2005 prices,adjusted for PPP. The new poverty threshold reflectsrevisions to PPP exchange rates based on the results ofthe 2005 International Comparison Program. The revisionsreveal that the cost of living is higher across the developingworld than previously estimated. As a result of theserevisions, poverty rates for individual countries cannot becompared with poverty rates reported in previous editions.More detailed information on the definition, methodologyand sources is available at .Table 8. Women: Delivery care coverage: For the first time,the table includes Caesarean section (C-section) as part ofthe indicator on delivery care coverage. C-section is anessential part of comprehensive emergency obstetric care.Maternal mortality ratio (adjusted): The table presents thenew ‘adjusted’ maternal mortality ratios for the year 2008.The new ‘adjusted’ maternal mortality estimates wereproduced by the Maternal Mortality Estimation Inter-agencyGroup (MMEIG), which is composed of WHO, UNICEF, theUnited Nations Population Fund (UNFPA) and the WorldBank, together with independent technical experts. Theinter-agency group has used a dual approach in derivingestimates of maternal mortality, which involves makingadjustments to existing estimates of maternal mortality fromcivil registration systems to correct for misclassification andunder-reporting, and generating model-based estimates forcountries that do not have reliable national-level estimates ofmaternal mortality from civil registration systems.These ‘adjusted’ estimates should not be compared toprevious inter-agency estimates, as the methodologicalSTATISTICAL TABLES 85
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AcknowledgementsThis report was pro
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THE STATE OF THE WORLD’S CHILDREN
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GLobal challenges for adolescents 1
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HALLENGES ANDRealizing the rights o
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FOCUS ONDemographic trends for adol
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country are particularly serious, g
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Gathering accurate data on adolesce
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sexes, there is still a considerabl
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PERSPECTIVEFacing the challenge:Rep
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FOCUS ONInequality in childhood and
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ADOLESCENT VOICESAct responsibly:Nu
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TABLE 12. EQUITYCountries andterrit
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TABLE 12. EQUITYBirth registration
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AcronymsAIDSCEDAWDHSFGM/CGDPHIVIUCW
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