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World Bank and Child Survival: The Facts


Though child deaths have declined, progress toward Millennium Development Goal 4 -- to reduce by 2/3 the under-5 mortality rate -- is lagging.

  • Child deaths have been halved over the last few decades thanks to better nutrition, health care, and standards of living.
  • In 1990, 13 million children in developing countries died before the age of 5 from diseases such as diarrhea, malnutrition, pneumonia, AIDS, malaria, and tuberculosis. By 2006, that number had dropped to 10 million.
  • Despite progress, under-5 mortality rates remain unacceptably high: 8 million under-5 children die a year from preventable causes. Sub-Saharan Africa accounts for about half of those deaths, with the HIV/AIDS epidemic and civil conflicts hampering the region’s progress.
  • Over half of MDG countries are not on track to achieve the under-5 mortality target.

The World Bank is committed to saving children’s lives.

  • Strengthening national health systems is at the center of the World Bank’s strategy to ensure children survive and lead healthy, productive lives. The Bank also focuses on linking financing to performance in improving children’s health; working across sectors, including girls’ education, and water/sanitation; and protecting the poor from ill health and unaffordable costs and treatment.
  • Twenty grants from the World Bank’s multi-donor Health Results Innovation Trust Fund (HRITF), totaling $209 million, are leveraging just over $363 million in International Development Association (IDA) assistance for programs including immunization, contraception, antenatal care, skilled attendance at birth, postnatal care, and growth monitoring.
  • Under its five-year Reproductive Health Action Plan (2010-15), the Bank is helping 57 low-income countries with high maternal death and fertility rates improve reproductive health services and help ensure that women and children survive. Bank projects work to increase access to family planning services, increase skilled attendance at births and train health care workers.
  • The Bank is a member of the Partnership for Maternal, Newborn & Child Health (PMNCH) to accelerate global efforts toward achieving MDGs 4 and 5.


The Bank has made important contributions toward achieving MDG 4.

  • From 2000 to 2011, investments by the International Development Association, the Bank’s fund for the poorest, provided 343 million children with immunizations; 124 million children with vitamin A supplements; 55 million pregnant women with antenatal care; and antiretroviral therapies to 1.5 million adults and children with HIV.
  • In Rwanda, incentives for increasing the quantity and quality of health facility services led to a 21% increase in institutional deliveries, 64% increase in preventive visits for children under age 2, and 133% increase in visits for children ages 2-5. In addition, bed net use among children under age 5 and pregnant women increased from 13-17% in 2005 to 70-72% in 2010.
  • In Tanzania, as a result of a health basket fund and other projects, infant mortality fell by nearly half from 1999 to 2010. Under-five mortality dropped from 146 deaths per 1,000 live births to 81 per 1,000 live births. The country is on track to meet MDG 4.
  • In Afghanistan, from 2002 to 2010, the government reduced the death rate of children and infants from 257 and 165 to 97 and 77 per 1000 live births, respectively. Performance on quality of care of all government-contracted health facilities increased by 32% from 2004 to 2007.
  • In Argentina, Plan Nacer has provided basic health insurance to nearly 1.5 million previously uninsured pregnant women and children. The program increased the probability of a first prenatal care visit before week 13 of pregnancy by 8.5% and before week 20 of pregnancy by 18%. Infant mortality has fallen 20 percent since 2002, particularly in the poorest provinces.

Updated June 13, 2012

Last updated: 2012-06-14

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