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Journal article
Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
The Lancet (British edition), Vol.388(10053), pp.1725-1774
2016
PMCID: PMC5224696
PMID: 27733285
Abstract
Background
Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time.
Methods
Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).
Findings
Globally, 5·8 million (95% uncertainty interval [UI] 5·7–6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7–53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3–43·6) to 2·6 million (2·6–2·7) neonatal deaths and 47·0% (35·1–57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6–3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone.
Interpretation
Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030.
Details
- Title
- Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
- Authors/Creators
- Haidong Wang - University of WashingtonZulfiqar A. Bhutta - Aga Khan Univ, Ctr Excellence Women & Child Hlth, Karachi, PakistanMatthew M. Coates - University of WashingtonMegan Coggeshall - University of WashingtonLalit Dandona - University of WashingtonKhassoum Diallo - WHO Reg Off Europe, Copenhagen, DenmarkElisabeth Barboza Franca - Univ Fed Minas Gerais, Belo Horizonte, MG, BrazilMaya Fraser - University of WashingtonNancy Fullman - University of WashingtonPeter W. Gething - University of OxfordSimon I. Hay - University of WashingtonYohannes Kinfu - University of CanberraMaaya Kita - The University of TokyoXie Rachel Kulikoff - University of WashingtonHeidi J. Larson - University of WashingtonJuan Liang - Sichuan UniversityXiaofeng Liang - Chinese Ctr Dis Control & Prevent, Beijing, Peoples R ChinaStephen S. Lim - University of WashingtonMargaret Lind - University of WashingtonAlan D. Lopez - University of WashingtonRafael Lozano - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoGeorge A. Mensah - NHLBI, Ctr Translat Res & Implementat Sci, NIH, Bldg 10, Bethesda, MD 20892 USAJoseph B. Mikesell - University of WashingtonAli H. Mokdad - University of WashingtonMeghan D. Mooney - University of WashingtonMohsen Naghavi - University of WashingtonGrant Nguyen - University of WashingtonIvo Rakovac - WHO Reg Off Europe, Copenhagen, DenmarkJoshua A. Salomon - Harvard UniversityNaris Silpakit - University of WashingtonAmber Sligar - University of WashingtonReed J. D. Sorensen - University of WashingtonTheo Vos - University of WashingtonJun Zhu - Natl Off MCH Surveillance China, Chengdu, Sichuan, Peoples R ChinaAmanuel Alemu Abajobir - Univ Queensland, Sch Publ Hlth, Brisbane, Qld, AustraliaKalkidan Hassen Abate - Jimma UniversityKaja M. Abbas - Virginia TechFoad Abd-Allah - Cairo UniversityAbdishakur M. Abdulle - New York University Abu DhabiSemaw Ferede Abera - Mekelle UniversityVictor Aboyans - Dupuytren Univ Hosp, Limoges, FranceBiju Abraham - NMSM Govt Coll Kalpetta, Kalpetta, Kerala, IndiaIbrahim Abubakar - UCL, Inst Global Hlth, London, EnglandLaith J. Abu-Raddad - College Station Medical CenterNiveen M. E. Abu-Rmeileh - Birzeit UniversityGebre Yitayih Abyu - Mekelle UniversityTom Achoki - University of WashingtonAkindele Olupelumi Adebiyi - University of IbadanIsaac Akinkunmi Adedeji - Olabisi Onabanjo UniversityAdemola Lukman Adelekan - University of IbadanArsene Kouablan Adou - Assoc Ivoirienne Bien Etre Familial, Abidjan, Cote IvoireArnav Agarwal - University of TorontoOluremi N. Ajala - Harvard UniversityTomi F. Akinyemiju - University of AlabamaNadia Akseer - Sick (Germany)Khurshid Alam - The University of MelbourneNoore K. M. Alam - Queensland Hlth, Herston, Qld, AustraliaDeena Alasfoor - Minist Hlth, Al Khuwair, OmanRobert William Aldridge - UCL, Ctr Publ Hlth Data Sci, Inst Hlth Informat, London, EnglandMiguel Angel Alegretti - College Station Medical CenterZewdie Aderaw Alemu - Debre Markos UniversityRaghib Ali - University of OxfordAla'a Alkerwi - Luxembourg Inst Hlth, Strassen, LuxembourgFrancois Alla - Université de LorraineRajaa Al-Raddadi - Minist Hlth, Jeddah, Saudi ArabiaUbai Alsharif - Charite, Berlin, GermanyKhalid A. Altirkawi - King Saud UniversityElena Alvarez Martin - Minist Hlth Social Policy & Equal, Govt Delegat Natl Plan Drugs, Spanish Observ Drugs, Madrid, SpainNelson Alvis-Guzman - University of CartagenaAzmeraw T. Amare - Univ Adelaide, Sch Med, Adelaide, SA, AustraliaAlemayehu Amberbir - Dignitas Int, Zomba, MalawiAdeladza Kofi Amegah - University of Cape CoastEmmanuel A. Ameh - Natl Hosp, Abuja, NigeriaWalid Ammar - Minist Publ Hlth, Beirut, LebanonStephen Marc Amrock - University of PortlandHjalte H. Andersen - Aalborg UniversityGregory M. Anderson - University of WashingtonCarl Abelardo T. Antonio - University of the Philippines ManilaJohan ArlovAl Artaman - University of ManitobaHamid Asayesh - Supreme Council Of HealthRana Jawad Asghar - Forum (United States)Reza Assadi - College Station Medical CenterSuleman Atique - College Station Medical CenterEuripide Frinel G. Arthur Avokpaho - Inst Rech Clin Benin, Cotonou, BeninAshish Awasthi - College Station Medical CenterBeatriz Paulina Ayala Quintanilla - La Trobe UniversityUmar Bacha - Supreme Council Of HealthAlaa Badawi - University of TorontoKalpana Balakrishnan - SRIAmitava Banerjee - Farr InstituteBolanle F. Banigbe - AIDS Prevent Initiat Nigeria, Abuja, NigeriaAleksandra Barac - University of BelgradeRyan M. Barber - University of WashingtonSuzanne L. Barker-Collo - University of AucklandTill Barnighausen - Harvard UniversityLope H. Barrero - Supreme Council Of HealthTigist Assefa Bayou - Mekelle UniversityYibeltal Tebekaw Bayou - Jhpiego Ethiopia, Addis Ababa, EthiopiaShahrzad Bazargan-Hejazi - Drew UniversityJustin Beardsley - University of OxfordNeeraj Bedi - College Station Medical CenterTolesa Bekele - Madda Walabu UniversityMichelle L. Bell - University of New HavenAminu K. Bello - University of AlbertaDerrick A. Bennett - University of OxfordIsabela M. Bensenor - University of Sao PauloAdugnaw Berhane - Debre Berhane Univ, Debre Berhan, EthiopiaEduardo Bernabe - Kings Coll London, London, EnglandBalem Demtsu Betsu - Mekelle UniversityAddisu Shunu Beyene - Haramaya UniversitySamir Bhatt - Imperial Coll London, London, EnglandSibhatu Biadgilign - Independent Publ Hlth Consultants, Addis Ababa, EthiopiaBoris Bikbov - Acad VI Shumakov Fed Res Ctr Transplantol & Arti, Dept Nephrol Issues Transplanted Kidney, Moscow, RussiaSait Mentes Birlik - GBS CIDP Int Fdn, Menemen, TurkeyDonal Bisanzio - University of OxfordEspen Bjertness - University of OsloJed D. Blore - University of WashingtonRupert R. A. Bourne - Anglia Ruskin UniversityMichael Brainin - Universität für Weiterbildung KremsAlexandra Brazinova - Trnava Univ, Fac Hlth Sci & Social Work, Dept Publ Hlth, Trnava, SlovakiaNicholas J. K. Breitborde - The Ohio State UniversityAlexandria Brown - University of WashingtonGeoff Rey Colin Buckle - Univ Calif San Francisco, San Francisco, CA 94143 USAMichael Burch - Ormond (United States)Zahid A. Butt - Al Shifa Trust Eye Hosp, Rawalpindi, PakistanIsmael Ricardo Campos-Nonato - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoJulio Cesar Campuzano - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoRosario Cardenas - Metropolitan Autonomous Univ, Mexico City, DF, MexicoDavid O. Carpenter - Univ Albany, Rensselaer, NY USAJuan Jesus Carrero - Karolinska InstitutetAustin Carter - University of WashingtonDaniel C. Casey - University of WashingtonCarlos A. Castaneda-Orjuela - Colombian Natl Hlth Observ, Inst Nacl Salud, Bogota, ColombiaJacqueline Castillo Rivas - Caja Costarricense Seguro Social, San Jose, Costa RicaRuben Estanislao Castro - Univ Diego Port, Santiago, ChileFerran Catala-Lopez - Universitat de ValènciaKelly Cercy - University of WashingtonHsing-Yi Chang - Natl Hlth Res Inst, Zhunan Town, TaiwanJung-Chen Chang - Supreme Council Of HealthChioma Ezinne Chibueze - Natl Ctr Child Hlth & Dev, Tokyo, JapanVesper Hichilombwe Chisumpa - University of ZambiaJee-Young Jasmine Choi - College Station Medical CenterRajiv Chowdhury - University of CambridgeDevasahayam Jesudas Christopher - College Station Medical CenterLiliana G. Ciobanu - Univ Adelaide, Adelaide, SA, AustraliaSamantha M. Colquhoun - The University of MelbourneCyrus Cooper - University of OxfordLeslie Cornaby - University of WashingtonSolomon Abrha Damtew - Wolaita Sodo UniversityHadi Danawi - Walden UniversityRakhi Dandona - Publ Hlth Fdn India, New Delhi, IndiaJose das Neves - Universidade do PortoAdrian C. Davis - Publ Hlth England, London, EnglandPieter de Jager - University of the WitwatersrandDiego De Leo - Griffith Univ, Brisbane, Qld, AustraliaLouisa Degenhardt - Univ New South Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW, AustraliaKebede Deribe - Supreme Council Of HealthAmare Deribew - University of OxfordDon C. Des Jarlais - Mt Sinai Beth Israel, New York, NY USAGabrielle A. deVeber - Sick (Germany)Samath D. Dharmaratne - University of PeradeniyaPreet K. Dhillon - Publ Hlth Fdn India, Gurgaon, IndiaEric L. Ding - Harvard UniversityPratik Pinal Doshi - Univ Southern Calif, Los Angeles, CA USAKerrie E. Doyle - RMIT Univ, Bundoora, Vic, AustraliaLeilei Duan - Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R ChinaManisha Dubey - Int Inst Populat Sci, Mumbai, Maharashtra, IndiaHedyeh Ebrahimi - University of TehranChristian Lycke Ellingsen - Norwegian Inst Publ Hlth, Oslo, NorwayIqbal Elyazar - Eijkman Oxford Clin Res Unit, Jakarta, IndonesiaAman Yesuf Endries - Arba Minch UniversitySergey Petrovich Ermakov - Russian Acad Sci, Inst Social & Econ Studies Populat, Moscow, RussiaBabak Eshrati - College Station Medical CenterAlireza Esteghamati - University of TehranEmerito Jose Aquino Faraon - University of the Philippines ManilaTalha A. Farid - University of LouisvilleCarla Sofia e Sa Farinha - DGS Directorate Gen Hlth, Lisbon, PortugalAndre Faro - Univ Fed Sergipe, Sergipe, BrazilMaryam S. Farvid - Harvard UniversityFarshad Farzadfar - University of TehranSeyed-Mohammad Fereshtehnejad - Karolinska InstitutetJoao C. Fernandes - Queen Mary University of LondonFlorian Fischer - Bielefeld UniversityJoseph R. A. Fitchett - Harvard UniversityNataliya Foigt - College Station Medical CenterRichard C. Franklin - James Cook UniversityJoseph Friedman - University of WashingtonThomas Furst - Imperial Coll London, Dept Infect Dis Epidemiol, London, EnglandKetevan Gambashidze - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaAmiran Gamkrelidze - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaParthasarathi Ganguly - Publ Hlth Fdn India, Gurgaon, IndiaTeshome Gebre - Task Force Global Hlth, Decatur, GA USATsegaye Tewelde Gebrehiwot - Jimma UniversityAmanuel Tesfay Gebremedhin - Jimma UniversityAlemseged Aregay Gebru - Mekelle UniversityJohanna M. Geleijnse - Wageningen Univ, Div Human Nutr, Wageningen, NetherlandsBradford D. Gessner - College Station Medical CenterIbrahim Abdelmageem Mohamed Ginawi - University of Ha'ilAbabi Zergaw Giref - Univ Addis Ababa, Addis Ababa, EthiopiaMelkamu Dedefo Gishu - Haramaya UniversityHector Gomez-Dantes - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoPhilimon Gona - University of Massachusetts BostonAmador Goodridge - CIUDADSameer Vali Gopalani - Natl Canc Ctr, Dept Hlth & Social Affairs, Govt Federated States Micronesia Palikir Federate, Tokyo, JapanAtsushi Goto - Natl Canc Ctr, Div Epidemiol, Ctr Publ Hlth Sci, Tokyo, JapanHebe N. Gouda - Univ Queensland, Brisbane, Qld, AustraliaHarish Chander Gugnani - Supreme Council Of HealthYuming Guo - The University of QueenslandRahul GuptaRajeev GuptaVipin Gupta - University of DelhiBishal Gyawali - Aarhus Univ, Aarhus, DenmarkJuanita A. Haagsma - University of WashingtonNima Hafezi-Nejad - University of TehranDemewoz Haile - Univ Addis Ababa, Addis Ababa, EthiopiaAlemayehu Desalegne Hailu - Supreme Council Of HealthGessessew Bugssa Hailu - Mekelle UniversityRandah Ribhi Hamadeh - Arabian Gulf UniversitySamer Hamidi - Hamdan Bin Mohammed Smart UniversityJamie Hancock - University of WashingtonAlexis J. Handal - Univ New Mexico, Albuquerque, NM 87131 USAGraeme J. Hankey - Univ Western Australia, Sch Med & Pharmacol, Perth, WA, AustraliaHilda L. Harb - Minist Publ Hlth, Beirut, LebanonSivadasanpillai Harikrishnan - College Station Medical CenterKimani M. Harun - University of Washington, SeattleRasmus Havmoeller - Karolinska InstitutetRoderick J. Hay - Kings Coll London, London, EnglandIleana Beatriz Heredia-Pi - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoHans W. Hoek - University of GroningenMasako Horino - Dept Hlth & Human Serv, Nevada Div Publ & Behav Hlth, Carson City, NV USANobuyuki Horita - Yokohama City UniversityH. Dean Hosgood - The Bronx DefendersPeter J. Hotez - College Station Medical CenterDamian G. Hoy - Pacific Community, Publ Hlth Div, Noumea, New CaledoniaMohamed Hsairi - Salah Azaiz Inst, Dept Epidemiol, Tunis, TunisiaGuoqing Hu - Cent South Univ, Dept Epidemiol & Hlth Stat, Sch Publ Hlth, Changsha, Hunan, Peoples R ChinaCheng Huang - George Washington UniversityJohn J. Huang - University of New HavenHsiang Huang - Cambridge Hlth Alliance, Cambridge, MA USALaetitia Huiart - CHU La Reun, St Denis, Reunion, FranceChantal Huynh - University of WashingtonKim Moesgaard Iburg - Aarhus University (Denmark)Bulat T. Idrisov - Boston UniversityKaire Innos - Natl Inst Hlth Dev, Tallinn, EstoniaKathryn H. Jacobsen - George Mason UniversityNader Jahanmehr - Shahid Beheshti UniversityMehdi Javanbakht - Univ Aberdeen, Aberdeen, ScotlandAchala Upendra Jayatilleke - College Station Medical CenterSun Ha Jee - Yonsei UniversityPanniyammakal Jeemon - Publ Hlth Fdn India, Ctr Control Chron Condit, New Delhi, IndiaVivekanand Jha - University of OxfordGuohong Jiang - Tianjin Ctr Dis Control & Prevent, Tianjin, Peoples R ChinaYing Jiang - Univ Occupat & Environm Hlth, Dept Hlth Dev, Inst Ind Ecol Sci, Kitakyushu, Fukuoka, JapanTariku Jibat - Univ Addis Ababa, Addis Ababa, EthiopiaYe Jin - Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R ChinaJost B. Jonas - Heidelberg UniversityZubair Kabir - Univ Coll Cork, Cork, IrelandYogeshwar Kalkonde - ACTRitul Kamal - CSIR Indian Inst Toxicol Res, Lucknow, Uttar Pradesh, IndiaHaidong Kan - Fudan UniversityGagandeep Kang - College Station Medical CenterAndre Karch - Helmholtz Ctr Infect Res, Epidemiol & Stat Methods Res Grp, Braunschweig, GermanyCorine Kakizi Karema - Swiss Trop & Publ Hlth Inst, Basel, SwitzerlandAmir Kasaeian - University of TehranAnil Kaul - Oklahoma State UniversityNorito Kawakami - The University of TokyoJeanne Francoise Kayibanda - Inst Rech Hop Monttfort, Ottawa, ON, CanadaKonstantin Kazanjan - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaPeter Njenga Keiyoro - Inst Trop & Infect Dis, Nairobi, KenyaAndrew Haddon Kemp - Swansea UniversityAndre Pascal Kengne - College Station Medical CenterAndre Keren - Assuta Hashalom, Assuta Hosp, Tel Aviv, IsraelMaia Kereselidze - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaChandrasekharan Nair Kesavachandran - CSIR Indian Inst Toxicol Res, Lucknow, Uttar Pradesh, IndiaYousef Saleh Khader - Jordan Univ Sci & Technol, Irbid, JordanIbrahim A. Khalil - University of WashingtonAbdur Rahman Khan - University of LouisvilleEjaz Ahmad Khan - Hlth Serv Acad, Islamabad, PakistanYoung-Ho Khang - College Station Medical CenterIrma Khonelidze - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaJagdish Khubchandani - Ball State UniversityCho-il Kim - Korea Hlth Ind Dev Inst, Cheongju, South KoreaDaniel Kim - Northeastern Univ, Dept Hlth Sci, Boston, MA 02115 USAYun Jin Kim - Southern Univ Coll, Skudai, MalaysiaNiranjan Kissoon - University of British ColumbiaMiia Kivipelto - Karolinska InstitutetLuke D. Knibbs - Univ Queensland, Sch Publ Hlth, Brisbane, Qld, AustraliaYoshihiro Kokubo - Natl Cerebral & Cardiovasc Ctr, Dept Prevent Cardiol, Suita, Osaka, JapanSoewarta Kosen - NIHRD, Ctr Community Empowerment Hlth Policy & Humanitie, Jakarta, IndonesiaParvaiz A. Koul - College Station Medical CenterAi Koyanagi - Parc Sanitari Sant Joan de DéuBarthelemy Kuate Defo - Université de MontréalBurcu Kucuk Bicer - Hacettepe UniversityAndreas A. Kudom - University of Cape CoastG. Anil Kumar - Publ Hlth Fdn India, New Delhi, IndiaMichael J. Kutz - University of WashingtonHmwe H. Kyu - University of WashingtonDharmesh Kumar Lal - Publ Hlth Fdn India, Gurgaon, IndiaRatilal Lalloo - Univ Queensland, Sch Dent, Brisbane, Qld, AustraliaHilton Lam - Natl Inst Hlth, Inst Hlth Policy & Dev Studies, Manila, PhilippinesJennifer O. Lam - Johns Hopkins UniversityVan C. Lansingh - Help Me See Inc, New York, NY USAAnders Larsson - Uppsala UniversityJames Leigh - The University of SydneyRicky Leung - SUNY Albany, Rensselaer, NY USAYichong LiYongmei LiM. Patrice Lindsay - University of TorontoPatrick Y. Liu - University of WashingtonShiwei Liu - Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R ChinaBelinda K. Lloyd - Monash UniversityWarren D. Lo - The Ohio State UniversityGiancarlo Logroscino - University of Bari Aldo MoroNicola Low - University of BernRaimundas Lunevicius - Aintree Univ Hosp Natl Hlth Serv Fdn Trust, Liverpool, Merseyside, EnglandRonan A. Lyons - Swansea UniversityStefan Ma - Minist Hlth Singapore, Singapore, SingaporeHassan Magdy Abd El Razek - College Station Medical CenterMohammed Magdy Abd El RazekMahdi Mahdavi - Social Secur Org Res Inst, Tehran, IranMarek Majdan - Trnava Univ, Fac Hlth Sci & Social Work, Dept Publ Hlth, Trnava, SlovakiaAzeem Majeed - Imperial Coll London, London, EnglandReza Malekzadeh - University of TehranChabila C. Mapoma - University of ZambiaWagner Marcenes - Kings Coll London, Inst Dent, Div Populat & Patient Hlth, London, EnglandJose Martinez-Raga - Universitat de ValènciaMelvin Barrientos Marzan - Univ East Ramon Magsaysay, Mem Med Ctr, Quezon City, PhilippinesFelix Masiye - University of WashingtonJohn J. McGrath - Univ Queensland, Brisbane, Qld, AustraliaPeter A. Meaney - Supreme Council Of HealthAlem Mehari - Howard UniversityMan Mohan Mehndiratta - Janakpuri Superspecialty Hosp, New Delhi, IndiaAlemayehu B. Mekonnen - The University of SydneyYohannes Adama Melaku - Mekelle UniversityPeter Memiah - Univ West Florida, Pensacola, FL USAZiad A. Memish - Saudi Minist Hlth, Riyadh, Saudi ArabiaWalter Mendoza - United NationsAtte Meretoja - The University of MelbourneTuomo J. Meretoja - Helsinki Univ Hosp, Ctr Comprehens Canc, Breast Surg Unit, Helsinki, FinlandFrancis Apolinary Mhimbira - Ifakara Hlth Inst, Bagamoyo, TanzaniaTed R. Miller - Pacific Inst Res & Evaluat, Calverton, MD USAEdward J. Mills - University of OttawaMojde Mirarefin - University of WashingtonAwoke Misganaw - University of WashingtonCharles N. Mock - University of WashingtonKarzan Abdulmuhsin Mohammad - Univ Salahaddin, Erbil, IraqAlireza Mohammadi - College Station Medical CenterShafi U. Mohammed - Heidelberg Univ, Inst Publ Hlth, Heidelberg, GermanyLorenzo Monasta - IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, ItalyJulio Cesar Montanez Hernandez - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoMarcella Montico - IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, ItalyAmi R. Moore - Univ North Texas, Denton, TX USAMaziar Moradi-Lakeh - University of WashingtonLidia Morawska - Queensland University of TechnologyRintaro Mori - Natl Ctr Child Hlth & Dev, Tokyo, JapanUlrich O. Mueller - Federal ReserveGeorgina A. V. Murphy - University of OxfordSrinivas Murthy - University of British ColumbiaJean B. Nachega - Johns Hopkins UniversityAliya Naheed - International Centre for Diarrhoeal Disease ResearchKovin S. Naidoo - Univ KwaZulu Natal, Durban, South AfricaLuigi Naldi - Azienda Osped Papa Giovanni XXIII, Bergamo, ItalyDevina Nand - SuvaVinay Nangia - Suraj Eye InstituteSubas Neupane - University of TampereCharles R. Newton - Wellcome TrustJohn N. Newton - Publ Hlth England, London, EnglandMarie NgFrida Namnyak Ngalesoni - Minist Hlth & Social Welf, Dar Es Salaam, TanzaniaPeter Nguhiu - Wellcome TrustQuyen Le Nguyen - Duy Tan UniversityMuhammad Imran Nisar - Aga Khan Univ, Karachi, PakistanPatrick Martial Nkamedjie Pete - Socio Econ Dev & Commun, Inst Res, Yaounde, CameroonOle F. Norheim - University of BergenRosana E. Norman - Queensland University of TechnologyFelix Akpojene Ogbo - Western Sydney UniversityIn-Hwan Oh - Kyung Hee UniversityFoluke Adetola Ojelabi - University of IbadanPedro R. Olivares - Univ Autonoma Chile, Talca, ChileBolajoko Olubukunola Olusanya - Healthy StartJacob Olusegun Olusanya - Healthy StartEyal Oren - University of ArizonaErika Ota - The University of TokyoP. A. Mahesh - JSS Academy of Higher Education and ResearchEun-Kee Park - Kosin UniversityHye-Youn Park - AIRMahboubeh Parsaeian - University of TehranAngel J. Paternina Caicedo - University of PittsburghScott B. Patten - University of CalgaryJoao Mario Pedro - Universidade do PortoDavid M. Pereira - Universidade do PortoNorberto Perico - IRCCS Ist Ric Farmacol Mario Negri, Bergamo, ItalyKonrad Pesudovs - Flinders UniversityMax Petzold - University of the WitwatersrandMichael Robert Phillips - Shanghai Jiao Tong UniversityJulian David Pillay - Durban University of TechnologyFarhad Pishgar - University of TehranSuzanne Polinder - Erasmus MCDaniel Pope - University of LiverpoolSvetlana Popova - University of TorontoFarshad Pourmalek - University of British ColumbiaMostafa Qorbani - Supreme Council Of HealthRynaz H. S. Rabiee - Karolinska InstitutetAnwar Rafay - Contech (Canada)Vafa Rahimi-Movaghar - University of TehranMahfuzar Rahman - BRACMohammad Hifz Ur Rahman - Int Inst Populat Sci, Mumbai, Maharashtra, IndiaSajjad Ur Rahman - College Station Medical CenterRajesh Kumar Rai - Soc Hlth & Demog Surveillance, Suri, IndiaMurugesan Raju - University of MissouriUsha Ram - Int Inst Populat Sci, Mumbai, Maharashtra, IndiaSaleem M. Rana - Contech Sch Publ Hlth, Lahore, PakistanChhabi Lal Ranabhat - Yonsei UniversityPuja Rao - University of WashingtonAmany H. Refaat - Walden UniversityGiuseppe Remuzzi - Azienda Osped Papa Giovanni XXIII, Bergamo, ItalySerge Resnikoff - Univ New South Wales, Brien Holden Vis Inst, Sydney, NSW, AustraliaAlex Reynolds - University of WashingtonDavid Rojas-Rueda - Barcelona Institute for Global HealthLuca Ronfani - IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, ItalyGholamreza Roshandel - University of TehranGregory A. Roth - University of WashingtonAmbuj Roy - College Station Medical CenterGeorge Mugambage Ruhago - Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, TanzaniaRajesh Sagar - College Station Medical CenterMuhammad Muhammad Saleh - Dev Res & Projects Ctr, Abuja, NigeriaJuan R. Sanabria - Marshall UniversityMaria Dolores Sanchez-Nino - IIS Fdn Jimenez Diaz, Madrid, SpainItamar S. Santos - University of Sao PauloJoao Vasco Santos - Universidade do PortoRodrigo Sarmiento-Suarez - Univ Ciencias Aplicadas & Ambient, Bogota, ColombiaBenn Sartorius - University of KwaZulu-NatalMaheswar Satpathy - College Station Medical CenterMiloje Savic - Norwegian Inst Publ Hlth, Oslo, NorwayMonika Sawhney - Marshall UniversityIone J. C. Schneider - Univ Fed Santa Catarina, Florianopolis, SC, BrazilBen Schottker - Heidelberg (Poland)David C. Schwebel - University of AlabamaSoraya Seedat - University of Cape TownSadaf G. Sepanlou - University of TehranEdson E. Servan-Mori - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoTesfaye Setegn - Bahir Dar UniversitySaeid Shahraz - College Station Medical CenterMasood Ali Shaikh - Independent Consultant, Karachi, PakistanMarina Shakh-Nazarova - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaRajesh Sharma - Indian Institute of Technology RoparJun She - Fudan UniversitySara Sheikhbahaei - University of TehranJiabin Shen - The Ohio State UniversityKevin N. Sheth - Yale UniversityKenji Shibuya - The University of TokyoHwashin Hyun Shin - Hlth Canada, Ottawa, ON, CanadaMin-Jeong Shin - Korea Univ, Dept Publ Hlth Sci, Grad Sch, Seoul, South KoreaRahman Shiri - Finnish Inst Occupat Hlth, Work Org, Work Disabil Prevent, Helsinki, FinlandIvy Shuie - Northumbria UniversityInga Dora Sigfusdottir - Reykjavík UniversityDiego Augusto Santos Silva - Univ Fed Santa Catarina, Florianopolis, SC, BrazilJonathan Silverberg - Northwestern UniversityEdgar P. Simard - Emory UniversityShireen Sindi - Karolinska InstitutetAbhishek Singh - Int Inst Populat Sci, Mumbai, Maharashtra, IndiaJasvinder A. Singh - University of AlabamaOm Prakash Singh - Banaras Hindu UniversityPrashant Kumar Singh - Inst Human Dev, New Delhi, IndiaVirendra Singh - Asthma Bhawan, Jaipur, Rajasthan, IndiaJoan B. Soriano - Univ Autonoma Madrid, Inst Invest Hosp Univ Princesa, Madrid, SpainSergey Soshnikov - Minist Hlth Russian Federat, Fed Res Inst Hlth Org & Informat, Moscow, RussiaLuciano A. Sposato - Western Univ, Dept Clin Neurol Sci, London, ON, CanadaChandrashekhar T. Sreeramareddy - College Station Medical CenterVasiliki Stathopoulou - Attikon Univ Hosp, Athens, GreeceNicholas Steel - Publ Hlth England, London, EnglandKonstantinos Stroumpoulis - Alexandra Gen Hosp Athens, Athens, GreeceLela Sturua - Natl Ctr Dis Control & Publ Hlth, Tbilisi, GeorgiaBruno F. Sunguya - Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, TanzaniaSoumya Swaminathan - College Station Medical CenterBryan L. Sykes - Univ Calif Irvine, Dept Criminol, Irvine, CA USACassandra E. I. Szoeke - The University of MelbourneRafael Tabares-Seisdedos - Universitat de ValènciaMohammad Tavakkoli - New York Medical CollegeBineyam Taye - Colgate UniversityBemnet Amare Tedla - University of GondarWorku Mekonnen Tefera - Supreme Council Of HealthTesfaye Tekle - Mekelle UniversityGirma Temam Shifa - Univ Addis Ababa, Addis Ababa, EthiopiaAbdullah Sulieman Terkawi - University of VirginiaFisaha Haile Tesfay - Mekelle UniversityGizachew Assefa Tessema - Univ Adelaide, Adelaide, SA, AustraliaKiran Thapa - College Station Medical CenterAlan J. Thomson - Adapt Knowledge Management, Victoria, BC, CanadaAndrew L. Thorne-Lyman - Harvard UniversityRuoyan Tobe-Gai - Natl Ctr Child Hlth & Dev, Tokyo, JapanMarcello Tonelli - University of CalgaryRoman Topor-Madry - Jagiellonian UniversityFotis Topouzis - Aristotle University of ThessalonikiBach Xuan Tran - Johns Hopkins UniversityChristopher Troeger - University of WashingtonThomas Truelsen - University of CopenhagenZacharie Tsala Dimbuene - University of KinshasaAbera Kenay Tura - Haramaya UniversityStefanos Tyrovolas - Universitat de BarcelonaKingsley N. Ukwaja - Fed Teaching Hosp, Dept Internal Med, Abakaliki, NigeriaChigozie Jesse Uneke - Ebonyi State UniversityOlalekan A. Uthman - University of WarwickMasoud Vaezghasemi - Umeå UniversityTommi Vasankari - UKK InstituteAna Maria Nogales Vasconcelos - Universidade de BrasíliaNarayanaswamy Venketasubramanian - Raffl Hosp, Raffl Neurosci Ctr, Singapore, SingaporeRaj Kumar Verma - Int Inst Populat Sci, Mumbai, Maharashtra, IndiaFrancesco S. Violante - University of BolognaSergey K. Vladimirov - Fed Res Inst Hlth Org & Informat, Moscow, RussiaVasiliy Victorovich Vlassov - Supreme Council Of HealthStein Emil Vollset - University of WashingtonLinhong Wang - Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R ChinaYanping Wang - Natl Off Maternal & Child Hlth Surveillance, Chengdu, Sichuan, Peoples R ChinaScott Weichenthal - McGill UniversityElisabete Weiderpass - Karolinska InstitutetRobert G. Weintraub - The University of MelbourneDaniel J. Weiss - University of OxfordAndrea Werdecker - Federal ReserveRonny Westerman - Federal ReserveMarc-Alain Widdowson - Ctr Dis Control Kenya, Nairobi, KenyaTissa Wijeratne - The University of MelbourneThomas Neil Williams - Imperial Coll London, London, EnglandCharles Shey Wiysonge - College Station Medical CenterCharles D. A. Wolfe - Kings Coll London, Div Hlth & Social Care Res, London, EnglandIngrid Wolfe - Kings Coll London, London, EnglandSungho Won - Supreme Council Of HealthMamo Wubshet - Millennium Engineering and Integration (United States)Qingyang Xiao - Emory UniversityGelin Xu - Nanjing UniversityAjit Kumar Yadav - Int Inst Populat Sci, Mumbai, Maharashtra, IndiaBereket Yakob - Univ KwaZulu Natal, Discipline Publ Hlth Med, Sch Nursing & Publ Hlth, Durban, South AfricaYuichiro Yano - Northwestern UniversityMehdi Yaseri - Shahid Beheshti UniversityPengpeng Ye - Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R ChinaHenock Gebremedhin Yebyo - Mekelle UniversityPaul Yip - University of Hong KongNaohiro Yonemoto - Kyoto UniversitySeok-Jun Yoon - Korea Univ, Dept Prevent Med, Coll Med, Seoul, South KoreaMustafa Z. Younis - Jackson State UniversityChuanhua Yu - Wuhan UniversityZoubida Zaidi - Univ Hosp, Setif, AlgeriaMaysaa El Sayed Zaki - Mansoura UniversityHajo Zeeb - Leibniz Inst Prevent Res & Epidemiol, Bremen, GermanyHao Zhang - Fudan UniversityYong Zhao - College Station Medical CenterYingfeng Zheng - Sun Yat-sen UniversityMaigeng Zhou - University of WashingtonSanjay Zodpey - Publ Hlth Fdn India, Gurgaon, IndiaChristopher J. L. Murray - University of WashingtonGBD 2015 Child Mortality Collabora
- Publication Details
- The Lancet (British edition), Vol.388(10053), pp.1725-1774
- Publisher
- Elsevier
- Number of pages
- 50
- Grant note
- 16H02643 / Grants-in-Aid for Scientific Research; Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT); Japan Society for the Promotion of Science; Grants-in-Aid for Scientific Research (KAKENHI) SGL014\1002 / Academy of Medical Sciences (AMS) Bill AMP; Melinda Gates Foundation; CGIAR NF-SI-0508-10082; RP-PG-0407-10184; CL-2015-18-011; NF-SI-0510-10060; NF-SI-0513-10085 / National Institute for Health Research; National Institute for Health Research (NIHR) U1475000001; MC_U147585819; MC_UU_12011/1; MC_UP_A620_1014; G0400491; MC_U147585824; MC_U147585827 / Medical Research Council; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) MC_U147585827; MC_U147585819; MR/K006525/1; G0400491; MR/K00669X/1 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) ES/L007444/1 / ESRC; UK Research & Innovation (UKRI); Economic & Social Research Council (ESRC)
- Identifiers
- 991005591499807891
- Copyright
- © 2016 The Author(s)
- Murdoch Affiliation
- Centre for Healthy Ageing
- Language
- English
- Resource Type
- Journal article
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- 1 Clinical & Life Sciences
- 1.156 Healthcare Policy
- 1.156.381 Maternal Health Equity
- Web Of Science research areas
- Public, Environmental & Occupational Health
- ESI research areas
- Clinical Medicine