Nigeria among worst-hit countries, 4.9m children die before age five – UN Report

Nigeria is among the countries bearing the higheat burden of global child mortality, as estimated 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns, according to a new United Nations Report.

The Report, Levels & Trends in Child Mortality, showed that most of these deaths were preventable through proven, low-cost interventions and improved access to quality healthcare, underscoring persistent gaps in health systems across high-burden countries.

According to the report published by the United Nations Inter-agency Group for Child Mortality Estimation, under-five deaths have declined by more than half since 2000, however, progress slowed sharply, with the pace of reduction falling by more than 60 percent since 2015, raising concerns about stalled gains in child survival. Other high-burden countries are Chad, the Democratic Republic of Congo and Niger.

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Of the total deaths recorded, complications from preterm birth was responsible for 36% of newborn deaths and labour and delivery complications accounting for a further 21%. Infectious diseases remained the leading causes of death among young children, malaria was the single largest killer, responsible for 17% of deaths among children aged one to 59 months, with the vast majority occurring in Nigeria other high burden countries

Other major causes included pneumonia and diarrhoea, diseases that are both preventable and treatable but continue to claim lives due to limited access to timely care and basic health services.

The report highlighted that sub-Saharan Africa accounted for 58% of all under-five deaths in 2024. In the region, nine leading infectious diseases were responsible for more than half of all child deaths, compared with just 9% in Europe and Northern America and 6 percent in Australia and New Zealand.

The Report also identified severe acute malnutrition as a critical but undercounted factor. For the first time, it estimates that more than 100,000 children aged one to 59 months died directly from the condition in 2024, representing about 5% of deaths in that age group.

However, the true toll is likely much higher, as malnutrition weakens immunity and increases vulnerability to diseases such as malaria, pneumonia and diarrhoea.

Evidence cited in the report showed that investments in child health remain among the most cost-effective development measures. Interventions such as vaccination, treatment for malnutrition and access to skilled healthcare personnel at birth can deliver significant social and economic returns, with every dollar invested in child survival generating up to twenty dollars in broader benefits.

To reverse the slowdown in progress, the report called on governments and partners to prioritise child survival, strengthen primary healthcare systems, and focus on high-risk populations, particularly in sub-Saharan Africa and Southern Asia.

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It also emphasised the need for stronger accountability through improved data collection, tracking and reporting.

UN officials warned that without renewed political commitment and sustained investment, preventable child deaths will continue at scale, particularly in high-burden countries such as Nigeria, where access to essential health and nutrition services remains uneven.