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

Haidong Wang, Zulfiqar Bhutta, Matthew M. Coates, Megan Coggeshall, Lalit Dandona, Khassoum Diallo, Elisabeth B. França, Maya S. Fraser, Nancy Fullman, Peter Gething, Simon Hay, Yohannes Kinfu, Maaya Kita, Xie Rachel Kulikoff, Heidi Larson, Juan Liang, Xiaofeng Liang, Margaret Lind, Alan D. Lopez, Rafael Lozano & 525 others George Mensah, Joseph Mikesell, Ali H. Mokdad, Meghan D. Mooney, Grant Nguyen, Ivo Rakovac, Joshua A. Salomon, Naris Silpakit, Amber Sligar, Reed J D Sorensen, Theo Vos, Jun Zhu, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Kaja M. Abbas, Foad Abd-Allah, Abdishakur M. Abdulle, Semaw F. Abera, Victor Aboyans, Biju Abraham, Ibrahim Abubakar, Laith J. Abu-Raddad, Niveen Abu-Rmeileh, Gebre Yitayih Abyu, Tom Achoki, Akindele Olupelumi Adebiyi, Isaac Akinkunmi Adedeji, Ademola Adelekan, Arsène K. Adou, Arnav Agarwal, Oluremi N. Ajala, Tomi F. Akinyemiju, Nadia Akseer, Khurshid Alam, Noore K M Alam, Deena Alasfoor, Robert William Aldridge, Miguel A. Alegretti, Zewdie Aderaw Alemu, Raghib Ali, Ala'a Alkerwi, François Alla, Rajaa Al-Raddadi, Ubai Alsharif, Khalid A. Altirkawi, Elena Alvarez Martin, Nelson Alvis-Guzman, Azmeraw T. Amare, Alemayehu Amberbir, Adeladza Kofi Amegah, Emmanuel A. Ameh, Walid Ammar, Stephen Marc Amrock, Hjalte H. Andersen, Gregory M. Anderson, Carl Abelardo T Antonio, Johan Ärnlöv, Al Artaman, Hamid Asayesh, Rana J. Asghar, Reza Assadi, Suleman Atique, Euripide Frinel G Arthur Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Umar Bacha, Alaa Badawi, Kalpana Balakrishnan, Amitava Banerjee, Bolanle F. Banigbe, Aleksandra Barac, Ryan M. Barber, Suzanne L. Barker-Collo, Till Bärnighausen, Lope H. Barrero, Tigist Assefa Bayou, Yibeltal Tebekaw Bayou, Shahrzad Bazargan-Hejazi, Justin Beardsley, Neeraj Bedi, Tolesa Bekele, Michelle L. Bell, Aminu K. Bello, Derrick A. Bennett, Isabela M. Bensenor, Adugnaw Berhane, Eduardo Bernabe, Balem Demtsu Betsu, Samir Bhatt, Sibhatu Biadgilign, Boris Bikbov, Sait Mentes Birlik, Donal Bisanzio, Espen Bjertness, Jed D. Blore, Rupert R. Bourne, Michael Brainin, Alexandra Bražinová, Nicholas J K Breitborde, Alexandria Brown, Geoffrey Colin Buckle, Michael Burch, Zahid A. Butt, Ismael R. Campos-Nonato, Julio C. Campuzano, Rosario Cardenas, David O. Carpenter, Juan Jesus Carrero, Austin Carter, Daniel Casey, Carlos A. Castaneda-Orjuela, Jacqueline Castillo Rivas, Ruben Estanislao Castro, Ferran Catala-Lopez, Kelly Cercy, Hsing Yi Chang, Jung Chen Chang, Chioma Ezinne Chibueze, Vesper Hichilombwe Chisumpa, Jee Young Jasmine Choi, Rajiv Chowdhury, Devasahayam Jesudas Christopher, Liliana G. Ciobanu, Samantha M. Colquhoun, C. Cooper, Leslie Cornaby, Solomon Abrha Damtew, Hadi Danawi, Rakhi Dandona, José das Neves, Adrian C. Davis, Pieter de Jager, Diego De Leo, Louisa Degenhardt, Kebede Deribe, Amare Deribew, Don C Des Jarlais, Gabrielle A. DeVeber, Samath D. Dharmaratne, Preet K. Dhillon, Eric L. Ding, Pratik Pinal Doshi, Kerrie E. Doyle, Leilei Duan, Manisha Dubey, Hedyeh Ebrahimi, Christian Lycke Ellingsen, Iqbal Elyazar, Aman Yesuf Endries, Sergey P. Ermakov, Babak Eshrati, Alireza Esteghamati, Emerito Jose A Faraon, Talha A. Farid, Carla Sofia e Sa Farinha, Andre Faro, Maryam S. Farvid, Farshad Farzadfar, Seyed Mohammad Fereshtehnejad, Joao C. Fernandes, Florian Fischer, Joseph Robert Ander Fitchett, Nataliya Foigt, Richard C. Franklin, Joseph Friedman, Thomas Fürst, Ketevan Gambashidze, A. Gamkrelidze, Parthasarathi Ganguly, Teshome Gebre, Tsegaye Tsewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Alemseged Aregay Gebru, Johanna M. Geleijnse, Bradford D. Gessner, Ibrahim A. Ginawi, Ababi Zergaw Giref, Melkamu Dedefo Gishu, Hector Gomez Dantes, Philimon Gona, Amador Goodridge, Sameer Vali Gopalani, Atsushi Goto, Hebe N. Gouda, Harish C. Gugnani, Yuming Guo, Rahul Gupta, Rajeev Gupta, Vipin Gupta, Bishal Gyawali, Juanita A. Haagsma, Nima Hafezi-Nejad, Demewoz Haile, Alemayehu Desalegne Hailu, Gessessew Bugssa Hailu, Randah R. Hamadeh, Jamie Hancock, Alexis J. Handal, G. J. Hankey, Hilda L. Harb, Sivadasanpillai Harikrishnan, Kimani M. Harun, Rasmus Havmoeller, Roderick J. Hay, Ileana B. Heredia Pi, Hans W. Hoek, Masako Horino, Nobuyuki Horita, H. Dean Hosgood, Peter J. Hotez, Damian G. Hoy, Mohamed Hsairi, Guoqing Hu, Cheng Huang, John J. Huang, Hsiang Huang, Laetitia Huiart, Kim M. Iburg, Bulat T. Idrisov, Kaire Innos, Kathryn H. Jacobsen, Nader Jahanmehr, Mehdi Javanbakht, Achala Upendra Jayatilleke, Sun Ha Jee, Panniyammakal Jeemon, Vivekanand Jha, Guohong Jiang, Ying Jiang, Tariku Jibat, Ye Jin, Jost B. Jonas, Zubair Kabir, Yogeshwar Kalkonde, Ritul Kamal, Haidong Kan, Gagandeep Kang, Andre Karch, Corine Kakizi Karema, Amir Kasaeian, Anil Kaul, Norito Kawakami, Jeanne Françoise Kayibanda, Konstantin Kazanjan, Peter Njenga Keiyoro, Andrew H. Kemp, Andrew Pascal Kengne, A. Keren, Maia Kereselidze, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Ibrahim A. Khalil, Abdur Rahman Khan, Ejaz Ahmad Khan, Young Ho Khang, Irma Khonelidze, Jagdish Khubchandani, Cho il Kim, Daniel Kim, Yunjin Kim, Niranjan Kissoon, M. Kivipelto, Luke Knibbs, Yoshihiro Kokubo, Soewarta Kosen, Parvaiz A. Koul, Ai Koyanagi, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Andreas A. Kudom, G. Anil Kumar, Hmwe Kyu, Dharmesh Kumar Lal, Ratilal Lalloo, Hilton Lam, Jennifer O. Lam, Van C. Lansingh, Anders Larsson, James Leigh, Ricky Leung, Yichong Li, Yongmei Li, M. Patrice Lindsay, Patrick Y. Liu, Shiwei Liu, Belinda K. Lloyd, Warren D. Lo, Giancarlo Logroscino, Nicola Low, Raimundas Lunevicius, Ronan A. Lyons, Stefan Ma, Hassan Magdy Abd El Razek, Mohamed Magdy Abd El Razek, Mahdi Mahdavi, Marek Majdan, Azeem Majeed, Reza Malekzadeh, Christopher C. Mapoma, Wagner Marcenes, Jose Martinez-Raga, Melvin B. Marzan, Felix Masiye, John J. McGrath, Peter A. Meaney, Alem Mehari, Man Mohan Mehndiratta, Alemayehu B. Mekonnen, Yohannes A. Melaku, Peter Memiah, Ziad Memish, Walter Mendoza, Atte Meretoja, Tuomo J. Meretoja, Francis Apolinary Mhimbira, Ted R. Miller, Edward J. Mills, Mojde Mirarefin, Awoke Misganaw, Charles N. Mock, Karzan Abdulmuhsin Mohammad, Alireza Mohammadi, Shafiu Mohammed, Lorenzo Monasta, Julio C Montanêz Hernandez, Marcella Montico, Ami R. Moore, Maziar Moradi-Lakeh, Lidia Morawska, Rintaro Mori, Ulrich O. Mueller, Georgina A V Murphy, Srinivas G. Murthy, Jean Nachega, Aliya Naheed, Kovin S. Naidoo, Luigi Naldi, Devina Nand, Vinay Nangia, Subas Neupane, Charles R. Newton, J. Newton, Marie Ng, Frida N. Ngalesoni, Peter Nguhiu, Quyen Le Nguyen, Muhammad Imran Nisar, Patrick Martial Nkamedjie Pete, Ole F. Norheim, Rosana E. Norman, Felix Akpojene Ogbo, In Hwan Oh, Foluke Adetola Ojelabi, Pedro R. Olivares, Bolajoko O. Olusanya, Jacob Olusegun Olusanya, Eyal Oren, Erika Ota, Mahesh PA, Eun Kee Park, Hye Youn Park, Mahboubeh Parsaeian, Angel J Paternina Caicedo, Scott B. Patten, João Mário Pedro, David M. Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael R. Phillips, Julian David Pillay, Farhad Pishgar, Suzanne Polinder, D. Pope, Svetlana Popova, Farshad Pourmalek, Mostafa Qorbani, Rynaz H S Rabiee, Anwar Rafay, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Sajjad U R Rahman, Rajesh Kumar Rai, Murugesan Raju, Usha Ram, Saleem M. Rana, Chhabi L. Ranabhat, Puja Rao, Amany H. Refaat, Giuseppe Remuzzi, Serge Resnikoff, Alex Reynolds, David Rojas-Rueda, Luca Ronfani, Gholamreza Roshandel, Gregory A. Roth, Ambuj Roy, George M. Ruhago, Rajesh Sagar, Muhammad Muhammad Saleh, Juan R. Sanabria, Maria Dolores Sanchez-Niño, Itamar S. Santos, João Vasco Santos, Rodrigo Sarmiento-Suarez, Benn Sartorius, Maheswar Satpathy, Miloje Savic, Monika Sawhney, Ione J C Schneider, Ben Schöttker, David C. Schwebel, S. Seedat, Sadaf G. Sepanlou, Edson E. Servan-Mori, Tesfaye Setegn, Saeid Shahraz, Masood Ali Shaikh, Marina Shakh-Nazarova, Rajesh Sharma, Jun She, Sara Sheikhbahaei, Jiabin Shen, Kevin N. Sheth, Kenji Shibuya, Hwashin Hyun Shin, Min Jeong Shin, Rahman Shiri, Ivy Shuie, Inga D. Sigfusdottir, Diego Augusto Santos Silva, Jonathan I. Silverberg, Edgar P. Simard, Shireen Sindi, Abhishek Singh, Jasvinder A. Singh, Om Prakash Singh, Prashant Kumar Singh, Virendra Singh, Joan B. Soriano, Sergey Soshnikov, Luciano A. Sposato, Chandrashekhar T. Sreeramareddy, Vasiliki Stathopoulou, Nicholas Steel, Konstantinos Stroumpoulis, Lela Sturua, Bruno F. Sunguya, Soumya Swaminathan, Bryan L. Sykes, Cassandra E I Szoeke, Rafael Tabares-Seisdedos, Mohammad Tavakkoli, Bineyam Taye, Bemnet Amare Tedla, Worku Mekonnen Tefera, Tesfaye Tekle, Girma Temam Shifa, Abdullah Sulieman Terkawi, Fisaha Haile Tesfay, Gizachew Assefa Tessema, Kiran Thapa, Alan J. Thomson, Andrew L. Thorne-Lyman, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Fotis Topouzis, Bach X. Tran, Christopher Troeger, Thomas Truelsen, Zacharie Tsala Dimbuene, Abera Kenay Tura, Stefanos Tyrovolas, Kingsley N. Ukwaja, Chigozie Jesse Uneke, Olalekan A. Uthman, Masoud Vaezghasemi, Tommi Vasankari, Ana Maria Nogales Vasconcelos, Narayanaswamy Venketasubramanian, Raj Kumar Verma, F. S. Violante, Sergey K. Vladimirov, Vasiliy V. Vlassov, Stein Emil Vollset, Linhong Wang, Yanping Wang, Scott Weichenthal, Elisabete Weiderpass, Robert G. Weintraub, Daniel J. Weiss, Andrea Werdecker, Ronny Westerman, Marc Alain Widdowson, Tissa Wijeratne, Thomas Neil Williams, Charles Shey Wiysonge, Charles D A Wolfe, Ingrid Wolfe, Sungho Won, Mamo Wubshet, Qingyang Xiao, Gelin Xu, Ajit Kumar Yadav, Bereket Yakob, Yuichiro Yano, Mehdi Yaseri, Pengpeng Ye, Henock Gebremedhin Yebyo, Paul Yip, Naohiro Yonemoto, Seok Jun Yoon, Mustafa Younis, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Hajo Zeeb, Hao Zhang, Yong Zhao, Yingfeng Zheng, Maigeng Zhou, Sanjay Zodpey, Christopher J L Murray

Research output: Contribution to journalArticle

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. Funding Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)1725-1774
Number of pages50
JournalThe Lancet
Volume388
Issue number10053
DOIs
Publication statusPublished - Oct 8 2016

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Stillbirth
Mortality
Geography
Child Mortality
Demography
Information Storage and Retrieval
Global Burden of Disease
Uncertainty
Communicable Diseases
Accidental Falls
Africa South of the Sahara
Measles
Malnutrition
Respiratory Tract Infections
Malaria

ASJC Scopus subject areas

  • Medicine(all)

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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. / Wang, Haidong; Bhutta, Zulfiqar; Coates, Matthew M.; Coggeshall, Megan; Dandona, Lalit; Diallo, Khassoum; França, Elisabeth B.; Fraser, Maya S.; Fullman, Nancy; Gething, Peter; Hay, Simon; Kinfu, Yohannes; Kita, Maaya; Kulikoff, Xie Rachel; Larson, Heidi; Liang, Juan; Liang, Xiaofeng; Lind, Margaret; Lopez, Alan D.; Lozano, Rafael; Mensah, George; Mikesell, Joseph; Mokdad, Ali H.; Mooney, Meghan D.; Nguyen, Grant; Rakovac, Ivo; Salomon, Joshua A.; Silpakit, Naris; Sligar, Amber; Sorensen, Reed J D; Vos, Theo; Zhu, Jun; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw F.; Aboyans, Victor; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen; Abyu, Gebre Yitayih; Achoki, Tom; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola; Adou, Arsène K.; Agarwal, Arnav; Ajala, Oluremi N.; Akinyemiju, Tomi F.; Akseer, Nadia; Alam, Khurshid; Alam, Noore K M; Alasfoor, Deena; Aldridge, Robert William; Alegretti, Miguel A.; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, François; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A.; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Ameh, Emmanuel A.; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H.; Anderson, Gregory M.; Antonio, Carl Abelardo T; Ärnlöv, Johan; Artaman, Al; Asayesh, Hamid; Asghar, Rana J.; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel G Arthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Banigbe, Bolanle F.; Barac, Aleksandra; Barber, Ryan M.; Barker-Collo, Suzanne L.; Bärnighausen, Till; Barrero, Lope H.; Bayou, Tigist Assefa; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L.; Bello, Aminu K.; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D.; Bourne, Rupert R.; Brainin, Michael; Bražinová, Alexandra; Breitborde, Nicholas J K; Brown, Alexandria; Buckle, Geoffrey Colin; Burch, Michael; Butt, Zahid A.; Campos-Nonato, Ismael R.; Campuzano, Julio C.; Cardenas, Rosario; Carpenter, David O.; Carrero, Juan Jesus; Carter, Austin; Casey, Daniel; Castaneda-Orjuela, Carlos A.; Rivas, Jacqueline Castillo; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cercy, Kelly; Chang, Hsing Yi; Chang, Jung Chen; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee Young Jasmine; Chowdhury, Rajiv; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G.; Colquhoun, Samantha M.; Cooper, C.; Cornaby, Leslie; Damtew, Solomon Abrha; Danawi, Hadi; Dandona, Rakhi; das Neves, José; Davis, Adrian C.; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Deribe, Kebede; Deribew, Amare; Jarlais, Don C Des; DeVeber, Gabrielle A.; Dharmaratne, Samath D.; Dhillon, Preet K.; Ding, Eric L.; Doshi, Pratik Pinal; Doyle, Kerrie E.; Duan, Leilei; Dubey, Manisha; Ebrahimi, Hedyeh; Ellingsen, Christian Lycke; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey P.; Eshrati, Babak; Esteghamati, Alireza; Faraon, Emerito Jose A; Farid, Talha A.; Farinha, Carla Sofia e Sa; Faro, Andre; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed Mohammad; Fernandes, Joao C.; Fischer, Florian; Fitchett, Joseph Robert Ander; Foigt, Nataliya; Franklin, Richard C.; Friedman, Joseph; Fürst, Thomas; Gambashidze, Ketevan; Gamkrelidze, A.; Ganguly, Parthasarathi; Gebre, Teshome; Gebrehiwot, Tsegaye Tsewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M.; Gessner, Bradford D.; Ginawi, Ibrahim A.; Giref, Ababi Zergaw; Gishu, Melkamu Dedefo; Gomez Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Gouda, Hebe N.; Gugnani, Harish C.; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gyawali, Bishal; Haagsma, Juanita A.; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Hamadeh, Randah R.; Hancock, Jamie; Handal, Alexis J.; Hankey, G. J.; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Harun, Kimani M.; Havmoeller, Rasmus; Hay, Roderick J.; Heredia Pi, Ileana B.; Hoek, Hans W.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hotez, Peter J.; Hoy, Damian G.; Hsairi, Mohamed; Hu, Guoqing; Huang, Cheng; Huang, John J.; Huang, Hsiang; Huiart, Laetitia; Iburg, Kim M.; Idrisov, Bulat T.; Innos, Kaire; Jacobsen, Kathryn H.; Jahanmehr, Nader; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jin, Ye; Jonas, Jost B.; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Kang, Gagandeep; Karch, Andre; Karema, Corine Kakizi; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Françoise; Kazanjan, Konstantin; Keiyoro, Peter Njenga; Kemp, Andrew H.; Kengne, Andrew Pascal; Keren, A.; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A.; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young Ho; Khonelidze, Irma; Khubchandani, Jagdish; Kim, Cho il; Kim, Daniel; Kim, Yunjin; Kissoon, Niranjan; Kivipelto, M.; Knibbs, Luke; Kokubo, Yoshihiro; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A.; Kumar, G. Anil; Kyu, Hmwe; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O.; Lansingh, Van C.; Larsson, Anders; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lindsay, M. 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In: The Lancet, Vol. 388, No. 10053, 08.10.2016, p. 1725-1774.

Research output: Contribution to journalArticle

Wang, H, Bhutta, Z, Coates, MM, Coggeshall, M, Dandona, L, Diallo, K, França, EB, Fraser, MS, Fullman, N, Gething, P, Hay, S, Kinfu, Y, Kita, M, Kulikoff, XR, Larson, H, Liang, J, Liang, X, Lind, M, Lopez, AD, Lozano, R, Mensah, G, Mikesell, J, Mokdad, AH, Mooney, MD, Nguyen, G, Rakovac, I, Salomon, JA, Silpakit, N, Sligar, A, Sorensen, RJD, Vos, T, Zhu, J, Abajobir, AA, Abate, KH, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abera, SF, Aboyans, V, Abraham, B, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, N, Abyu, GY, Achoki, T, Adebiyi, AO, Adedeji, IA, Adelekan, A, Adou, AK, Agarwal, A, Ajala, ON, Akinyemiju, TF, Akseer, N, Alam, K, Alam, NKM, Alasfoor, D, Aldridge, RW, Alegretti, MA, Alemu, ZA, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ameh, EA, Ammar, W, Amrock, SM, Andersen, HH, Anderson, GM, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Badawi, A, Balakrishnan, K, Banerjee, A, Banigbe, BF, Barac, A, Barber, RM, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bekele, T, Bell, ML, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabe, E, Betsu, BD, Bhatt, S, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Bjertness, E, Blore, JD, Bourne, RR, Brainin, M, Bražinová, A, Breitborde, NJK, Brown, A, Buckle, GC, Burch, M, Butt, ZA, Campos-Nonato, IR, Campuzano, JC, Cardenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Casey, D, Castaneda-Orjuela, CA, Rivas, JC, Castro, RE, Catala-Lopez, F, Cercy, K, Chang, HY, Chang, JC, Chibueze, CE, Chisumpa, VH, Choi, JYJ, Chowdhury, R, Christopher, DJ, Ciobanu, LG, Colquhoun, SM, Cooper, C, Cornaby, L, Damtew, SA, Danawi, H, Dandona, R, das Neves, J, Davis, AC, de Jager, P, De Leo, D, Degenhardt, L, Deribe, K, Deribew, A, Jarlais, DCD, DeVeber, GA, Dharmaratne, SD, Dhillon, PK, Ding, EL, 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Truelsen, T, Dimbuene, ZT, Tura, AK, Tyrovolas, S, Ukwaja, KN, Uneke, CJ, Uthman, OA, Vaezghasemi, M, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Verma, RK, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, RG, Weiss, DJ, Werdecker, A, Westerman, R, Widdowson, MA, Wijeratne, T, Williams, TN, Wiysonge, CS, Wolfe, CDA, Wolfe, I, Won, S, Wubshet, M, Xiao, Q, Xu, G, Yadav, AK, Yakob, B, Yano, Y, Yaseri, M, Ye, P, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, SJ, Younis, M, Yu, C, Zaidi, Z, Zaki, MES, Zeeb, H, Zhang, H, Zhao, Y, Zheng, Y, Zhou, M, Zodpey, S & Murray, CJL 2016, '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, vol. 388, no. 10053, pp. 1725-1774. https://doi.org/10.1016/S0140-6736(16)31575-6
Wang, Haidong ; Bhutta, Zulfiqar ; Coates, Matthew M. ; Coggeshall, Megan ; Dandona, Lalit ; Diallo, Khassoum ; França, Elisabeth B. ; Fraser, Maya S. ; Fullman, Nancy ; Gething, Peter ; Hay, Simon ; Kinfu, Yohannes ; Kita, Maaya ; Kulikoff, Xie Rachel ; Larson, Heidi ; Liang, Juan ; Liang, Xiaofeng ; Lind, Margaret ; Lopez, Alan D. ; Lozano, Rafael ; Mensah, George ; Mikesell, Joseph ; Mokdad, Ali H. ; Mooney, Meghan D. ; Nguyen, Grant ; Rakovac, Ivo ; Salomon, Joshua A. ; Silpakit, Naris ; Sligar, Amber ; Sorensen, Reed J D ; Vos, Theo ; Zhu, Jun ; Abajobir, Amanuel Alemu ; Abate, Kalkidan Hassen ; Abbas, Kaja M. ; Abd-Allah, Foad ; Abdulle, Abdishakur M. ; Abera, Semaw F. ; Aboyans, Victor ; Abraham, Biju ; Abubakar, Ibrahim ; Abu-Raddad, Laith J. ; Abu-Rmeileh, Niveen ; Abyu, Gebre Yitayih ; Achoki, Tom ; Adebiyi, Akindele Olupelumi ; Adedeji, Isaac Akinkunmi ; Adelekan, Ademola ; Adou, Arsène K. ; Agarwal, Arnav ; Ajala, Oluremi N. ; Akinyemiju, Tomi F. ; Akseer, Nadia ; Alam, Khurshid ; Alam, Noore K M ; Alasfoor, Deena ; Aldridge, Robert William ; Alegretti, Miguel A. ; Alemu, Zewdie Aderaw ; Ali, Raghib ; Alkerwi, Ala'a ; Alla, François ; Al-Raddadi, Rajaa ; Alsharif, Ubai ; Altirkawi, Khalid A. ; Martin, Elena Alvarez ; Alvis-Guzman, Nelson ; Amare, Azmeraw T. ; Amberbir, Alemayehu ; Amegah, Adeladza Kofi ; Ameh, Emmanuel A. ; Ammar, Walid ; Amrock, Stephen Marc ; Andersen, Hjalte H. ; Anderson, Gregory M. ; Antonio, Carl Abelardo T ; Ärnlöv, Johan ; Artaman, Al ; Asayesh, Hamid ; Asghar, Rana J. ; Assadi, Reza ; Atique, Suleman ; Avokpaho, Euripide Frinel G Arthur ; Awasthi, Ashish ; Quintanilla, Beatriz Paulina Ayala ; Bacha, Umar ; Badawi, Alaa ; Balakrishnan, Kalpana ; Banerjee, Amitava ; Banigbe, Bolanle F. ; Barac, Aleksandra ; Barber, Ryan M. ; Barker-Collo, Suzanne L. ; Bärnighausen, Till ; Barrero, Lope H. ; Bayou, Tigist Assefa ; Bayou, Yibeltal Tebekaw ; Bazargan-Hejazi, Shahrzad ; Beardsley, Justin ; Bedi, Neeraj ; Bekele, Tolesa ; Bell, Michelle L. ; Bello, Aminu K. ; Bennett, Derrick A. ; Bensenor, Isabela M. ; Berhane, Adugnaw ; Bernabe, Eduardo ; Betsu, Balem Demtsu ; Bhatt, Samir ; Biadgilign, Sibhatu ; Bikbov, Boris ; Birlik, Sait Mentes ; Bisanzio, Donal ; Bjertness, Espen ; Blore, Jed D. ; Bourne, Rupert R. ; Brainin, Michael ; Bražinová, Alexandra ; Breitborde, Nicholas J K ; Brown, Alexandria ; Buckle, Geoffrey Colin ; Burch, Michael ; Butt, Zahid A. ; Campos-Nonato, Ismael R. ; Campuzano, Julio C. ; Cardenas, Rosario ; Carpenter, David O. ; Carrero, Juan Jesus ; Carter, Austin ; Casey, Daniel ; Castaneda-Orjuela, Carlos A. ; Rivas, Jacqueline Castillo ; Castro, Ruben Estanislao ; Catala-Lopez, Ferran ; Cercy, Kelly ; Chang, Hsing Yi ; Chang, Jung Chen ; Chibueze, Chioma Ezinne ; Chisumpa, Vesper Hichilombwe ; Choi, Jee Young Jasmine ; Chowdhury, Rajiv ; Christopher, Devasahayam Jesudas ; Ciobanu, Liliana G. ; Colquhoun, Samantha M. ; Cooper, C. ; Cornaby, Leslie ; Damtew, Solomon Abrha ; Danawi, Hadi ; Dandona, Rakhi ; das Neves, José ; Davis, Adrian C. ; de Jager, Pieter ; De Leo, Diego ; Degenhardt, Louisa ; Deribe, Kebede ; Deribew, Amare ; Jarlais, Don C Des ; DeVeber, Gabrielle A. ; Dharmaratne, Samath D. ; Dhillon, Preet K. ; Ding, Eric L. ; Doshi, Pratik Pinal ; Doyle, Kerrie E. ; Duan, Leilei ; Dubey, Manisha ; Ebrahimi, Hedyeh ; Ellingsen, Christian Lycke ; Elyazar, Iqbal ; Endries, Aman Yesuf ; Ermakov, Sergey P. ; Eshrati, Babak ; Esteghamati, Alireza ; Faraon, Emerito Jose A ; Farid, Talha A. ; Farinha, Carla Sofia e Sa ; Faro, Andre ; Farvid, Maryam S. ; Farzadfar, Farshad ; Fereshtehnejad, Seyed Mohammad ; Fernandes, Joao C. ; Fischer, Florian ; Fitchett, Joseph Robert Ander ; Foigt, Nataliya ; Franklin, Richard C. ; Friedman, Joseph ; Fürst, Thomas ; Gambashidze, Ketevan ; Gamkrelidze, A. ; Ganguly, Parthasarathi ; Gebre, Teshome ; Gebrehiwot, Tsegaye Tsewelde ; Gebremedhin, Amanuel Tesfay ; Gebru, Alemseged Aregay ; Geleijnse, Johanna M. ; Gessner, Bradford D. ; Ginawi, Ibrahim A. ; Giref, Ababi Zergaw ; Gishu, Melkamu Dedefo ; Gomez Dantes, Hector ; Gona, Philimon ; Goodridge, Amador ; Gopalani, Sameer Vali ; Goto, Atsushi ; Gouda, Hebe N. ; Gugnani, Harish C. ; Guo, Yuming ; Gupta, Rahul ; Gupta, Rajeev ; Gupta, Vipin ; Gyawali, Bishal ; Haagsma, Juanita A. ; Hafezi-Nejad, Nima ; Haile, Demewoz ; Hailu, Alemayehu Desalegne ; Hailu, Gessessew Bugssa ; Hamadeh, Randah R. ; Hancock, Jamie ; Handal, Alexis J. ; Hankey, G. 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Dean ; Hotez, Peter J. ; Hoy, Damian G. ; Hsairi, Mohamed ; Hu, Guoqing ; Huang, Cheng ; Huang, John J. ; Huang, Hsiang ; Huiart, Laetitia ; Iburg, Kim M. ; Idrisov, Bulat T. ; Innos, Kaire ; Jacobsen, Kathryn H. ; Jahanmehr, Nader ; Javanbakht, Mehdi ; Jayatilleke, Achala Upendra ; Jee, Sun Ha ; Jeemon, Panniyammakal ; Jha, Vivekanand ; Jiang, Guohong ; Jiang, Ying ; Jibat, Tariku ; Jin, Ye ; Jonas, Jost B. ; Kabir, Zubair ; Kalkonde, Yogeshwar ; Kamal, Ritul ; Kan, Haidong ; Kang, Gagandeep ; Karch, Andre ; Karema, Corine Kakizi ; Kasaeian, Amir ; Kaul, Anil ; Kawakami, Norito ; Kayibanda, Jeanne Françoise ; Kazanjan, Konstantin ; Keiyoro, Peter Njenga ; Kemp, Andrew H. ; Kengne, Andrew Pascal ; Keren, A. ; Kereselidze, Maia ; Kesavachandran, Chandrasekharan Nair ; Khader, Yousef Saleh ; Khalil, Ibrahim A. ; Khan, Abdur Rahman ; Khan, Ejaz Ahmad ; Khang, Young Ho ; Khonelidze, Irma ; Khubchandani, Jagdish ; Kim, Cho il ; Kim, Daniel ; Kim, Yunjin ; Kissoon, Niranjan ; Kivipelto, M. ; Knibbs, Luke ; Kokubo, Yoshihiro ; Kosen, Soewarta ; Koul, Parvaiz A. ; Koyanagi, Ai ; Defo, Barthelemy Kuate ; Bicer, Burcu Kucuk ; Kudom, Andreas A. ; Kumar, G. Anil ; Kyu, Hmwe ; Lal, Dharmesh Kumar ; Lalloo, Ratilal ; Lam, Hilton ; Lam, Jennifer O. ; Lansingh, Van C. ; Larsson, Anders ; Leigh, James ; Leung, Ricky ; Li, Yichong ; Li, Yongmei ; Lindsay, M. Patrice ; Liu, Patrick Y. ; Liu, Shiwei ; Lloyd, Belinda K. ; Lo, Warren D. ; Logroscino, Giancarlo ; Low, Nicola ; Lunevicius, Raimundas ; Lyons, Ronan A. ; Ma, Stefan ; Razek, Hassan Magdy Abd El ; Razek, Mohamed Magdy Abd El ; Mahdavi, Mahdi ; Majdan, Marek ; Majeed, Azeem ; Malekzadeh, Reza ; Mapoma, Christopher C. ; Marcenes, Wagner ; Martinez-Raga, Jose ; Marzan, Melvin B. ; Masiye, Felix ; McGrath, John J. ; Meaney, Peter A. ; Mehari, Alem ; Mehndiratta, Man Mohan ; Mekonnen, Alemayehu B. ; Melaku, Yohannes A. ; Memiah, Peter ; Memish, Ziad ; Mendoza, Walter ; Meretoja, Atte ; Meretoja, Tuomo J. ; Mhimbira, Francis Apolinary ; Miller, Ted R. ; Mills, Edward J. ; Mirarefin, Mojde ; Misganaw, Awoke ; Mock, Charles N. ; Mohammad, Karzan Abdulmuhsin ; Mohammadi, Alireza ; Mohammed, Shafiu ; Monasta, Lorenzo ; Hernandez, Julio C Montanêz ; Montico, Marcella ; Moore, Ami R. ; Moradi-Lakeh, Maziar ; Morawska, Lidia ; Mori, Rintaro ; Mueller, Ulrich O. ; Murphy, Georgina A V ; Murthy, Srinivas G. ; Nachega, Jean ; Naheed, Aliya ; Naidoo, Kovin S. ; Naldi, Luigi ; Nand, Devina ; Nangia, Vinay ; Neupane, Subas ; Newton, Charles R. ; Newton, J. ; Ng, Marie ; Ngalesoni, Frida N. ; Nguhiu, Peter ; Nguyen, Quyen Le ; Nisar, Muhammad Imran ; Pete, Patrick Martial Nkamedjie ; Norheim, Ole F. ; Norman, Rosana E. ; Ogbo, Felix Akpojene ; Oh, In Hwan ; Ojelabi, Foluke Adetola ; Olivares, Pedro R. ; Olusanya, Bolajoko O. ; Olusanya, Jacob Olusegun ; Oren, Eyal ; Ota, Erika ; PA, Mahesh ; Park, Eun Kee ; Park, Hye Youn ; Parsaeian, Mahboubeh ; Caicedo, Angel J Paternina ; Patten, Scott B. ; Pedro, João Mário ; Pereira, David M. ; Perico, Norberto ; Pesudovs, Konrad ; Petzold, Max ; Phillips, Michael R. ; Pillay, Julian David ; Pishgar, Farhad ; Polinder, Suzanne ; Pope, D. ; Popova, Svetlana ; Pourmalek, Farshad ; Qorbani, Mostafa ; Rabiee, Rynaz H S ; Rafay, Anwar ; Rahimi-Movaghar, Vafa ; Rahman, Mahfuzar ; Rahman, Mohammad Hifz Ur ; Rahman, Sajjad U R ; Rai, Rajesh Kumar ; Raju, Murugesan ; Ram, Usha ; Rana, Saleem M. ; Ranabhat, Chhabi L. ; Rao, Puja ; Refaat, Amany H. ; Remuzzi, Giuseppe ; Resnikoff, Serge ; Reynolds, Alex ; Rojas-Rueda, David ; Ronfani, Luca ; Roshandel, Gholamreza ; Roth, Gregory A. ; Roy, Ambuj ; Ruhago, George M. ; Sagar, Rajesh ; Saleh, Muhammad Muhammad ; Sanabria, Juan R. ; Sanchez-Niño, Maria Dolores ; Santos, Itamar S. ; Santos, João Vasco ; Sarmiento-Suarez, Rodrigo ; Sartorius, Benn ; Satpathy, Maheswar ; Savic, Miloje ; Sawhney, Monika ; Schneider, Ione J C ; Schöttker, Ben ; Schwebel, David C. ; Seedat, S. ; Sepanlou, Sadaf G. ; Servan-Mori, Edson E. ; Setegn, Tesfaye ; Shahraz, Saeid ; Shaikh, Masood Ali ; Shakh-Nazarova, Marina ; Sharma, Rajesh ; She, Jun ; Sheikhbahaei, Sara ; Shen, Jiabin ; Sheth, Kevin N. ; Shibuya, Kenji ; Shin, Hwashin Hyun ; Shin, Min Jeong ; Shiri, Rahman ; Shuie, Ivy ; Sigfusdottir, Inga D. ; Silva, Diego Augusto Santos ; Silverberg, Jonathan I. ; Simard, Edgar P. ; Sindi, Shireen ; Singh, Abhishek ; Singh, Jasvinder A. ; Singh, Om Prakash ; Singh, Prashant Kumar ; Singh, Virendra ; Soriano, Joan B. ; Soshnikov, Sergey ; Sposato, Luciano A. ; Sreeramareddy, Chandrashekhar T. ; Stathopoulou, Vasiliki ; Steel, Nicholas ; Stroumpoulis, Konstantinos ; Sturua, Lela ; Sunguya, Bruno F. ; Swaminathan, Soumya ; Sykes, Bryan L. ; Szoeke, Cassandra E I ; Tabares-Seisdedos, Rafael ; Tavakkoli, Mohammad ; Taye, Bineyam ; Tedla, Bemnet Amare ; Tefera, Worku Mekonnen ; Tekle, Tesfaye ; Shifa, Girma Temam ; Terkawi, Abdullah Sulieman ; Tesfay, Fisaha Haile ; Tessema, Gizachew Assefa ; Thapa, Kiran ; Thomson, Alan J. ; Thorne-Lyman, Andrew L. ; Tobe-Gai, Ruoyan ; Tonelli, Marcello ; Topor-Madry, Roman ; Topouzis, Fotis ; Tran, Bach X. ; Troeger, Christopher ; Truelsen, Thomas ; Dimbuene, Zacharie Tsala ; Tura, Abera Kenay ; Tyrovolas, Stefanos ; Ukwaja, Kingsley N. ; Uneke, Chigozie Jesse ; Uthman, Olalekan A. ; Vaezghasemi, Masoud ; Vasankari, Tommi ; Vasconcelos, Ana Maria Nogales ; Venketasubramanian, Narayanaswamy ; Verma, Raj Kumar ; Violante, F. S. ; Vladimirov, Sergey K. ; Vlassov, Vasiliy V. ; Vollset, Stein Emil ; Wang, Linhong ; Wang, Yanping ; Weichenthal, Scott ; Weiderpass, Elisabete ; Weintraub, Robert G. ; Weiss, Daniel J. ; Werdecker, Andrea ; Westerman, Ronny ; Widdowson, Marc Alain ; Wijeratne, Tissa ; Williams, Thomas Neil ; Wiysonge, Charles Shey ; Wolfe, Charles D A ; Wolfe, Ingrid ; Won, Sungho ; Wubshet, Mamo ; Xiao, Qingyang ; Xu, Gelin ; Yadav, Ajit Kumar ; Yakob, Bereket ; Yano, Yuichiro ; Yaseri, Mehdi ; Ye, Pengpeng ; Yebyo, Henock Gebremedhin ; Yip, Paul ; Yonemoto, Naohiro ; Yoon, Seok Jun ; Younis, Mustafa ; Yu, Chuanhua ; Zaidi, Zoubida ; Zaki, Maysaa El Sayed ; Zeeb, Hajo ; Zhang, Hao ; Zhao, Yong ; Zheng, Yingfeng ; Zhou, Maigeng ; Zodpey, Sanjay ; Murray, Christopher J L. / 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. In: The Lancet. 2016 ; Vol. 388, No. 10053. pp. 1725-1774.
@article{bf73fbbe7373467e876b9a679dc130b8,
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",
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. Funding Bill & Melinda Gates Foundation.",
author = "Haidong Wang and Zulfiqar Bhutta and Coates, {Matthew M.} and Megan Coggeshall and Lalit Dandona and Khassoum Diallo and Fran{\cc}a, {Elisabeth B.} and Fraser, {Maya S.} and Nancy Fullman and Peter Gething and Simon Hay and Yohannes Kinfu and Maaya Kita and Kulikoff, {Xie Rachel} and Heidi Larson and Juan Liang and Xiaofeng Liang and Margaret Lind and Lopez, {Alan D.} and Rafael Lozano and George Mensah and Joseph Mikesell and Mokdad, {Ali H.} and Mooney, {Meghan D.} and Grant Nguyen and Ivo Rakovac and Salomon, {Joshua A.} and Naris Silpakit and Amber Sligar and Sorensen, {Reed J D} and Theo Vos and Jun Zhu and Abajobir, {Amanuel Alemu} and Abate, {Kalkidan Hassen} and Abbas, {Kaja M.} and Foad Abd-Allah and Abdulle, {Abdishakur M.} and Abera, {Semaw F.} and Victor Aboyans and Biju Abraham and Ibrahim Abubakar and Abu-Raddad, {Laith J.} and Niveen Abu-Rmeileh and Abyu, {Gebre Yitayih} and Tom Achoki and Adebiyi, {Akindele Olupelumi} and Adedeji, {Isaac Akinkunmi} and Ademola Adelekan and Adou, {Ars{\`e}ne K.} and Arnav Agarwal and Ajala, {Oluremi N.} and Akinyemiju, {Tomi F.} and Nadia Akseer and Khurshid Alam and Alam, {Noore K M} and Deena Alasfoor and Aldridge, {Robert William} and Alegretti, {Miguel A.} and Alemu, {Zewdie Aderaw} and Raghib Ali and Ala'a Alkerwi and Fran{\cc}ois Alla and Rajaa Al-Raddadi and Ubai Alsharif and Altirkawi, {Khalid A.} and Martin, {Elena Alvarez} and Nelson Alvis-Guzman and Amare, {Azmeraw T.} and Alemayehu Amberbir and Amegah, {Adeladza Kofi} and Ameh, {Emmanuel A.} and Walid Ammar and Amrock, {Stephen Marc} and Andersen, {Hjalte H.} and Anderson, {Gregory M.} and Antonio, {Carl Abelardo T} and Johan {\"A}rnl{\"o}v and Al Artaman and Hamid Asayesh and Asghar, {Rana J.} and Reza Assadi and Suleman Atique and Avokpaho, {Euripide Frinel G Arthur} and Ashish Awasthi and Quintanilla, {Beatriz Paulina Ayala} and Umar Bacha and Alaa Badawi and Kalpana Balakrishnan and Amitava Banerjee and Banigbe, {Bolanle F.} and Aleksandra Barac and Barber, {Ryan M.} and Barker-Collo, {Suzanne L.} and Till B{\"a}rnighausen and Barrero, {Lope H.} and Bayou, {Tigist Assefa} and Bayou, {Yibeltal Tebekaw} and Shahrzad Bazargan-Hejazi and Justin Beardsley and Neeraj Bedi and Tolesa Bekele and Bell, {Michelle L.} and Bello, {Aminu K.} and Bennett, {Derrick A.} and Bensenor, {Isabela M.} and Adugnaw Berhane and Eduardo Bernabe and Betsu, {Balem Demtsu} and Samir Bhatt and Sibhatu Biadgilign and Boris Bikbov and Birlik, {Sait Mentes} and Donal Bisanzio and Espen Bjertness and Blore, {Jed D.} and Bourne, {Rupert R.} and Michael Brainin and Alexandra Bražinov{\'a} and Breitborde, {Nicholas J K} and Alexandria Brown and Buckle, {Geoffrey Colin} and Michael Burch and Butt, {Zahid A.} and Campos-Nonato, {Ismael R.} and Campuzano, {Julio C.} and Rosario Cardenas and Carpenter, {David O.} and Carrero, {Juan Jesus} and Austin Carter and Daniel Casey and Castaneda-Orjuela, {Carlos A.} and Rivas, {Jacqueline Castillo} and Castro, {Ruben Estanislao} and Ferran Catala-Lopez and Kelly Cercy and Chang, {Hsing Yi} and Chang, {Jung Chen} and Chibueze, {Chioma Ezinne} and Chisumpa, {Vesper Hichilombwe} and Choi, {Jee Young Jasmine} and Rajiv Chowdhury and Christopher, {Devasahayam Jesudas} and Ciobanu, {Liliana G.} and Colquhoun, {Samantha M.} and C. Cooper and Leslie Cornaby and Damtew, {Solomon Abrha} and Hadi Danawi and Rakhi Dandona and {das Neves}, Jos{\'e} and Davis, {Adrian C.} and {de Jager}, Pieter and {De Leo}, Diego and Louisa Degenhardt and Kebede Deribe and Amare Deribew and Jarlais, {Don C Des} and DeVeber, {Gabrielle A.} and Dharmaratne, {Samath D.} and Dhillon, {Preet K.} and Ding, {Eric L.} and Doshi, {Pratik Pinal} and Doyle, {Kerrie E.} and Leilei Duan and Manisha Dubey and Hedyeh Ebrahimi and Ellingsen, {Christian Lycke} and Iqbal Elyazar and Endries, {Aman Yesuf} and Ermakov, {Sergey P.} and Babak Eshrati and Alireza Esteghamati and Faraon, {Emerito Jose A} and Farid, {Talha A.} and Farinha, {Carla Sofia e Sa} and Andre Faro and Farvid, {Maryam S.} and Farshad Farzadfar and Fereshtehnejad, {Seyed Mohammad} and Fernandes, {Joao C.} and Florian Fischer and Fitchett, {Joseph Robert Ander} and Nataliya Foigt and Franklin, {Richard C.} and Joseph Friedman and Thomas F{\"u}rst and Ketevan Gambashidze and A. Gamkrelidze and Parthasarathi Ganguly and Teshome Gebre and Gebrehiwot, {Tsegaye Tsewelde} and Gebremedhin, {Amanuel Tesfay} and Gebru, {Alemseged Aregay} and Geleijnse, {Johanna M.} and Gessner, {Bradford D.} and Ginawi, {Ibrahim A.} and Giref, {Ababi Zergaw} and Gishu, {Melkamu Dedefo} and {Gomez Dantes}, Hector and Philimon Gona and Amador Goodridge and Gopalani, {Sameer Vali} and Atsushi Goto and Gouda, {Hebe N.} and Gugnani, {Harish C.} and Yuming Guo and Rahul Gupta and Rajeev Gupta and Vipin Gupta and Bishal Gyawali and Haagsma, {Juanita A.} and Nima Hafezi-Nejad and Demewoz Haile and Hailu, {Alemayehu Desalegne} and Hailu, {Gessessew Bugssa} and Hamadeh, {Randah R.} and Jamie Hancock and Handal, {Alexis J.} and Hankey, {G. J.} and Harb, {Hilda L.} and Sivadasanpillai Harikrishnan and Harun, {Kimani M.} and Rasmus Havmoeller and Hay, {Roderick J.} and {Heredia Pi}, {Ileana B.} and Hoek, {Hans W.} and Masako Horino and Nobuyuki Horita and Hosgood, {H. Dean} and Hotez, {Peter J.} and Hoy, {Damian G.} and Mohamed Hsairi and Guoqing Hu and Cheng Huang and Huang, {John J.} and Hsiang Huang and Laetitia Huiart and Iburg, {Kim M.} and Idrisov, {Bulat T.} and Kaire Innos and Jacobsen, {Kathryn H.} and Nader Jahanmehr and Mehdi Javanbakht and Jayatilleke, {Achala Upendra} and Jee, {Sun Ha} and Panniyammakal Jeemon and Vivekanand Jha and Guohong Jiang and Ying Jiang and Tariku Jibat and Ye Jin and Jonas, {Jost B.} and Zubair Kabir and Yogeshwar Kalkonde and Ritul Kamal and Haidong Kan and Gagandeep Kang and Andre Karch and Karema, {Corine Kakizi} and Amir Kasaeian and Anil Kaul and Norito Kawakami and Kayibanda, {Jeanne Fran{\cc}oise} and Konstantin Kazanjan and Keiyoro, {Peter Njenga} and Kemp, {Andrew H.} and Kengne, {Andrew Pascal} and A. Keren and Maia Kereselidze and Kesavachandran, {Chandrasekharan Nair} and Khader, {Yousef Saleh} and Khalil, {Ibrahim A.} and Khan, {Abdur Rahman} and Khan, {Ejaz Ahmad} and Khang, {Young Ho} and Irma Khonelidze and Jagdish Khubchandani and Kim, {Cho il} and Daniel Kim and Yunjin Kim and Niranjan Kissoon and M. Kivipelto and Luke Knibbs and Yoshihiro Kokubo and Soewarta Kosen and Koul, {Parvaiz A.} and Ai Koyanagi and Defo, {Barthelemy Kuate} and Bicer, {Burcu Kucuk} and Kudom, {Andreas A.} and Kumar, {G. Anil} and Hmwe Kyu and Lal, {Dharmesh Kumar} and Ratilal Lalloo and Hilton Lam and Lam, {Jennifer O.} and Lansingh, {Van C.} and Anders Larsson and James Leigh and Ricky Leung and Yichong Li and Yongmei Li and Lindsay, {M. 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S.} and Vladimirov, {Sergey K.} and Vlassov, {Vasiliy V.} and Vollset, {Stein Emil} and Linhong Wang and Yanping Wang and Scott Weichenthal and Elisabete Weiderpass and Weintraub, {Robert G.} and Weiss, {Daniel J.} and Andrea Werdecker and Ronny Westerman and Widdowson, {Marc Alain} and Tissa Wijeratne and Williams, {Thomas Neil} and Wiysonge, {Charles Shey} and Wolfe, {Charles D A} and Ingrid Wolfe and Sungho Won and Mamo Wubshet and Qingyang Xiao and Gelin Xu and Yadav, {Ajit Kumar} and Bereket Yakob and Yuichiro Yano and Mehdi Yaseri and Pengpeng Ye and Yebyo, {Henock Gebremedhin} and Paul Yip and Naohiro Yonemoto and Yoon, {Seok Jun} and Mustafa Younis and Chuanhua Yu and Zoubida Zaidi and Zaki, {Maysaa El Sayed} and Hajo Zeeb and Hao Zhang and Yong Zhao and Yingfeng Zheng and Maigeng Zhou and Sanjay Zodpey and Murray, {Christopher J L}",
year = "2016",
month = "10",
day = "8",
doi = "10.1016/S0140-6736(16)31575-6",
language = "English",
volume = "388",
pages = "1725--1774",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Lancet Publishing Group",
number = "10053",

}

TY - JOUR

T1 - Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015

T2 - a systematic analysis for the Global Burden of Disease Study 2015

AU - Wang, Haidong

AU - Bhutta, Zulfiqar

AU - Coates, Matthew M.

AU - Coggeshall, Megan

AU - Dandona, Lalit

AU - Diallo, Khassoum

AU - França, Elisabeth B.

AU - Fraser, Maya S.

AU - Fullman, Nancy

AU - Gething, Peter

AU - Hay, Simon

AU - Kinfu, Yohannes

AU - Kita, Maaya

AU - Kulikoff, Xie Rachel

AU - Larson, Heidi

AU - Liang, Juan

AU - Liang, Xiaofeng

AU - Lind, Margaret

AU - Lopez, Alan D.

AU - Lozano, Rafael

AU - Mensah, George

AU - Mikesell, Joseph

AU - Mokdad, Ali H.

AU - Mooney, Meghan D.

AU - Nguyen, Grant

AU - Rakovac, Ivo

AU - Salomon, Joshua A.

AU - Silpakit, Naris

AU - Sligar, Amber

AU - Sorensen, Reed J D

AU - Vos, Theo

AU - Zhu, Jun

AU - Abajobir, Amanuel Alemu

AU - Abate, Kalkidan Hassen

AU - Abbas, Kaja M.

AU - Abd-Allah, Foad

AU - Abdulle, Abdishakur M.

AU - Abera, Semaw F.

AU - Aboyans, Victor

AU - Abraham, Biju

AU - Abubakar, Ibrahim

AU - Abu-Raddad, Laith J.

AU - Abu-Rmeileh, Niveen

AU - Abyu, Gebre Yitayih

AU - Achoki, Tom

AU - Adebiyi, Akindele Olupelumi

AU - Adedeji, Isaac Akinkunmi

AU - Adelekan, Ademola

AU - Adou, Arsène K.

AU - Agarwal, Arnav

AU - Ajala, Oluremi N.

AU - Akinyemiju, Tomi F.

AU - Akseer, Nadia

AU - Alam, Khurshid

AU - Alam, Noore K M

AU - Alasfoor, Deena

AU - Aldridge, Robert William

AU - Alegretti, Miguel A.

AU - Alemu, Zewdie Aderaw

AU - Ali, Raghib

AU - Alkerwi, Ala'a

AU - Alla, François

AU - Al-Raddadi, Rajaa

AU - Alsharif, Ubai

AU - Altirkawi, Khalid A.

AU - Martin, Elena Alvarez

AU - Alvis-Guzman, Nelson

AU - Amare, Azmeraw T.

AU - Amberbir, Alemayehu

AU - Amegah, Adeladza Kofi

AU - Ameh, Emmanuel A.

AU - Ammar, Walid

AU - Amrock, Stephen Marc

AU - Andersen, Hjalte H.

AU - Anderson, Gregory M.

AU - Antonio, Carl Abelardo T

AU - Ärnlöv, Johan

AU - Artaman, Al

AU - Asayesh, Hamid

AU - Asghar, Rana J.

AU - Assadi, Reza

AU - Atique, Suleman

AU - Avokpaho, Euripide Frinel G Arthur

AU - Awasthi, Ashish

AU - Quintanilla, Beatriz Paulina Ayala

AU - Bacha, Umar

AU - Badawi, Alaa

AU - Balakrishnan, Kalpana

AU - Banerjee, Amitava

AU - Banigbe, Bolanle F.

AU - Barac, Aleksandra

AU - Barber, Ryan M.

AU - Barker-Collo, Suzanne L.

AU - Bärnighausen, Till

AU - Barrero, Lope H.

AU - Bayou, Tigist Assefa

AU - Bayou, Yibeltal Tebekaw

AU - Bazargan-Hejazi, Shahrzad

AU - Beardsley, Justin

AU - Bedi, Neeraj

AU - Bekele, Tolesa

AU - Bell, Michelle L.

AU - Bello, Aminu K.

AU - Bennett, Derrick A.

AU - Bensenor, Isabela M.

AU - Berhane, Adugnaw

AU - Bernabe, Eduardo

AU - Betsu, Balem Demtsu

AU - Bhatt, Samir

AU - Biadgilign, Sibhatu

AU - Bikbov, Boris

AU - Birlik, Sait Mentes

AU - Bisanzio, Donal

AU - Bjertness, Espen

AU - Blore, Jed D.

AU - Bourne, Rupert R.

AU - Brainin, Michael

AU - Bražinová, Alexandra

AU - Breitborde, Nicholas J K

AU - Brown, Alexandria

AU - Buckle, Geoffrey Colin

AU - Burch, Michael

AU - Butt, Zahid A.

AU - Campos-Nonato, Ismael R.

AU - Campuzano, Julio C.

AU - Cardenas, Rosario

AU - Carpenter, David O.

AU - Carrero, Juan Jesus

AU - Carter, Austin

AU - Casey, Daniel

AU - Castaneda-Orjuela, Carlos A.

AU - Rivas, Jacqueline Castillo

AU - Castro, Ruben Estanislao

AU - Catala-Lopez, Ferran

AU - Cercy, Kelly

AU - Chang, Hsing Yi

AU - Chang, Jung Chen

AU - Chibueze, Chioma Ezinne

AU - Chisumpa, Vesper Hichilombwe

AU - Choi, Jee Young Jasmine

AU - Chowdhury, Rajiv

AU - Christopher, Devasahayam Jesudas

AU - Ciobanu, Liliana G.

AU - Colquhoun, Samantha M.

AU - Cooper, C.

AU - Cornaby, Leslie

AU - Damtew, Solomon Abrha

AU - Danawi, Hadi

AU - Dandona, Rakhi

AU - das Neves, José

AU - Davis, Adrian C.

AU - de Jager, Pieter

AU - De Leo, Diego

AU - Degenhardt, Louisa

AU - Deribe, Kebede

AU - Deribew, Amare

AU - Jarlais, Don C Des

AU - DeVeber, Gabrielle A.

AU - Dharmaratne, Samath D.

AU - Dhillon, Preet K.

AU - Ding, Eric L.

AU - Doshi, Pratik Pinal

AU - Doyle, Kerrie E.

AU - Duan, Leilei

AU - Dubey, Manisha

AU - Ebrahimi, Hedyeh

AU - Ellingsen, Christian Lycke

AU - Elyazar, Iqbal

AU - Endries, Aman Yesuf

AU - Ermakov, Sergey P.

AU - Eshrati, Babak

AU - Esteghamati, Alireza

AU - Faraon, Emerito Jose A

AU - Farid, Talha A.

AU - Farinha, Carla Sofia e Sa

AU - Faro, Andre

AU - Farvid, Maryam S.

AU - Farzadfar, Farshad

AU - Fereshtehnejad, Seyed Mohammad

AU - Fernandes, Joao C.

AU - Fischer, Florian

AU - Fitchett, Joseph Robert Ander

AU - Foigt, Nataliya

AU - Franklin, Richard C.

AU - Friedman, Joseph

AU - Fürst, Thomas

AU - Gambashidze, Ketevan

AU - Gamkrelidze, A.

AU - Ganguly, Parthasarathi

AU - Gebre, Teshome

AU - Gebrehiwot, Tsegaye Tsewelde

AU - Gebremedhin, Amanuel Tesfay

AU - Gebru, Alemseged Aregay

AU - Geleijnse, Johanna M.

AU - Gessner, Bradford D.

AU - Ginawi, Ibrahim A.

AU - Giref, Ababi Zergaw

AU - Gishu, Melkamu Dedefo

AU - Gomez Dantes, Hector

AU - Gona, Philimon

AU - Goodridge, Amador

AU - Gopalani, Sameer Vali

AU - Goto, Atsushi

AU - Gouda, Hebe N.

AU - Gugnani, Harish C.

AU - Guo, Yuming

AU - Gupta, Rahul

AU - Gupta, Rajeev

AU - Gupta, Vipin

AU - Gyawali, Bishal

AU - Haagsma, Juanita A.

AU - Hafezi-Nejad, Nima

AU - Haile, Demewoz

AU - Hailu, Alemayehu Desalegne

AU - Hailu, Gessessew Bugssa

AU - Hamadeh, Randah R.

AU - Hancock, Jamie

AU - Handal, Alexis J.

AU - Hankey, G. J.

AU - Harb, Hilda L.

AU - Harikrishnan, Sivadasanpillai

AU - Harun, Kimani M.

AU - Havmoeller, Rasmus

AU - Hay, Roderick J.

AU - Heredia Pi, Ileana B.

AU - Hoek, Hans W.

AU - Horino, Masako

AU - Horita, Nobuyuki

AU - Hosgood, H. Dean

AU - Hotez, Peter J.

AU - Hoy, Damian G.

AU - Hsairi, Mohamed

AU - Hu, Guoqing

AU - Huang, Cheng

AU - Huang, John J.

AU - Huang, Hsiang

AU - Huiart, Laetitia

AU - Iburg, Kim M.

AU - Idrisov, Bulat T.

AU - Innos, Kaire

AU - Jacobsen, Kathryn H.

AU - Jahanmehr, Nader

AU - Javanbakht, Mehdi

AU - Jayatilleke, Achala Upendra

AU - Jee, Sun Ha

AU - Jeemon, Panniyammakal

AU - Jha, Vivekanand

AU - Jiang, Guohong

AU - Jiang, Ying

AU - Jibat, Tariku

AU - Jin, Ye

AU - Jonas, Jost B.

AU - Kabir, Zubair

AU - Kalkonde, Yogeshwar

AU - Kamal, Ritul

AU - Kan, Haidong

AU - Kang, Gagandeep

AU - Karch, Andre

AU - Karema, Corine Kakizi

AU - Kasaeian, Amir

AU - Kaul, Anil

AU - Kawakami, Norito

AU - Kayibanda, Jeanne Françoise

AU - Kazanjan, Konstantin

AU - Keiyoro, Peter Njenga

AU - Kemp, Andrew H.

AU - Kengne, Andrew Pascal

AU - Keren, A.

AU - Kereselidze, Maia

AU - Kesavachandran, Chandrasekharan Nair

AU - Khader, Yousef Saleh

AU - Khalil, Ibrahim A.

AU - Khan, Abdur Rahman

AU - Khan, Ejaz Ahmad

AU - Khang, Young Ho

AU - Khonelidze, Irma

AU - Khubchandani, Jagdish

AU - Kim, Cho il

AU - Kim, Daniel

AU - Kim, Yunjin

AU - Kissoon, Niranjan

AU - Kivipelto, M.

AU - Knibbs, Luke

AU - Kokubo, Yoshihiro

AU - Kosen, Soewarta

AU - Koul, Parvaiz A.

AU - Koyanagi, Ai

AU - Defo, Barthelemy Kuate

AU - Bicer, Burcu Kucuk

AU - Kudom, Andreas A.

AU - Kumar, G. Anil

AU - Kyu, Hmwe

AU - Lal, Dharmesh Kumar

AU - Lalloo, Ratilal

AU - Lam, Hilton

AU - Lam, Jennifer O.

AU - Lansingh, Van C.

AU - Larsson, Anders

AU - Leigh, James

AU - Leung, Ricky

AU - Li, Yichong

AU - Li, Yongmei

AU - Lindsay, M. Patrice

AU - Liu, Patrick Y.

AU - Liu, Shiwei

AU - Lloyd, Belinda K.

AU - Lo, Warren D.

AU - Logroscino, Giancarlo

AU - Low, Nicola

AU - Lunevicius, Raimundas

AU - Lyons, Ronan A.

AU - Ma, Stefan

AU - Razek, Hassan Magdy Abd El

AU - Razek, Mohamed Magdy Abd El

AU - Mahdavi, Mahdi

AU - Majdan, Marek

AU - Majeed, Azeem

AU - Malekzadeh, Reza

AU - Mapoma, Christopher C.

AU - Marcenes, Wagner

AU - Martinez-Raga, Jose

AU - Marzan, Melvin B.

AU - Masiye, Felix

AU - McGrath, John J.

AU - Meaney, Peter A.

AU - Mehari, Alem

AU - Mehndiratta, Man Mohan

AU - Mekonnen, Alemayehu B.

AU - Melaku, Yohannes A.

AU - Memiah, Peter

AU - Memish, Ziad

AU - Mendoza, Walter

AU - Meretoja, Atte

AU - Meretoja, Tuomo J.

AU - Mhimbira, Francis Apolinary

AU - Miller, Ted R.

AU - Mills, Edward J.

AU - Mirarefin, Mojde

AU - Misganaw, Awoke

AU - Mock, Charles N.

AU - Mohammad, Karzan Abdulmuhsin

AU - Mohammadi, Alireza

AU - Mohammed, Shafiu

AU - Monasta, Lorenzo

AU - Hernandez, Julio C Montanêz

AU - Montico, Marcella

AU - Moore, Ami R.

AU - Moradi-Lakeh, Maziar

AU - Morawska, Lidia

AU - Mori, Rintaro

AU - Mueller, Ulrich O.

AU - Murphy, Georgina A V

AU - Murthy, Srinivas G.

AU - Nachega, Jean

AU - Naheed, Aliya

AU - Naidoo, Kovin S.

AU - Naldi, Luigi

AU - Nand, Devina

AU - Nangia, Vinay

AU - Neupane, Subas

AU - Newton, Charles R.

AU - Newton, J.

AU - Ng, Marie

AU - Ngalesoni, Frida N.

AU - Nguhiu, Peter

AU - Nguyen, Quyen Le

AU - Nisar, Muhammad Imran

AU - Pete, Patrick Martial Nkamedjie

AU - Norheim, Ole F.

AU - Norman, Rosana E.

AU - Ogbo, Felix Akpojene

AU - Oh, In Hwan

AU - Ojelabi, Foluke Adetola

AU - Olivares, Pedro R.

AU - Olusanya, Bolajoko O.

AU - Olusanya, Jacob Olusegun

AU - Oren, Eyal

AU - Ota, Erika

AU - PA, Mahesh

AU - Park, Eun Kee

AU - Park, Hye Youn

AU - Parsaeian, Mahboubeh

AU - Caicedo, Angel J Paternina

AU - Patten, Scott B.

AU - Pedro, João Mário

AU - Pereira, David M.

AU - Perico, Norberto

AU - Pesudovs, Konrad

AU - Petzold, Max

AU - Phillips, Michael R.

AU - Pillay, Julian David

AU - Pishgar, Farhad

AU - Polinder, Suzanne

AU - Pope, D.

AU - Popova, Svetlana

AU - Pourmalek, Farshad

AU - Qorbani, Mostafa

AU - Rabiee, Rynaz H S

AU - Rafay, Anwar

AU - Rahimi-Movaghar, Vafa

AU - Rahman, Mahfuzar

AU - Rahman, Mohammad Hifz Ur

AU - Rahman, Sajjad U R

AU - Rai, Rajesh Kumar

AU - Raju, Murugesan

AU - Ram, Usha

AU - Rana, Saleem M.

AU - Ranabhat, Chhabi L.

AU - Rao, Puja

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AU - Remuzzi, Giuseppe

AU - Resnikoff, Serge

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AU - Rojas-Rueda, David

AU - Ronfani, Luca

AU - Roshandel, Gholamreza

AU - Roth, Gregory A.

AU - Roy, Ambuj

AU - Ruhago, George M.

AU - Sagar, Rajesh

AU - Saleh, Muhammad Muhammad

AU - Sanabria, Juan R.

AU - Sanchez-Niño, Maria Dolores

AU - Santos, Itamar S.

AU - Santos, João Vasco

AU - Sarmiento-Suarez, Rodrigo

AU - Sartorius, Benn

AU - Satpathy, Maheswar

AU - Savic, Miloje

AU - Sawhney, Monika

AU - Schneider, Ione J C

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AU - Shahraz, Saeid

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AU - Sharma, Rajesh

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AU - Shin, Hwashin Hyun

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AU - Shiri, Rahman

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AU - Singh, Prashant Kumar

AU - Singh, Virendra

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AU - Sposato, Luciano A.

AU - Sreeramareddy, Chandrashekhar T.

AU - Stathopoulou, Vasiliki

AU - Steel, Nicholas

AU - Stroumpoulis, Konstantinos

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AU - Swaminathan, Soumya

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AU - Szoeke, Cassandra E I

AU - Tabares-Seisdedos, Rafael

AU - Tavakkoli, Mohammad

AU - Taye, Bineyam

AU - Tedla, Bemnet Amare

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AU - Tekle, Tesfaye

AU - Shifa, Girma Temam

AU - Terkawi, Abdullah Sulieman

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AU - Tessema, Gizachew Assefa

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AU - Uneke, Chigozie Jesse

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AU - Vasankari, Tommi

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AU - Venketasubramanian, Narayanaswamy

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AU - Violante, F. S.

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AU - Vlassov, Vasiliy V.

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AU - Wang, Linhong

AU - Wang, Yanping

AU - Weichenthal, Scott

AU - Weiderpass, Elisabete

AU - Weintraub, Robert G.

AU - Weiss, Daniel J.

AU - Werdecker, Andrea

AU - Westerman, Ronny

AU - Widdowson, Marc Alain

AU - Wijeratne, Tissa

AU - Williams, Thomas Neil

AU - Wiysonge, Charles Shey

AU - Wolfe, Charles D A

AU - Wolfe, Ingrid

AU - Won, Sungho

AU - Wubshet, Mamo

AU - Xiao, Qingyang

AU - Xu, Gelin

AU - Yadav, Ajit Kumar

AU - Yakob, Bereket

AU - Yano, Yuichiro

AU - Yaseri, Mehdi

AU - Ye, Pengpeng

AU - Yebyo, Henock Gebremedhin

AU - Yip, Paul

AU - Yonemoto, Naohiro

AU - Yoon, Seok Jun

AU - Younis, Mustafa

AU - Yu, Chuanhua

AU - Zaidi, Zoubida

AU - Zaki, Maysaa El Sayed

AU - Zeeb, Hajo

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AU - Zheng, Yingfeng

AU - Zhou, Maigeng

AU - Zodpey, Sanjay

AU - Murray, Christopher J L

PY - 2016/10/8

Y1 - 2016/10/8

N2 - 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. Funding Bill & Melinda Gates Foundation.

AB - 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. Funding Bill & Melinda Gates Foundation.

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U2 - 10.1016/S0140-6736(16)31575-6

DO - 10.1016/S0140-6736(16)31575-6

M3 - Article

VL - 388

SP - 1725

EP - 1774

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10053

ER -