Millennium Developmental Goal 4 aims for a global reduction in
under five mortality of two thirds between 1990 and 2015 and a
remarkable 50% reduction has been achieved so far. However,
most of the estimated 6.3 million deaths in under fives in 2013
were preventable. Under five mortality remains high in sub
Saharan Africa (92/1000 live births) and Southern Asia (55/1000
live births), compared with developed countries (6/1000 live
births). Outside the neonatal period, the most common primary
causes of death are pneumonia and diarrhoea (Figure 1). However,
researchers estimate that in 2011, 45% of all deaths were
attributable to underlying undernutrition, including growth restriction
in-utero, wasting, stunting, micronutrient deficiencies
and suboptimum breastfeeding. As a result, significant further
reductions in under five mortality will only be achieved with
improved prevention and management of malnutrition.