Articles 1990 2010 Neonatal Postneonatal Childhood Neonatal Postneonatal Childhood (Continued from previous page) Caribbean Antigua and Barbuda 106(6-3-146) 5-3(2-4-94) 2-2(0-8-54) 82(4-6-12-2) 4-0(17-7-3) 1-6(06-42) Barbados 148(8-9-20-6) 83(3-8-136 3-5(14-7-9) 6435-9-6) 311-1-5-6) 1-2(0-4-33) Belize 23-5(145-32-8) 14-47-1-22-6) 6-3(2-7-134) 12-97-8-18.7) 7-0(3-2-11-9) 2-9(1-1-7-1) Cuba 7-9(6-3-95) 4-6(3-4-5-9) 1-4(0-9-2-4) 28(2-1-37刃 17(1-2-23) 07(04-1-2) Dominica 13-9(8-3-18.9) 7-3(35-12-2) 31(12-7-2） 9-7(5-5-14-3) 49(2-0-9-0) 2-0(07-5-0) Dominican Republic 25-4(199-31-2) 193(155-22-9) 13-4(9-3-192) 149(114-18-5) 8-1(55-113) 4-72-7-7-8) Grenada 15-1(92-21-2) 8-4B9-13-9) 3-5(14-83) 6.9(41-10-2) 3-4(1-4-6.3) 13(0-4-37八 Guyana 32-0(20-1-449) 20-8(108-31.5) 9-4(42-195) 20-7(12-9-30-0) 12359211) 54(21-12.5) Haiti 44-0344-55-5) 56-8(46-3-66-8) 56-4(42-1-71-5) 304(23-0-397) 39-2(30-4-47-2) 36-8(25-7-499) Jamaica 18-7(11-5-26-1) 10-9(5-3-17-8) 47(2-0-105) 106(61-15-2) 5-6(2-4-95) 2-3(0-8-5-7刀 Saint Lucia 13-2(78-183) 7-2(3-2-12-0) 3-0(1-2-7-0) 6-8(3-8-10-1) 33(13-6-0) 13(05-3-6) Saint Vincent and the 141(8-5-196 7-7(3-5-13-0) 3-2(13-7-6) 13-17-8-196 7-23-1-12-4) 3-0(11-7-5) Grenadines Suriname 249(15-2-35-1) 153(7-6-23-6) 68(2-8-144) 194(11-0-27.9) 11-4(51-19-0) 5-0(1-8-11-4) The Bahamas 19-7(12-2-27-8) 117(5-7-18-9) 5-0(2-0-111) 9-2(53-133) 472-0-8-4) 1-9(06-4-8) Trinidad and Tobago 203(17-1-23-2) 7-0(50-93) 3-0(1-8-5-0) 174(13-6-22.4) 5-8(39-8-4) 2-5(14-43引 Europe,central Albania 92(6.9-12-6) 243(205-27-4) 7-0(4-7-10-2） 37(2-5-53) 8-3(6-2-11-0) 32(2-0-50) Bosnia and Herzegovina 9-8(5-7-13-8) 6-5(2-9-105) 1-5(0-6-4-2) 45(246-9) 2-6(1-0-44) 08(02-2-2) Bulgaria 8-9(6-9-113) 7-6(5-8-9-3) 1-9(12-30) 543-8-71) 4-1(2-9-57) 1-3(07-2-1) Croatia 9-0(7-4-104) 3-6(2-5-4-8) 09(05-1-6) 3-83-0-45) 13(08-1-8) 04(0-2-0-8) Czech Republic 7-9(4-6-114) 51(23-82) 12(04-35) 25(13-3-6) 12(04-2-3引 0-4(01-14) Hungary 11-6(97-134) 41(2-9-57刀 1-1(0-6-1.9) 34(2-7-44) 1-6(1-1-2-2) 0-5(03-0-9) Macedonia 15-2(12.1-18-6) 9-77-1-12-3) 1-6(1-0-2-6 74(55-97刃 372-4-55) 08(04-14) Montenegro 13-6(7-5-21-0) 9-7(4-2-16-2) 2-0(0-7-5-7) 54(30-8.0) 32(13-5-7) 09(0-3-2-6) Poland 12-1(10-1-13-9) 57(41-75) 13(0-8-2-2) 44(33-58) 1-6(1-0-23) 05(03-09) Romania 10-6(8-2-13-8) 16-9(13-5-20-0) 3-2(2-0-50) 62(4-5-8-2) 7-4(5-2-100) 1-6(1-0-2-6) Serbia 8-1(5-9-10-9) 37(2-3-5-6) 09(05-1-7) 27(2-1-33) 10(0-6-14) 0-3(0-2-0-6) Slovakia 7-7(6-2-93) 52(3-9-6-4) 1-3(0-8-2-1) 38(2-7-5-0) 2-2(14-3-3) 07(04-12) Slovenia 6-6(53-78) 31(2-2-4-2) 09(05-1-6) 21(1-5-2-6) 08(05-1-2) 04(0-2-0-7 Europe,eastern Belarus 12-8(7-7-17-7 6-6(3-0-115) 2-2(0-861) 57(3-1-86) 3-6(1-5-59) 1-2(04-3-4) Estonia 109(8-7-132) 53(3-9-6-9) 2-0(12-33) 33(24-42) 2-2(1-6-2-9) 0-8(05-13) Latvia 10-0(7-9-12.2) 5-5(4-0-7-0) 1-8(1-1-3-0) 5-2(3-8-6.8) 3-2(2-3-43) 11(0-6-1-9) Lithuania 8-1(6-3-98) 49(3-6-6-2) 1-5(09-2-5) 34(2-5-4-5) 2-6(1-9-34) 0-8(05-14) Moldova 17-2(13-5-215) 14-8(11.6-17-8 35(2-3-56) 5-6(4-2-7-7) 6-6(4-9-8-1) 1-5(09-2-5) Russia 16-1(97-219) 8-1(3-6-13-7) 27(1-0-71) 8.2(45-121) 48(2-0-7-8) 1-6(0-6-4-3) Ukraine 14-2(11-6-16.5) 4-9(35-6-5) 2-6(1-6-43) 9977-12-4) 37(2-6-5-1 2-0(1-2-33) (Continues on next page) and southeast Asia.north Africa and the Middle East. largely driven by rates in the USA.Central and eastern and regions of Latin America has decreased by 63% Europe have notably higher rates of mortality throughout between 1970 and 2010.Less than 1%of child deaths the entire period.Across all regions of Latin America and occur in high-income countries. north Africa and the Middle East,there has been Figure 4 shows the trends in under-5 mortality for each sustained decline in under-5 mortality (figure 4B).The of the 21 regions between 1970 and 2010.Among regions fluctuations in post-1990 under-5 mortality in southern with the lowest rates of under-5 mortality (figure 4A), sub-Saharan Africa show the effect of HIV in the region western Europe,Australasia,Asia-Pacific high income, (figure 4C).Consistently high rates of mortality in and North America high income have tracked each other Oceania indicate poor progress.The four regions with closely.However,high income countries in North the highest rates of under-5 mortality are east,west,and America have seen less progress in the past 15 years, central sub-Saharan Africa,and south Asia(figure 4D). 2000 www.thelancet.com Vol 375 June 5,2010Articles 2000 www.thelancet.com Vol 375 June 5, 2010 and southeast Asia, north Africa and the Middle East, and regions of Latin America has decreased by 63% between 1970 and 2010. Less than 1% of child deaths occur in high-income countries. Figure 4 shows the trends in under-5 mortality for each of the 21 regions between 1970 and 2010. Among regions with the lowest rates of under-5 mortality (fi gure 4A), western Europe, Australasia, Asia-Pacifi c high income, and North America high income have tracked each other closely. However, high income countries in North America have seen less progress in the past 15 years, largely driven by rates in the USA. Central and eastern Europe have notably higher rates of mortality throughout the entire period. Across all regions of Latin America and north Africa and the Middle East, there has been sustained decline in under-5 mortality (fi gure 4B). The fl uctuations in post-1990 under-5 mortality in southern sub-Saharan Africa show the eff ect of HIV in the region (fi gure 4C). Consistently high rates of mortality in Oceania indicate poor progress. The four regions with the highest rates of under-5 mortality are east, west, and central sub-Saharan Africa, and south Asia (fi gure 4D). 1990 2010 Neonatal Postneonatal Childhood Neonatal Postneonatal Childhood (Continued from previous page) Caribbean Antigua and Barbuda 10·6 (6·3–14·6) 5·3 (2·4–9·4) 2·2 (0·8–5·4) 8·2 (4·6–12·2) 4·0 (1·7–7·3) 1·6 (0·6–4·2) Barbados 14·8 (8·9–20·6) 8·3 (3·8–13·6) 3·5 (1·4–7·9) 6·4 (3·5–9·6) 3·1 (1·1–5·6) 1·2 (0·4–3·3) Belize 23·5 (14·5–32·8) 14·4 (7·1–22·6) 6·3 (2·7–13·4) 12·9 (7·8–18·7) 7·0 (3·2–11·9) 2·9 (1·1–7·1) Cuba 7·9 (6·3–9·5) 4·6 (3·4–5·9) 1·4 (0·9–2·4) 2·8 (2·1–3·7) 1·7 (1·2–2·3) 0·7 (0·4–1·2) Dominica 13·9 (8·3–18·9) 7·3 (3·5–12·2) 3·1 (1·2–7·2) 9·7 (5·5–14·3) 4·9 (2·0–9·0) 2·0 (0·7–5·0) Dominican Republic 25·4 (19·9–31·2) 19·3 (15·5–22·9) 13·4 (9·3–19·2) 14·9 (11·4–18·5) 8·1 (5·5–11·3) 4·7 (2·7–7·8) Grenada 15·1 (9·2–21·2) 8·4 (3·9–13·9) 3·5 (1·4–8·3) 6·9 (4·1–10·2) 3·4 (1·4–6·3) 1·3 (0·4–3·7) Guyana 32·0 (20·1–44·9) 20·8 (10·8–31·5) 9·4 (4·2–19·5) 20·7 (12·9–30·0) 12·3 (5·9–21·1) 5·4 (2·1–12·5) Haiti 44·0 (34·4–55·5) 56·8 (46·3–66·8) 56·4 (42·1–71·5) 30·4 (23·0–39·7) 39·2 (30·4–47·2) 36·8 (25·7–49·9) Jamaica 18·7 (11·5–26·1) 10·9 (5·3–17·8) 4·7 (2·0–10·5) 10·6 (6·1–15·2) 5·6 (2·4–9·5) 2·3 (0·8–5·7) Saint Lucia 13·2 (7·8–18·3) 7·2 (3·2–12·0) 3·0 (1·2–7·0) 6·8 (3·8–10·1) 3·3 (1·3–6·0) 1·3 (0·5–3·6) Saint Vincent and the Grenadines 14·1 (8·5–19·6) 7·7 (3·5–13·0) 3·2 (1·3–7·6) 13·1 (7·8–19·6) 7·2 (3·1–12·4) 3·0 (1·1–7·5) Suriname 24·9 (15·2–35·1) 15·3 (7·6–23·6) 6·8 (2·8–14·4) 19·4 (11·0–27·9) 11·4 (5·1–19·0) 5·0 (1·8–11·4) The Bahamas 19·7 (12·2–27·8) 11·7 (5·7–18·9) 5·0 (2·0–11·1) 9·2 (5·3–13·3) 4·7 (2·0–8·4) 1·9 (0·6–4·8) Trinidad and Tobago 20·3 (17·1–23·2) 7·0 (5·0–9·3) 3·0 (1·8–5·0) 17·4 (13·6–22·4) 5·8 (3·9–8·4) 2·5 (1·4–4·3) Europe, central Albania 9·2 (6·9–12·6) 24·3 (20·5–27·4) 7·0 (4·7–10·2) 3·7 (2·5–5·3) 8·3 (6·2–11·0) 3·2 (2·0–5·0) Bosnia and Herzegovina 9·8 (5·7–13·8) 6·5 (2·9–10·5) 1·5 (0·6–4·2) 4·5 (2·4–6·9) 2·6 (1·0–4·4) 0·8 (0·2–2·2) Bulgaria 8·9 (6·9–11·3) 7·6 (5·8–9·3) 1·9 (1·2–3·0) 5·4 (3·8–7·1) 4·1 (2·9–5·7) 1·3 (0·7–2·1) Croatia 9·0 (7·4–10·4) 3·6 (2·5–4·8) 0·9 (0·5–1·6) 3·8 (3·0–4·5) 1·3 (0·8–1·8) 0·4 (0·2–0·8) Czech Republic 7·9 (4·6–11·4) 5·1 (2·3–8·2) 1·2 (0·4–3·5) 2·5 (1·3–3·6) 1·2 (0·4–2·3) 0·4 (0·1–1·4) Hungary 11·6 (9·7–13·4) 4·1 (2·9–5·7) 1·1 (0·6–1·9) 3·4 (2·7–4·4) 1·6 (1·1–2·2) 0·5 (0·3–0·9) Macedonia 15·2 (12·1–18·6) 9·7 (7·1–12·3) 1·6 (1·0–2·6) 7·4 (5·5–9·7) 3·7 (2·4–5·5) 0·8 (0·4–1·4) Montenegro 13·6 (7·5–21·0) 9·7 (4·2–16·2) 2·0 (0·7–5·7) 5·4 (3·0–8·0) 3·2 (1·3–5·7) 0·9 (0·3–2·6) Poland 12·1 (10·1–13·9) 5·7 (4·1–7·5) 1·3 (0·8–2·2) 4·4 (3·3–5·8) 1·6 (1·0–2·3) 0·5 (0·3–0·9) Romania 10·6 (8·2–13·8) 16·9 (13·5–20·0) 3·2 (2·0–5·0) 6·2 (4·5–8·2) 7·4 (5·2–10·0) 1·6 (1·0–2·6) Serbia 8·1 (5·9–10·9) 3·7 (2·3–5·6) 0·9 (0·5–1·7) 2·7 (2·1–3·3) 1·0 (0·6–1·4) 0·3 (0·2–0·6) Slovakia 7·7 (6·2–9·3) 5·2 (3·9–6·4) 1·3 (0·8–2·1) 3·8 (2·7–5·0) 2·2 (1·4–3·3) 0·7 (0·4–1·2) Slovenia 6·6 (5·3–7·8) 3·1 (2·2–4·2) 0·9 (0·5–1·6) 2·1 (1·5–2·6) 0·8 (0·5–1·2) 0·4 (0·2–0·7) Europe, eastern Belarus 12·8 (7·7–17·7) 6·6 (3·0–11·5) 2·2 (0·8–6·1) 5·7 (3·1–8·6) 3·6 (1·5–5·9) 1·2 (0·4–3·4) Estonia 10·9 (8·7–13·2) 5·3 (3·9–6·9) 2·0 (1·2–3·3) 3·3 (2·4–4·2) 2·2 (1·6–2·9) 0·8 (0·5–1·3) Latvia 10·0 (7·9–12·2) 5·5 (4·0–7·0) 1·8 (1·1–3·0) 5·2 (3·8–6·8) 3·2 (2·3–4·3) 1·1 (0·6–1·9) Lithuania 8·1 (6·3–9·8) 4·9 (3·6–6·2) 1·5 (0·9–2·5) 3·4 (2·5–4·5) 2·6 (1·9–3·4) 0·8 (0·5–1·4) Moldova 17·2 (13·5–21·5) 14·8 (11·6–17·8) 3·5 (2·3–5·6) 5·6 (4·2–7·7) 6·6 (4·9–8·1) 1·5 (0·9–2·5) Russia 16·1 (9·7–21·9) 8·1 (3·6–13·7) 2·7 (1·0–7·1) 8·2 (4·5–12·1) 4·8 (2·0–7·8) 1·6 (0·6–4·3) Ukraine 14·2 (11·6–16·5) 4·9 (3·5–6·5) 2·6 (1·6–4·3) 9·9 (7·7–12·4) 3·7 (2·6–5·1) 2·0 (1·2–3·3) (Continues on next page)