UN Report: Nigeria Has Highest Under-Five Mortality Rate Globally — 115 Deaths Per 1,000 Live Births

By Elvis Onuigbo 

Nigeria has been ranked the country with the highest under-five mortality rate in the world, according to a new United Nations report released this week — a grim finding that has renewed urgent calls for investment in child healthcare across Africa.

The report, titled Levels & Trends in Child Mortality, published by the UN Inter-agency Group for Child Mortality Estimation (UN IGME), found that Nigeria recorded 115 deaths per 1,000 live births among children under five years of age in 2024 — the highest rate of any country on earth.

"For many Nigerian mothers in rural communities, this report confirms what they already live every day."

Where Nigeria Stands Globally

Nigeria tops a devastating list dominated entirely by sub-Saharan African nations. Niger Republic came second with 110 deaths per 1,000 births, while Somalia ranked third at 101 deaths per 1,000 births. Chad and the Democratic Republic of Congo also feature among the highest-burden countries.

The reality is heartbreaking. While children in places like Australia and New Zealand have a much better chance of reaching their fifth birthday, the story is very different in sub-Saharan Africa — where children are about 19 times more likely to die before age five.

Across high-income countries, the risk is still far lower — about 14 times less.

Even more troubling is Nigeria’s situation. The country alone accounts for roughly 17% of all childhood deaths worldwide — an overwhelming and deeply concerning share for just one nation.

The Numbers Behind the Crisis

Globally, an estimated 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns who did not survive their first month of life. Sub-Saharan Africa accounted for 58% of all under-five deaths worldwide.

While global under-five deaths have dropped by more than half since the year 2000, the pace of progress has slowed sharply. Since 2015, the rate of improvement in child survival has declined by more than 60% — a warning sign that the world is losing momentum.

On current trends, Nigeria's under-five mortality rate is projected to remain critically high at 113.3 deaths per 1,000 live births by 2030. Experts warn the country is unlikely to meet the Sustainable Development Goal target on child mortality until after 2050.

Key Causes of Death

Infectious diseases remain the leading cause of under-five deaths in sub-Saharan Africa, responsible for 54% of fatalities in the region. Pneumonia, diarrhoea, and malaria are among the deadliest, particularly in children with weakened immunity.

Newborn deaths account for nearly half of all under-five mortality globally, with complications from preterm birth contributing to 36% of neonatal deaths. Limited access to skilled birth attendants and emergency obstetric care remains a major gap, especially in Nigeria's rural north.

For the first time, a UN report has put a number to a tragedy that often goes unseen — more than 100,000 young children, between one month and five years old, died in 2024 because of severe acute malnutrition.

But experts warn that this figure likely doesn’t tell the full story. Malnutrition is often not recorded as the actual cause of death, even though it quietly weakens a child’s body, leaving them too fragile to fight off common illnesses that can then turn deadly.

Research shows that under-five mortality risk in Nigeria is most severe in the North-west and North-east regions, particularly in states including Kebbi, Kaduna, Jigawa, Adamawa, Kano, and Sokoto.

What Global Leaders Are Saying

UNICEF Executive Director Catherine Russell did not mince words in her response to the findings. "No child should die from diseases that we know how to prevent," she said, warning that recent cuts in global health funding threaten to reverse hard-won gains in child survival.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus echoed her concern, noting that children in fragile and conflict-affected environments face nearly three times the risk of dying before age five compared to children in stable countries. He stressed the need to protect access to essential healthcare and nutrition services.

Both leaders emphasised that many of these deaths are preventable through proven, low-cost interventions — including vaccines, improved nutrition, and skilled care during and after childbirth.

A Crisis That Demands Action

Nigeria's position at the top of this tragic global ranking is not new — the country has consistently carried one of the world's heaviest burdens of child mortality for decades. What makes this report particularly alarming is the evidence that progress is slowing down, not speeding up.

With 200 million people and enormous oil wealth, Nigeria has the resources to change this story. What has been lacking is sustained political will, equitable healthcare investment, and targeted action in the country's highest-risk communities.

Every child who dies before the age of five from a preventable disease is not a statistic — it is a failure of systems, of policy, and of priorities. The question is whether Nigeria's leaders will treat this UN report as a wake-up call, or simply another number to be explained away.