In 2024, an estimated 4.9 million children died before age five, with another 2.1 million deaths among older children and adolescents. While global child mortality has fallen dramatically since 1990, progress is slowing and in some regions stalling, especially in sub‑Saharan Africa and Southern Asia.

The Levels and trends in child mortality, the United Nations Inter-Agency Group for Child Mortality Estimation, Report 2025 (March 17, 2026) provides the most comprehensive picture yet of child deaths, combining all‑cause and cause‑specific estimates, though major data gaps persist in the highest‑burden countries.

The report emphasizes that the tools to prevent these deaths already exist, but they are not reaching children at the scale or quality required. Conflict, climate shocks, fragile health systems, and funding pressures are intensifying risks and narrowing the window for action.

Child deaths remain unevenly distributed, shaped by geography, income, maternal education, and access to essential services. Fragile and conflict‑affected settings face the steepest challenges. Where investments have been targeted, mortality has fallen sharply; where health systems are weak, progress has slowed or reversed.

Since 1990, under‑five mortality has dropped by about 60%, and neonatal mortality by 45%, thanks to investments in immunization, newborn care, nutrition, and management of childhood illnesses. But at the current pace, 27.3 million under‑five deaths are projected between 2025 and 2030—nearly half among newborns. These deaths will remain concentrated in regions with the weakest health systems, especially sub‑Saharan Africa.

The UNICEF report makes one point clear: the solutions to prevent child deaths already exist, but they must be delivered with quality, scale, and strong local health systems. This is exactly where ICHA excels.

1. Working in the highest‑burden region
Sub‑Saharan Africa carries the greatest share of preventable child deaths. ICHA is rooted in this region, partnering with hospitals, clinicians, and ministries of health to strengthen neonatal and pediatric care where the need is most urgent.

2. Targeting the leading causes of newborn and child mortality
ICHA directly addresses prematurity, birth complications, and neonatal infections through:

• Tiny Feet Big Steps (TFBS) Neonatology Conferences that co‑train physicians and nurses.
• Hands‑on training in essential newborn care, CPAP, infection management, and care for small and sick newborns—the very interventions UNICEF identifies as most lifesaving.
• The Every Breath Counts handbook, ​a practical neonatal care manual developed from real-world experience caring for critically ill newborns in resource-limited hospitals.

3. Building local capacity
UNICEF highlights weak health systems and shortages of skilled providers as major barriers. ICHA’s model—training African clinicians and strengthening hospital systems—builds long‑term capacity rather than dependency. Since 2021, TFBS has trained 829 clinicians from 203 hospitals in 21 countries, creating a continent‑wide network of neonatal providers.

4. Aligning with the life‑course approach
UNICEF calls for continuity of care from pregnancy through adolescence. ICHA’s programs integrate maternal and newborn care, pediatric emergency care, nutrition, infection management, and long‑term system strengthening—mirroring this life‑course model.

5. Operating in data‑poor, high‑burden settings
Many high‑mortality countries lack reliable data. ICHA’s partnerships with hospitals across Africa help generate real‑world clinical insights, improve quality of care, and strengthen monitoring—critical for targeting interventions effectively.