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New Report: The Lottery of Birth

February 18, 2015

A new report says that while there has been much progress made in reducing under-five child mortality rates over the past 15 years, a significant number of children–mostly poor and minorities–are not living long, productive lives.

Published by Save the Children, “The Lottery of Birth” assess data collected from 87 low and middle income countries around the world. The report reveals that in more than three quarters of these countries, inequalities in child survival rates are actually getting worse, and alarming disparities exist between children living in specific regions within specific ethnic groups.

For example, according to the report, in Niger children born in the sub-national region with the highest mortality rate in 2012 was nearly five times more likely to die before their fifth birthday than in the region with the lowest rate. And in Honduras, a child born in Islas de Bahia region was 3.5 times more likely to die than a child born in the most advantaged regions in the country.

The Lottery of Birth report found that disparities in child mortality by region increased 59% and disparities in child mortality by ethnic group increased 78%.

The report underscores that without taking action, the “lottery of birth” will continue, inhibiting progress towards reducing and eventually ending child mortality, as outlined in the Millennium Development Goals (Goal 4).

From Save the Children, key Lottery of Birth findings include:

  • In Indonesia a child born into the poorest 40 percent of households in 2012 was nearly 2.5 times more likely to die than a child in the richest 10 percent. This inequality has grown double since 2002.
  • In Honduras, in 2012, a child born in Islas de Bahia region was 3.5 times more likely to die than a child born in the most advantaged regions in the country. This inequality has increased considerably since 2006.
  • In Vietnam children born into the Kinh ethnic group in 2010 were 3.5 times less likely to die than their non-Kinh peers.
  • Disadvantaged ethnic groups and regions are most likely to be left behind; regional disparities in child mortality rates increased in 59 percent of the countries, while disparities between ethnic groups in 76 percent.
  • More positively, 17,000 fewer children now die every day than they did in 1990, and the global under-five child mortality rate nearly halved from 90 to 46 deaths per 1,000 live births between 1990 and 2013.
  • About a fifth of countries have achieved above median reductions in child mortality over the past decade, while at the same time ensuring that no particular groups of children are left behind.

However, reducing these disparities and child mortality is not impossible. According to the report, the global under-five child mortality rate nearly halved from 90 to 46 deaths per 1,000 births between 1990 and 2013.

In order to achieve tangible success in reducing child mortality, all children must have access to healthcare and life saving mechanisms regardless of where they are born. This can only be achieved through teaching and empowering mothers with the tools to best take care of their infants and children, and engaging communities and local governments in the effort.

The Hunger Project is working to reduce child mortality and improve childhood nutrition through local efforts in 12 countries. These efforts, such as the 1,000 Days program, are centered around women’s education and empowerment. The Hunger Project’s 1,000 Days program educates mothers on the key nutrients that they must have during pregnancy and those that their children must have during the first 2 years of life in order to grow and thrive. The Hunger Project is committed to providing the best healthcare and nutrition to all children regardless of the region and ethnicity to which they were born.

Learn More:

Find out more about 1,000 Days program being enacted at The Hunger Project epicenters to improve childhood nutrition during the first 1,000 days of life.

Read the full Lottery of Birth Report and more about Save the Children’s efforts to reduce child mortality visit

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Stay Informed
Stay connected to The Hunger Project and join a community committed to creating a world without hunger.