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China has achieved the Millennium Development Goal 4 (a 67% reduction in under-5 deaths between 1990 and 2015). The country has been regarded as a ‘gap’ in global health statistics, particularly about child health, although nearly one in six of the world's children live there. Now the Child Health Epidemiology Reference Group (CHERG) of the World Health Organisation and the United Nations, along with Chinese researchers, have trawled through Chinese databases and over 200 high quality Chinese language studies of child mortality in China to identify the main causes of death in children under the age of 5 years (Lancet 2010;375: 1083–9; see also Comment, ibid: 1055–6). In the period 1990–2008 mortality in neonates, postneonatal infants, and all children <5 years old fell by 70%, 72%, and 71% respectively. The Millennium Development Goal 4 was reached in 2006. In 2008 the most common causes of death in children aged <5 years were pneumonia, birth asphyxia, and complications of preterm birth, each causing 15-17% of deaths. In 2000 under-5 mortality was 10 and 11 per 1000 live births in large cities and towns, and 17, 30, 37, and 64 per 1000 live births in rural areas with increasing levels of poverty. In neonates the main causes of death were birth asphyxia and complications of preterm birth; in children aged 1–11 months, pneumonia, congenital abnormalities, sudden infant death syndrome, diarrhoea, and accidents; and in children aged 1–4 years, accidents, pneumonia, and congenital abnormalities. …

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