Countries with high death registration

Vital registration data Survey data adjusted for changes in U5MR through 2008 for country or region Livebirths, population aged 0 and 1-4 years Total number of deaths in children aged 0-59 months NMR for each country

U5MR for each country Livebirths, population aged 0 and 1-4 years

Surveys, censuses, vital registration data UN Population Division data

Countries with low death registration

UN Population Division data

Total number of deaths in neonates aged 0-27 days

Total number of deaths in children aged 1-59 months

Estimation of causes of death in neonates aged 0-27 days Method used to produce cause-specific proportionate mortality Countries with >80% of deaths recorded as part of routine vital registration data Countries with 80% vital registration data combined with: NMR <15 per 1000 livebirths Multicause model with use of vital registration data Mean of vital registration multicause model (above) and high-mortality multicause model (below) Multicause model with use of community-based studies with 5 causes of death and countrylevel covariates for 2008 Registered deaths grouped according to standard ICD-10 codes

Estimation of causes of death in children aged 1-59 months Method used to produce cause-specific proportionate mortality Registered deaths grouped according to standard ICD-10 codes Countries with >85% of deaths recorded as part of routine vital registration data Countries with 85% vital registration data combined with: Multicause model with use of vital registration data Mean of vital registration multicause model (above) and high-mortality multicause model (below) Multicause model with use of community-based studies with 2 causes of death and countrylevel covariates for 2008 U5MR <26 per 1000 livebirths and GNI >$7510

NMR 15-20 per 1000 livebirths

U5MR 26-35 per 1000 livebirths and GNI >$7510

NMR >20 per 1000 livebirths

U5MR >35 per 1000 livebirths and GNI <$7510

Neonatal tetanus model

WHO estimates for malaria, measles, and pertussis UNAIDS estimates for AIDS

Number of deaths by cause

Figure 1: Overview of procedures for estimation of deaths by cause in children younger than 5 years of age U5MR=mortality rate in children younger than 5 years. NMR=neonatal mortality rate. GNI=gross national income per person (international dollars). ICD10=International Classification of Diseases, 10th revision.

Child mortality estimates that we have used are generally consistent with those previously published, 9 apart from those for several high-income countries in which death registration data became available for a more recent year. These published estimates also incorporate a new adjustment in which data for 17 countries with high HIV prevalence were revised to correct for bias in survey data from deceased mothers; such bias is

particularly a problem in settings with high AIDS mortality. Data were also adjusted for misreporting of the date of birth and the estimated change in child deaths due to AIDS.10

Estimated livebirths, and de-facto numbers of children aged 0 and 1-4 years for 2008 are taken from the UN Population Division 2008 revision.11 Total deaths in children younger than 5 years for 2008 were estimated by application of the IGME-estimated mortality rates for children aged 0 and 1-4 years to the de-facto population for these agegroups.

Neonatal mortality rates

Figure 1 summarises the process used to develop the estimates. Methods used to estimate mortality rates in