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SEX DIFFERENTIALS

IN CHILDHOOD

MORTALITY
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4q1

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ST/ESA/SER.A/314

Department of Economic and Social Affairs Population Division

Sex Differentials in Childhood Mortality

United Nations New York, 2011

DESA
The Department of Economic and Social Affairs of the United Nations Secretariat is a vital interface between global policies in the economic, social and environmental spheres and national action. The Department works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic, social and environmental data and information on which Member States of the United Nations draw to review common problems and take stock of policy options; (ii) it facilitates the negotiations of Member States in many intergovernmental bodies on joint courses of action to address ongoing or emerging global challenges; and (iii) it advises interested Governments on the ways and means of translating policy frameworks developed in United Nations conferences and summits into programmes at the country level and, through technical assistance, helps build national capacities.

Note
The designations employed in this report and the material presented in it do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Symbols of United Nations documents are composed of capital letters combined with figures. This publication has been issued without formal editing.

Suggested citation: United Nations, Department of Economic and Social Affairs, Population Division (2011). Sex Differentials in Childhood Mortality (United Nations publication, ST/ESA/SER.A/314).

UNITED NATIONS PUBLICATION ST/ESA/SER.A/314 Copyright United Nations 2011 All rights reserved

PREFACE Equity in health and survival is an important policy issue, and differentials by sex are one of the areas requiring special focus. The Programme of Action of the International Conference on Population and Development (ICPD) called on leaders to act forcefully against patterns of discrimination within the family and to eliminate excess mortality girls, where such a pattern existed (paragraph 4.17). This call was echoed eight years later in A World Fit for Children, the declaration of the twenty-seventh special session of the General Assembly (A/RES/S-27/2, Annex, para. 37.4). The survival of children is prominent on the international agenda in light of the Millennium Development Goals and substantial reductions in childhood mortality have been achieved in many countries in recent decades. However, the question of whether the recent increases in survival have benefited boys and girls equally has rarely been addressed on a global scale. The Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat has a long record in the estimation and analysis of sex differentials in mortality. The most recent major report on sex differentials in childhood mortality, Too Young to Die: Genes or Gender? (United Nations, 1998), examined a range of biological, social and economic mechanisms producing these differentials, and provided estimates of infant, child (ages 1 to 4) and under-five mortality by sex for the 1970s and 1980s for 82 developing countries, of which 52 had sufficient data to produce estimates for both decades. The estimates here represent a significant expansion of both the number of countries and the time periods covered. The geographical scope has been expanded to include 109 countries in the less developed regions, with trend estimates available for 83 of these countries. In addition, the same analysis was extended to 40 countries in the more developed regions. The estimates span four decades, from the 1970s to the first decade of the 2000s, providing a long-term perspective on the size and change of sex differentials throughout the world. While the estimates here will be valuable from a policy and advocacy standpoint for calling attention to persisting or worsening differentials in child mortality that disadvantage girls or boys, the present report does not attempt any explanatory analysis or policy prescription beyond a brief review of relevant literature. Examination of the determinants of sex differentials in childhood mortality is more limited in scope, with a focus on China and India, where the female disadvantage in under-five mortality is large and persistent. For providing information used in the preparation of these estimates, the Population Division gratefully acknowledges the assistance and cooperation of the Statistics Division of the Department of Economic and Social Affairs; the regional commissions, specialized agencies and other relevant bodies of the United Nations; national statistical offices; survey organizations; academic researchers; and others. Responsibility for any errors or omissions rests with the Population Division. Inquiries regarding this report may be addressed to the Director, Population Division, Department of Economic and Social Affairs, United Nations Secretariat, New York, N.Y. 10017, fax number (212) 9632147.

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CONTENTS
Page

PREFACE.............................................................................................................................................................. EXPLANATORY NOTES ......................................................................................................................................... EXECUTIVE SUMMARY ........................................................................................................................................

iii x xv

Chapter I. INTRODUCTION............................................................................................................................................. A. Background ............................................................................................................................................ B. Understanding sex differentials in childhood mortality ......................................................................... C. Challenges in estimating childhood mortality by sex............................................................................. II. DATA AND METHODS .................................................................................................................................... A. Data sources ........................................................................................................................................... B. Estimating trends in sex differentials in childhood mortality................................................................. III. RESULTS....................................................................................................................................................... A. Distribution of countries by sex differentials in childhood mortality..................................................... B. Regional average sex differentials ......................................................................................................... C. Country levels and trends in sex differentials ........................................................................................ D. Relationship between sex differentials and levels of mortality for countries within a given region ...... E. Comparison of estimated differentials for selected countries to the historical experience of developed countries................................................................................................................................................. IV. DISCUSSION.................................................................................................................................................. A. Sources of sex differentials in childhood mortality................................................................................ B. Trends in the sex ratio of infant mortality.............................................................................................. C. Countries and regions............................................................................................................................. D. Limitations of the study ......................................................................................................................... E. Conclusions............................................................................................................................................ REFERENCES ....................................................................................................................................................... 1 1 2 4 6 6 8 12 12 44 49 56 64 66 66 66 67 75 75 77

TABLES I.1. Number of countries or areas and percentage of population covered in the study................................. III.1. Estimates of male, female and both sexes infant, child and under-five mortality, and sex differentials in infant, child and under-five mortality, by country and decade, for countries with trend information on sex differentials, 1970-2000s ............................................................................................................ III.2. Estimates of male, female and both sexes infant, child and under-five mortality, and sex differentials in infant, child and under-five mortality, by country and decade, for countries with weighted average estimates of sex differentials, 1970s-2000s ........................................................................................... III.3. Median sex ratios of infant, child and under-five mortality by region, 1970s-2000s ............................ III.4. Regional average estimates of infant, child, and under-five mortality, and sex ratios of infant, child and under-five mortality, 1970s-2000s (countries weighted by number of births) ............................... III.5. Classification of countries by changes in the sex ratio of infant mortality (SR1) and sex ratio of child mortality (SR4) between the 1970s and the 2000s, less developed regions ............................. 5 13 29 33 45 50

III.6. Countries in which the sex ratio of child mortality has increased from below 100 to above 100 between the 1970s and the 2000s........................................................................................................... III.7. Countries in which the sex ratio of child mortality has remained below 100 from the 1970s to the 2000s ............................................................................................................................................ III.8. Countries in which the sex ratio of child mortality has declined from above 100 to below 100 from the 1970s to the 2000s............................................................................................................................ III.9. Countries in which the sex ratio of infant mortality was higher than 130 in the 2000s ......................... III.10. Classification of countries by trends in the sex ratio of infant mortality (SR1) and sex ratio of child mortality (SR4), more developed regions............................................................................................. III.11. Implied sex ratio of child mortality (SR4) in the 2000s for countries with weighted average estimates III.12. Correlation between the level of under-five mortality and sex differentials in infant, child and under-five mortality..............................................................................................................................

51 52 52 54 55 56 57

FIGURES I.1. Historical change in the sex ratio of mortality as under-five mortality declined, selected developed countries................................................................................................................................................. II.1. Sex ratio of infant and child mortality from National Family Health Surveys (NFHS) and Sample Registration System (SRS), India ....................................................................................... III.1. Distribution of countries by sex differential in the 2000s, by region ..................................................... III.2. Distribution of countries by sex differential by decade: Less developed regions .................................. III.3. Distribution of countries by sex differential by decade: Sub-Saharan Africa ........................................ III.4. Distribution of countries by sex differential by decade: Northern Africa and Western Asia................. III.5. Distribution of countries by sex differential by decade: Eastern and South-Eastern Asia ..................... III.6. Distribution of countries by sex differential by decade: Southern Asia ................................................. III.7. Distribution of countries by sex differential by decade: CIS Asia ......................................................... III.8. Distribution of countries by sex differential by decade: Latin America and the Caribbean .................. III.9. Distribution of countries by sex differential by decade: More developed regions ................................. III.10. Sex ratio of infant mortality by level of under-five mortality, regional average, 1970s-2000s.............. III.11. Sex ratio of child mortality by level of under-five mortality, regional average, 1970s-2000s............... III.12. Sex ratio of under-five mortality by level of under-five mortality, regional average, 1970s-2000s ...... III.13. Sex ratio of infant mortality by level of under-five mortality, for countries by region, 1970s-2000s.... III.14. Sex ratio of child mortality by level of under-five mortality, for countries by region, 1970s-2000s..... III.15. Sex ratio of under-five mortality by level of under-five mortality, for countries by region, 1970s-2000s ........................................................................................................................................... III.18. Sex ratios of infant, child and under-five mortality compared to sex ratios from Hill-Upchurch model, Senegal, Philippines and Benin, 1970s-2000s............................................................................ IV.1. Sex ratio of infant mortality, China........................................................................................................ IV.2. Sex ratio of neonatal and postneonatal mortality from National Family Health Surveys (NFHS), India .......................................................................................................................................................

3 11 35 36 37 38 39 40 41 42 43 47 47 48 58 60 62 65 68 71

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V.

COUNTRY PROFILES ................................................................................................................................. Afghanistan.............................................................................................................................................. Albania..................................................................................................................................................... Algeria ..................................................................................................................................................... Angola...................................................................................................................................................... Argentina ................................................................................................................................................. Armenia ................................................................................................................................................... Australia................................................................................................................................................... Austria...................................................................................................................................................... Azerbaijan................................................................................................................................................ Bangladesh............................................................................................................................................... Belarus ..................................................................................................................................................... Belgium.................................................................................................................................................... Benin........................................................................................................................................................ Bolivia (Plurinational State of) ................................................................................................................ Bosnia and Herzegovina .......................................................................................................................... Botswana.................................................................................................................................................. Brazil........................................................................................................................................................ Bulgaria.................................................................................................................................................... Burkina Faso ............................................................................................................................................ Burundi .................................................................................................................................................... Cambodia................................................................................................................................................. Cameroon................................................................................................................................................. Canada ..................................................................................................................................................... Central African Republic ......................................................................................................................... Chad......................................................................................................................................................... Chile......................................................................................................................................................... China........................................................................................................................................................ China, Hong Kong SAR .......................................................................................................................... Colombia.................................................................................................................................................. Congo....................................................................................................................................................... Costa Rica ................................................................................................................................................ Cte dIvoire ............................................................................................................................................ Croatia...................................................................................................................................................... Cuba......................................................................................................................................................... Czech Republic ........................................................................................................................................ Democratic Peoples Republic of Korea.................................................................................................. Democratic Republic of the Congo.......................................................................................................... Denmark .................................................................................................................................................. Dominican Republic ................................................................................................................................ Ecuador .................................................................................................................................................... Egypt........................................................................................................................................................ El Salvador............................................................................................................................................... Eritrea ...................................................................................................................................................... Estonia ..................................................................................................................................................... Ethiopia.................................................................................................................................................... Finland ..................................................................................................................................................... France ...................................................................................................................................................... Gabon....................................................................................................................................................... Gambia..................................................................................................................................................... Georgia .................................................................................................................................................... Germany .................................................................................................................................................. Ghana....................................................................................................................................................... Greece ......................................................................................................................................................

79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132

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Guatemala ................................................................................................................................................ Guinea...................................................................................................................................................... Guinea-Bissau.......................................................................................................................................... Haiti ......................................................................................................................................................... Honduras.................................................................................................................................................. Hungary ................................................................................................................................................... India ......................................................................................................................................................... Indonesia.................................................................................................................................................. Iran (Islamic Republic of)........................................................................................................................ Iraq........................................................................................................................................................... Ireland ...................................................................................................................................................... Israel ........................................................................................................................................................ Italy .......................................................................................................................................................... Japan ........................................................................................................................................................ Jordan....................................................................................................................................................... Kazakhstan............................................................................................................................................... Kenya....................................................................................................................................................... Kuwait...................................................................................................................................................... Kyrgyzstan ............................................................................................................................................... Lao Peoples Democratic Republic.......................................................................................................... Latvia ....................................................................................................................................................... Lesotho .................................................................................................................................................... Liberia...................................................................................................................................................... Libyan Arab Jamahiriya........................................................................................................................... Lithuania .................................................................................................................................................. Madagascar .............................................................................................................................................. Malawi ..................................................................................................................................................... Malaysia................................................................................................................................................... Mali.......................................................................................................................................................... Mauritania................................................................................................................................................ Mauritius.................................................................................................................................................. Mexico ..................................................................................................................................................... Mongolia.................................................................................................................................................. Morocco................................................................................................................................................... Mozambique ............................................................................................................................................ Myanmar.................................................................................................................................................. Namibia.................................................................................................................................................... Nepal........................................................................................................................................................ Netherlands .............................................................................................................................................. New Zealand ............................................................................................................................................ Nicaragua................................................................................................................................................. Niger ........................................................................................................................................................ Nigeria ..................................................................................................................................................... Norway .................................................................................................................................................... Occupied Palestinian Territory ................................................................................................................ Pakistan.................................................................................................................................................... Panama..................................................................................................................................................... Papua New Guinea................................................................................................................................... Paraguay .................................................................................................................................................. Peru .......................................................................................................................................................... Philippines ............................................................................................................................................... Poland ...................................................................................................................................................... Portugal.................................................................................................................................................... Puerto Rico .............................................................................................................................................. Republic of Korea.................................................................................................................................... Republic of Moldova ...............................................................................................................................

133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188

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Romania ................................................................................................................................................... Russian Federation................................................................................................................................... Rwanda .................................................................................................................................................... Senegal..................................................................................................................................................... Serbia ....................................................................................................................................................... Sierra Leone............................................................................................................................................. Singapore ................................................................................................................................................. Slovakia ................................................................................................................................................... Slovenia ................................................................................................................................................... Somalia .................................................................................................................................................... South Africa............................................................................................................................................. Spain ........................................................................................................................................................ Sri Lanka.................................................................................................................................................. Sudan ....................................................................................................................................................... Swaziland................................................................................................................................................. Sweden..................................................................................................................................................... Switzerland .............................................................................................................................................. Syrian Arab Republic............................................................................................................................... Tajikistan ................................................................................................................................................. Thailand ................................................................................................................................................... The former Yugoslav Republic of Macedonia......................................................................................... Timor-Leste ............................................................................................................................................. Togo......................................................................................................................................................... Trinidad and Tobago................................................................................................................................ Tunisia ..................................................................................................................................................... Turkey...................................................................................................................................................... Turkmenistan ........................................................................................................................................... Uganda..................................................................................................................................................... Ukraine .................................................................................................................................................... United Arab Emirates .............................................................................................................................. United Kingdom ...................................................................................................................................... United Republic of Tanzania ................................................................................................................... United States of America ......................................................................................................................... Uruguay ................................................................................................................................................... Uzbekistan ............................................................................................................................................... Venezuela (Bolivarian Republic of) ........................................................................................................ Viet Nam.................................................................................................................................................. Yemen...................................................................................................................................................... Zambia ..................................................................................................................................................... Zimbabwe ................................................................................................................................................

189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228

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Explanatory notes The following conventions have been used in the tables throughout this report: Two dots (..) indicate that data are not available or are not reported separately. A full stop (.) is used to indicate decimals. Ratios of mortality indicators are multiplied by 100 for presentation. The terms 1970s, 1980s, 1990s and 2000s refer, respectively, to the periods 1 July 1970 - 1 July 1980, 1 July 1980 - 1 July 1990; 1 July 1990 - 1 July 2000, and 1 July 2000 - 1 July 2010.

References to countries, territories and areas: The designations developed countries, developing countries, more developed regions and less developed regions are intended for statistical convenience and do not necessarily express a judgment about the stage reached by a particular country or area in the development process. The term country as used in the text of this publication also refers, as appropriate, to territories or areas. More developed regions comprise all regions of Europe plus Northern America, Australia/New Zealand and Japan. Less developed regions comprise all regions of Africa, Asia (excluding Japan) and Latin America and the Caribbean, as well as Melanesia, Micronesia and Polynesia. The designation sub-Saharan Africa is used to indicate all of Africa except Northern Africa. In this report, Sudan is included in Northern Africa. For analytical purposes, country groupings in the following table have been used. These groupings differ from those normally used in reports of the Population Division/DESA. The changes were made in order to better capture regional similarities in childhood mortality differentials by sex. The following abbreviations have been used: DHS ICPD IGME MDGs MICS NFHS PAPFAM RHS SAR SR1 SR4 SR5 SRS UNICEF WFS WHO Demographic and Health Survey(s) International Conference on Population and Development Inter-Agency Group for Child Mortality Estimation Millennium Development Goals Multiple Indicator Cluster Survey(s) National Family Health Survey Pan Arab Project for Family Health Reproductive Health Survey(s) Special Administrative Region Ratio of male to female infant mortality (multiplied by 100) Ratio of male to female child mortality (multiplied by 100) Ratio of male to female under-five mortality (multiplied by 100) Sample Registration System United Nations Childrens Fund World Fertility Survey(s) World Health Organization

CLASSIFICATION OF COUNTRIES BY REGION OF THE WORLD 1. Less developed regions


Sub-Saharan Africa Eastern Africa
Burundi Comoros* Djibouti* Eritrea Ethiopia Kenya Madagascar Malawi Mauritius1 Mayotte* Mozambique Runion* Rwanda Seychelles* Somalia Uganda United Republic of Tanzania Zambia Zimbabwe

Middle Africa
Angola Cameroon Central African Republic Chad Congo Democratic Republic of the Congo Equatorial Guinea* Gabon So Tom and Prncipe*

Southern Africa
Botswana Lesotho Namibia South Africa Swaziland

Western Africa
Benin Burkina Faso Cape Verde* Cte dIvoire Gambia Ghana Guinea Guinea-Bissau Liberia Mali Mauritania Niger Nigeria Saint Helena2* Senegal Sierra Leone Togo

Northern Africa and Western Asia Northern Africa


Algeria Egypt Libyan Arab Jamahiriya Morocco Sudan3 Tunisia Western Sahara*

Western Asia
Armenia Azerbaijan Bahrain* Cyprus* Georgia Iraq Israel Jordan Kuwait Lebanon Occupied Palestinian Territory Oman Qatar Saudi Arabia Syrian Arab Republic Turkey United Arab Emirates Yemen

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CLASSIFICATION OF COUNTRIES (continued)


Eastern and South-Eastern Asia Eastern Asia South-Eastern Asia
China China, Hong Kong SAR China, Macao SAR* Democratic Peoples Republic of Korea Japan Mongolia Republic of Korea Brunei Darussalam* Cambodia Indonesia Lao Peoples Democratic Republic Malaysia Myanmar Philippines Singapore Thailand Timor-Leste Viet Nam

Southern Asia
Afghanistan Bangladesh Bhutan* India Iran (Islamic Republic of) Maldives* Nepal Pakistan Sri Lanka

CIS Asia
Armenia Azerbaijan Georgia Kazakhstan Kyrgyzstan Tajikistan Turkmenistan Uzbekistan

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CLASSIFICATION OF COUNTRIES (continued)


Latin America and the Caribbean Caribbean
Anguilla* Antigua and Barbuda* Aruba* Bahamas* Barbados* British Virgin Islands* Cayman Islands* Cuba Dominica* Dominican Republic Grenada* Guadeloupe* Haiti Jamaica Martinique* Montserrat* Netherlands Antilles* Puerto Rico Saint Kitts and Nevis* Saint Lucia* Saint Vincent and the Grenadines* Trinidad and Tobago Turks and Caicos Islands* United States Virgin Islands*

Central America
Belize* Costa Rica El Salvador Guatemala Honduras Mexico Nicaragua Panama

South America
Argentina Bolivia (Plurinational State of) Brazil Chile Colombia Ecuador Falkland Islands (Malvinas)* French Guiana* Guyana* Paraguay Peru Suriname* Uruguay Venezuela (Bolivarian Republic of)

Developing Oceania Melanesia


Fiji* New Caledonia* Papua New Guinea Solomon Islands* Vanuatu*

Micronesia
Guam* Kiribati* Marshall Islands* Micronesia (Federated States of)* Nauru* Northern Mariana Islands* Palau*

Polynesia
American Samoa* Cook Islands* French Polynesia* Niue* Pitcairn* Samoa* Tokelau* Tonga* Tuvalu* Wallis and Futuna Islands*

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CLASSIFICATION OF COUNTRIES (continued) 2. More developed regions


Europe Eastern Europe
Belarus Bulgaria Czech Republic Hungary Poland Republic of Moldova Romania Russian Federation Slovakia Ukraine

Northern Europe
Channel Islands* Denmark Estonia Faeroe Islands* Finland5 Iceland* Ireland Isle of Man* Latvia Lithuania Norway6 Sweden United Kingdom of Great Britain and Northern Ireland6
4

Southern Europe
Albania Andorra* Bosnia and Herzegovina Croatia Gibraltar* Greece Holy See8* Italy Malta* Montenegro* Portugal San Marino* Serbia Slovenia Spain The former Yugoslav Republic of Macedonia9

Western Europe
Austria Belgium France Germany Liechtenstein* Luxembourg* Monaco* Netherlands Switzerland

Northern America
Bermuda* Canada Greenland* Saint Pierre and Miquelon* United States of America10

Other more developed countries


Australia11 Japan New Zealand

NOTES
* Indicates countries or areas with a population of less than 1 million in 2009. These countries were not included in the study. They are, however, included in the regional population totals in table I.1.
1 2

Including Agalega, Rodrigues, and Saint Brandon. Including Ascension, and Tristan da Cunha. 3 Including South Sudan, which became independent on 9 July 2011. 4 Refers to Guernsey, and Jersey. 5 Including land Islands. 6 Including Svalbard and Jan Mayen Islands. 7 Also referred to as United Kingdom. 8 Refers to the Vatican City State. 9 Also referred to as TFYR Macedonia. 10 Also referred to as United States. 11 Including Christmas Island, Cocos (Keeling) Islands, and Norfolk Island.

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EXECUTIVE SUMMARY
In most countries of the world, national levels of mortality in childhood have fallen substantially in recent decades. However, it is critical to ensure that improvements in survival are benefitting all children to the greatest extent possible. One key area for assessment is differences in survival for boys and girls. This report examines sex differentials in childhood mortality for countries and regions from the 1970s to the first decade of the 2000s. The mortality rates considered refer to deaths occurring to children below the age of 5. Under-five mortality, denoted as 5q0, expresses the probability of dying between birth and exact age 5 years per 1,000 live births. Focus will also be placed upon the components of under-five mortality, that is, infant mortality (the probability of dying between birth and exact age 1 year, denoted 1q0) and child mortality (the probability of dying between exact ages 1 and 5 years, denoted as 4q1). To estimate and analyze sex differentials, ratios of male mortality levels to female mortality levels will be used as follows: Sex ratio of under-five mortality: Sex ratio of infant mortality: Sex ratio of child mortality: (5q0male/5q0female) 100 (1q0male/1q0female) 100 (4q1male/4q1female) 100

Before analyzing the results it is important to emphasize that equity in survival between females and males does not imply equal mortality rates (that is, ratios equal to 100). Under circumstances where boys and girls have the same access to resources such as food and medical care, boys have higher mortality rates than girls during childhood and the examined ratios would overall be expected to be greater than 100. Newborn girls have a biological advantage in survival over newborn boys, with lesser vulnerability to perinatal conditions (including birth trauma, intrauterine hypoxia and birth asphyxia, prematurity, respiratory distress syndrome and neonatal tetanus), congenital anomalies, and such infectious diseases as intestinal infections and lower respiratory infections. However, beyond early infancy, girls do not enjoy the same advantage in relation to certain infectious diseases, which are the primary causes of death in later infancy and early childhood in settings where overall mortality is high. Thus, the sex ratio of child mortality is generally lower than the sex ratio of infant mortality. The sex ratio of under-five mortality is intermediate between the two, and will depend on the relative mortality levels of the infant and child age groups. As living conditions improve, an epidemiological transition occurs whereby infectious diseases recede as a cause of death. As this occurs, perinatal and congenital causes form an increasing share of total mortality among infants, while external causes, more typically affecting boys, form an increasing share of mortality for children between ages 1 and 5. Hence, as overall levels of mortality fall, female advantage in infant and child mortality would normally increase assuming no sex-specific changes in the treatment of children. Figure I shows the historical change in sex ratios of infant, child, and under-five mortality for several developed countries where access of children to resources was not believed to differ greatly by sex. The female advantage in survival, however, can be eroded if girls are deprived relative to boys in access to health care or to proper nutrition. If such deprivation occurs, the sex ratio of mortality might be substantially below the values shown in figure I for a given level of mortality. Because of the biologically-based characteristics of differential survival by sex, it is difficult to construct a precise target of gender equity in survival in childhood. However, situations in which the survival of girls is lower than that of boysthat is, the sex ratio of mortality is less

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Figure I. Historical change in the sex ratio of mortality as under-five mortality declined, selected developed countries
140

Female advantage

Infant Child Under-five

120 Male/female ratio of mortality

100

Male advantage

80

Adapted from Hill and Upchurch (1995)

60 350

300

250

200

150

100

50

Deaths under age 5 per 1,000 live births

Decline in under-five mortality

than 100give a powerful warning that differential treatment or access to resources is putting girls at a disadvantage. Earlier studies, including a major study published by the United Nations Population Division in 1998, found numerous countries in many regions of the world, particularly Southern Asia, Eastern Asia, and Northern Africa and Western Asia, where mortality at ages 1-4 was higher for girls than for boys. This report is the first global review of sex differentials in infant and child mortality produced by the United Nations in over a decade. It uses a greatly expanded database of estimates of child mortality by sex from vital registration, demographic surveys, and censuses to provide a longer time series than in previous studies as well as estimates for a greater number of countries. Trends from the 1970s or 1980s to the 2000s are estimated for 122 countries with populations greater than 1 million in 2009, 83 in the less developed regions and 39 in the more developed regions. These countries contained 92 per cent of world population in 2009. For an additional 27 countries, while the available data did not support construction of a time series, it was possible to use country-specific information to estimate a general level of the sex differentials in infant or under-five mortality. The derived trends presented here provide an advantage over estimates of sex differentials from single surveys, which are subject to a high degree of random error. However, the estimates in this report should be used with a degree of caution, particularly for developing countries, due to high levels of variability in the underlying data and scarce data for some countries. The margins of error may be more pronounced in countries with scarce or poor quality data, for which, in some cases, the results suggest more extreme sex ratio levels. Furthermore, the estimated sex ratio levels for some country aggregates, including the world, can be significantly influenced by estimated levels in very populous countries. While errors in the estimated levels of multiple countries with small or medium-sized populations may cancel out at the aggregated level, the same may not apply for large countries.

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The key findings of the report are as follows: 1. In the less developed regions, individual countries have varying trends in sex differentials in infant, child and under-five mortality, but when all countries are considered as units, the median sex ratio of under-five mortality has been increasing. For the 83 countries in the less developed regions for which trends were estimated in this study, the median sex ratio of under-five mortality increased from 111 in the 1970s to 119 in the first decade of the 2000s (table 1). Thus, in the majority of developing countries, females have an advantage in survival to age 5, and this advantage has increased in the expected direction as mortality has declined. This is due primarily to increases in the ratio at ages 1-4 in many countries, while increases in the sex ratio of infant mortality have been smaller. 2. However, when countries are weighted according to the number of births, the opposite trend is apparent. On average, the sex ratio of under-five mortality in the less developed regions fell from 103 in the 1970s to 99 in the 2000s (table 2 and figure II). In other words, based on these estimates boys currently have slightly lower under-five mortality than girls in the less developed regions. This is because the two most populous countries, China and India, constitute important exceptions to the rising trend. Sex ratios of under-five mortality are well below 100 in both countries (table 2), indicating substantial excess female mortality. In both countries, the sex ratio of under-five mortality declined between the 1970s and the 2000s, meaning that even though mortality was declining in both countries, girls did not share in survival improvements to the same extent as boys. The average ratio for less developed regions excluding China and India rose from 109 to 112. 3. Moreover, China and India were the only two countries in the world where female infant mortality was higher than male infant mortality in the 2000s. In China, female disadvantage is particularly concentrated among young infants, and the sex ratio of infant mortality fell from 112 in the 1970s to 76 in the 2000s, that is, from a situation where infant mortality was 12 per cent higher for boys to one where infant mortality was 24 per cent lower for boys than for girls. 4. In India, female infant mortality was slightly higher than male infant mortality, but girls survival disadvantage was particularly acute in the 1-4 age group. In the 2000s, the ratio of male to female child mortality was estimated to have fallen to 56. Expressed in terms of excess female mortality, this means the risk of dying between ages 1 and 5 is more than 75 per cent higher for girls. Data from both the Sample Registration System and the National Family Health Surveys substantiate the declining sex ratio of mortality in this age group. 5. The lower relative survival of girl children in China and India has a large impact on estimates of average sex differentials for their respective regions of Asia. The average sex ratio of under-five mortality for Eastern and South-Eastern Asia declined from 109 in the 1970s to 92 in the 2000s (table 2). However, the average for the countries of the region apart from China rose from 117 to 120. Likewise, the sex ratio of under-five mortality in Southern Asia fell from 93 to 88, but rose from 102 to 111 in the countries of the region other than India. The estimates in this study suggest that the survival disadvantage of girls has lessened in other countries of Southern Asia, with the exception of Nepal. 6. In many of the less developed regions, girls past disadvantage in mortality at ages 1-4 appears to be easing. The regions of Northern Africa and Western Asia, Eastern and South-Eastern Asia (excluding China), Southern Asia (excluding India), CIS Asia, and Latin America and the Caribbean all experienced increases in the average sex ratio of child mortality of 8 or more

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TABLE 1. MEDIAN SEX RATIOS OF INFANT, CHILD AND UNDER-FIVE MORTALITY BY REGION, 1970S-2000S
Median ratio of male to female mortality (per 100) Child Change 1970s2000s 0 3 3 7 -4 1 7 2 -7 Change 1970s2000s 7 10 5 22 13 18 11 8 -1

Number of countries with trend estimates World...................................................... Less developed regions............................. Sub-Saharan Africa............................ Northern Africa and Western Asia.... Eastern and South-Eastern Asia........ Southern Asia.................................... CIS Asia............................................. Latin America and the Caribbean...... More developed regions........................... 122 83 28 11 9 5 8 22 39

Infant

Under-five Change 1970s2000s 4 8 2 12 -3 8 10 6 -7

1970s* 122 119 116 112 124 110 .. 121 130

1980s 123 119 116 116 123 113 124 124 129

1990s 123 121 117 117 122 114 127 124 126

2000s 122 122 118 119 120 111 131 124 123

1970s* 109 101 102 94 102 82 .. 107 125

1980s 109 103 104 96 105 83 100 110 125

1990s 112 107 107 102 112 83 104 110 125

2000s 116 111 107 116 115 100 111 115 124

1970s* 116 111 109 107 120 100 .. 116 130

1980s 118 114 110 110 118 101 117 120 128

1990s 120 117 112 114 118 103 122 121 126

2000s 121 119 112 119 117 108 127 122 122

Note: *Estimates for the 1970s exclude the following 14 countries that are included for subsequent decades: Albania, Armenia, Azerbaijan, Croatia, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Serbia, Sierra Leone, Slovenia, Tajikistan, the former Yugoslav Republic of Macedonia, and Turkmenistan

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TABLE 2. REGIONAL AVERAGE ESTIMATES OF MALE, FEMALE AND BOTH SEXES INFANT, CHILD AND UNDER-FIVE MORTALITY, AND SEX RATIOS OF INFANT, CHILD AND UNDER-FIVE MORTALITY, 1970S-2000S (COUNTRIES WEIGHTED BY NUMBER OF BIRTHS)
Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes 89 71 59 48 92 75 63 52 101 79 65 53 115 91 75 61 20 15 12 8.1 135 123 113 97 124 87 62 45 80 64 55 45 78 63 54 44 91 72 61 50 97 78 64 52 15 11 9.0 6.5 116 105 97 82 112 78 54 38 85 68 57 47 85 69 59 48 96 76 63 52 106 85 70 57 18 13 10 7.3 126 114 105 90 118 83 58 42 Child mortality (probability of dying at ages 1-4, per 1,000) Both Male Female sexes 45 34 28 23 48 38 34 28 52 38 31 26 62 48 41 33 4.0 2.9 2.2 1.4 104 94 85 68 47 33 22 14 50 38 32 27 49 39 34 27 58 43 35 30 64 50 41 33 3.2 2.4 1.8 1.1 100 91 82 66 52 35 22 14 48 36 30 25 48 39 34 27 55 41 33 28 63 49 41 33 3.6 2.7 2.0 1.3 102 92 83 67 50 34 22 14 Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes 129 101 84 69 133 109 93 77 147 113 93 77 168 134 112 92 24 18 14 9.5 224 204 188 158 165 117 82 59 125 99 84 70 121 99 84 69 143 111 93 78 154 122 101 82 19 14 11 7.6 204 185 170 143 158 109 74 51 127 100 84 70 127 104 89 73 145 112 93 77 161 128 107 87 21 16 12 8.6 214 195 179 150 162 113 78 55 Ratio of male to female mortality (per 100) Underfive 103 102 100 99 110 110 111 112 103 102 100 99 109 110 111 112 128 128 127 125 110 110 110 111 104 107 110 114

Decade* World 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

Infant 111 110 108 107 118 118 118 118 111 110 107 107 118 118 118 118 129 129 128 126 116 117 117 118 111 112 115 119

Child 90 89 87 86 97 98 100 102 89 88 87 86 97 98 100 102 123 122 124 124 103 104 103 103 90 94 97 102

World excluding China and India

Development group Less developed regions

Less developed regions excluding China and India

More developed regions

Region Sub-Saharan Africa

Northern Africa and Western Asia

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TABLE 2 (continued)
Infant mortality (deaths under age 1 per 1,000 live births) Decade* 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s Male 72 45 31 23 102 68 44 28 118 97 77 58 135 110 85 62 .. 83 68 51 82 57 40 27 Female 61 41 34 26 81 55 36 23 116 94 74 58 118 95 74 54 .. 66 53 39 67 46 32 22 Both sexes 67 43 32 25 92 62 40 25 117 95 76 58 127 103 79 58 .. 75 60 45 75 52 36 24 Child mortality (probability of dying at ages 1-4, per 1,000) Male 34 21 10 6.5 47 26 14 6.7 58 38 29 22 67 49 35 23 .. 20 15 11 34 18 12 7.0 Female 35 22 11 6.4 46 26 13 6.0 76 53 42 34 82 61 40 23 .. 19 14 10 32 16 11 6.2 Both sexes 34 22 10 6.4 47 26 13 6.3 67 45 35 28 75 55 37 23 .. 19 15 10 33 17 11 6.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 103 65 41 30 143 93 57 34 170 132 103 79 193 153 117 83 .. 101 81 61 113 73 51 34 Female 94 62 44 32 122 79 48 28 183 141 113 90 190 150 111 75 .. 83 66 48 97 62 43 28 Both sexes 99 64 42 31 133 86 53 31 176 136 108 84 191 152 114 79 .. 93 74 55 105 68 47 31 Ratio of male to female mortality (per 100) Underfive 109 104 94 92 117 118 119 120 93 93 92 88 102 102 105 111 .. 121 123 126 116 119 120 122

Eastern and South-Eastern Asia

Eastern and South-Eastern Asia excluding China

Southern Asia

Southern Asia excluding India

CIS Asia

Latin America and the Caribbean

Infant 118 109 93 90 127 125 124 123 102 104 103 101 115 115 115 116 .. 127 128 130 122 124 124 124

Child 95 94 97 101 101 103 105 112 77 72 69 64 81 81 87 99 .. 102 105 110 105 106 110 113

NOTE: * Estimates for the 1970s exclude the following 14 countries that are included for subsequent decades: Albania, Armenia, Azerbaijan, Croatia, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Serbia, Sierra Leone, Slovenia, Tajikistan, the former Yugoslav Republic of Macedonia, and Turkmenistan.

xx

Figure II. Trends in the sex ratio of under-five mortality by level of under-five mortality, less developed regions, 1970s-2000s
140

Female advantage

Male/female ratio of under-five mortality

CIS Asia 120 N. Africa/ W. Asia Sub-Saharan Africa 100 All less developed Lat. America/ Carib E./S.E. Asia

Male advantage

80

Southern Asia

60 350

300

250 200 150 100 Deaths under age 5 per 1,000 live births

50

Decline in under-five mortality


Note: Dashed line is the historical sex ratio of under-five mortality for selected developed countries from Hill and Upchurch (1995)

percentage points (table 2). In sub-Saharan Africa, however, there was little change in the average sex ratio of child mortality, with increasing ratios in many countries offset by decreasing ratios in others. For the less developed regions on average (excluding China and India), girls went from a situation of slight disadvantage in mortality at ages 1-4 in the 1970s to a slight advantage in the 2000s. Nevertheless, for all of the less developed regions average sex ratios of mortality at ages 1-4 remain below the ratios experienced by developed countries at similar levels of mortality that were shown in figure I. 7. There are a number of countries in the less developed regions where the estimates suggest continued or worsening female disadvantage in mortality at ages 1-4. The countries where excess female child mortality was apparent in the 2000s are indicated on the map in figure III. While countries with excess female mortality can be found in most regions of the developing world, there are notable concentrations in Southern Asia and in the Western and Middle regions of subSaharan Africa, as well as several countries in Northern Africa and Western Asia. While data quality issues may affect the reliability of these estimates, countries with apparent female disadvantage merit further study to see if differential treatment is an issue. 8. Among infants under age 1, girls continue to have the advantage in survival in all countries apart from China and India. However, the female survival advantage in infancy in most of the developing world is not as great as would be expected based on the historical experience of some developed countries at similar levels of mortality shown in figure I. It cannot be stated with certainty whether this finding is due to actual differences in the treatment of girls and boys, to epidemiological factors such as differences in the cause-of-death composition or the rollout of medical interventions in different locations at a given level of mortality, or if there are issues with the quality of the data for some countries that affect the estimates in a systematic way.

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9. In the more developed regions, ratios of male to female infant mortality have been declining in recent decades, meaning that the male disadvantage in infant mortality is becoming smaller. This trend started in certain countries in the 1970s and has since spread to almost all of the developed countries and to a number of countries in the less developed regions that have relatively low levels of mortality. The change in trend may be attributable to improvements in neonatal care that have decreased deaths from prematurity and respiratory distress, causes that had a greater impact on male infants. However, further study is required to elucidate the causes of this trend. 10. Several countries had findings of unusually high sex ratios of infant mortality (greater than 130), suggesting a greater than expected degree of male disadvantage in survival. These countries, found in both developed and developing regions, include many of the European and Asian countries of the former Union of Soviet Socialist Republics (figure IV). The high ratios could be due to lack of access to the advances in medical care that have led to declining sex ratios of infant mortality in most of the more developed regions, but again, more detailed examination of causes of infant deaths by age and sex is required. In sum, the results of this study highlight the importance of estimating childhood mortality rates separately by sex. In many areas of the world, advances in survival appear to be accruing relatively equitably to girls and boys, in line with the changes in sex differentials expected given changing cause-ofdeath patterns that accompany mortality decline. However, this is not universally the case. In particular, the plight of girls in China and India should remain in the global spotlight as there is evidence that girls are not benefitting as much as boys from the mortality declines in these countries. The interaction of strong son preference and declining fertility has continued implications for the health and survival of girls in these countries. Both countries have implemented policies and programmes intended to improve the status of girls and women as well as directly influence families treatment of girls, but no significant change is apparent in girls relative survival as yet. In both countries, media and policy attention have concentrated largely on sex-selective abortion i.e., prenatal discrimination in recent years, but postnatal discrimination still affects large numbers of girls, particularly in India where relatively high infant and child mortality rates mean that a significant number of excess deaths among girls still occur. Estimates of under-five mortality levels are receiving intense focus as the world nears the 2015 target date for the Millennium Development Goals. The target for MDG4 calls for reducing under-five mortality by two-thirds from its 1990 level, and efforts to strengthen child survival programmes are intensifying. In this light, the finding of declining sex ratios of infant or child mortality in a number of countries that still have relatively high mortality merits concern, as it suggests that girls in these countries may not be sharing fully in the recent improvements in survival. Further study is needed to confirm these findings, to identify why girls relative survival is not keeping pace, and to assess interactions with other barriers to care such as poverty or marginalization. Countries with declining sex ratios often have neighbouring countries where such a phenomenon is not evident, so case studies from countries that have been successful in reducing inequalities in the survival of girls and boys whether this was a conscious policy choice or an indirect outcome of generally expanded access to interventions could provide useful insights and guidance to the planning of child health interventions and health system improvements.

xxii

Figure III. Countries where excess female child mortality (ages 1-4) was found in the 2000s

Female 4q1 higher than male 4q1 Insufficient data

Figure IV. Countries where excess male infant mortality was found in the 2000s

Sex ratio of infant mortality higher than 130 Insufficient data

xxiii

I. INTRODUCTION
A. BACKGROUND The study of differences in survival between males and females is a major focus of demographic research. Sex differentials in survival result from a complex interplay of biological and behavioural factors that impact mortality at different stages in the life course. In countries with very low mortality, females have lower mortality than males at all ages. However, in some populations in the developing world, and in studies of historical mortality patterns from the developed world, female disadvantage in mortality has been found in some age groups, particularly among girls and young women (Tabutin and Willems, 1998). In recent decades, major reductions of infant and child mortality have been achieved in most countries of the world. The global rate of underfive mortality (expressed as deaths of children under age 5 per 1,000 live births) fell from 109 in 1980-1985 to 71 in 2005-2010 according to the 2008 Revision of World Population Prospects (United Nations, Department of Economic and Social Affairs, Population Division, 2009). Given the current state of information, however, it is difficult to state with certainty whether the benefits of advances in child survival in recent decades have accrued equally for girls and boys. This is due to the inadequate nature of birth and death statistics in most developing countries. In the absence of complete vital registration, mortality estimates for these countries are derived primarily from sample surveys and population censuses, through questions posed to women about the survival of their children. Such estimates can be subject to a great deal of uncertainty due to small sample sizes, as well as biases affecting the consistent reporting of all children. A proliferation of sample survey programmes in recent years has greatly expanded the amount of data available, but in some cases has led to greater uncertainty as different surveys produce widely varying estimates of mortality for overlapping time periods. Since 2004, demographers from the United Nations system, working through the Inter-Agency Group for Child Mortality Estimation (IGME), have addressed the harmonisation of conflicting estimates that arise from increasing numbers of data sources (Child Mortality Coordination Group, 2006). The IGME has thus far, however, produced estimates only for both sexes combined and has not addressed sex differentials in child mortality. In the 1990s, the United Nations Population Division estimated sex differentials in infant, child and under-five mortality for those developing countries with adequate survey or vital registration data for the report Too Young to Die: Genes or Gender? (United Nations Secretariat, 1998). However, due to the relatively short data series available at the time, the analysis conducted for Genes or Gender produced summary estimates for only two periods, the 1970s and 1980s. Estimates for both periods were available for 52 of 82 developing countries covered in the study. Changes between these two periods were analyzed but only tentative conclusions could be drawn. A later study by Tabutin and others (2001), using a similar approach, produced estimates of changes in sex differentials for 19 African countries between the periods 1970-1985 and 1986-1997. Any important changes in the sex differential between the two periods were presented at face value in these two studies, although it was acknowledged that such changes could have arisen either from real changes in relative mortality by sex or from differences between surveys due to sampling variation. Rapid changes in sex ratios of child mortality were difficult to account for analytically. In addition, they were difficult to incorporate into consistent time series of life tables for use in population estimation. In this context, the Population Division has undertaken the task of expanding its collection of mortality data disaggregated by sex and analyzing the data to estimate trends in sex differentials of childhood mortality using a consistent methodology. The present study takes advantage of the large quantity of data that has become available in the past decade to estimate a continuous time series of sex differentials in infant, child and under-five mortality from the 1970s to the first decade of the 2000s (hereafter
1

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

referred to as the 2000s). Estimates were attempted for all countries or areas (hereafter referred to as countries) that had a population of 1 million or higher in 2009. Out of the 154 countries with such a population, estimates were generated for a total of 149 countries (table I.1). Of these, 109 were in the less developed regions: 83 developing countries containing 91 per cent of the population of the less developed regions, had sufficient data to apply the methods developed for trend analysis. For an additional 26 developing countries holding 8 per cent of the population of the less developed regions, enough data were available to estimate average sex differentials in under-five or infant mortality, which were assumed to apply to the entire time span under consideration. An additional extension beyond the analysis from Genes or Gender is the inclusion of countries of the more developed regions. Most countries in these regions have highly reliable vital statistics that can be used to construct accurate annual life tables. However, due to the relatively small numbers of child deaths in developed countries, the sex differential in mortality rates can vary from year to year, particularly in smaller countries, making smoothed estimates desirable for purposes of estimation and projection and for comparative study. Moreover, a shift to a downward trend in sex differentials of infant mortality was recently identified for 15 developed countries1 by Drevenstedt and others (2008). The analysis here examines whether such a shift has occurred in other developed countries, and whether any similar phenomenon has occurred for child mortality. In total, trends were estimated for 39 developed countries (table I.1) while for 1 developed country (Bosnia and Herzegovina) only average sex differentials were obtained. This report does not present any new estimates of the levels of infant and child mortality for both sexes combined. Rather, sex differentials presented here are intended to be used to disaggregate agreed estimates of bothsexes mortality, such as those produced by the IGME, that take into account all sources of mortality data including those sources that have not provided data by sex. The resulting
2

disaggregated estimates will be useful for a number of purposes including for producing population estimates and projections, as carried out in the biennial Revisions of World Population Prospects produced by the Population Division; the use of child mortality estimates by sex as inputs into model life table systems; the development of models for disaggregation by sex when only both-sexes estimates are available; as well as substantive analysis of sex differentials. The estimates by sex presented here are not intended to replace estimates from any United Nations source such as World Population Prospects, but may suggest refinements that could usefully be applied in future Revisions. Moreover, while the estimates here will be valuable from a policy and advocacy standpoint for calling attention to persisting or worsening differentials in child mortality that disadvantage girls or boys, the present report does not attempt any explanatory analysis or policy prescription beyond a brief review of relevant literature. B. UNDERSTANDING SEX DIFFERENTIALS IN
CHILDHOOD MORTALITY

The mortality rates considered in this report refer to deaths occurring to children below the age of 5. Under-five mortality, denoted as 5q0, expresses the probability of dying between birth and exact age 5 years. In common usage this probability is multiplied by 1,000 and expressed as deaths per 1,000 live births. While overall under-five mortality is a commonly used indicator of health and development, from a policy standpoint it is useful to examine childhood mortality in smaller age groups. Furthermore there are important differences in expected sex differentials for infants under the age of 1 versus children between ages 1 and 5. Therefore focus will be placed separately upon infant mortality (the probability of dying between birth and exact age 1 year, denoted 1q0) and child mortality (the probability of dying between exact ages 1 and 5 years, denoted as 4q1). The indicators 1q0, 4q1 and 5q0 are related to one another by the following equation:
5 0

q 1q 0 4 q1(1 1q 0)

(1)

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

In this report, simple ratios of male mortality levels to female mortality levels will be used to estimate and analyze sex differentials.

SR5 (5q 0 male / 5q 0 female) 100 SR1 (1q 0 male / 1q 0 female ) 100 SR 4 ( 4 q1male / 4 q1 female) 100

(2) (3) (4)

Since boys are subject to higher mortality levels than girls during childhood in a majority of countries, the discussion will highlight levels of SR5, SR1, or SR4 that are lower than 100, that is, where girls have higher mortality than boys. Under normal conditions female infants and small children have an advantage in survival over boys of the same age (Waldron, 1998). Thus, a malefemale ratio higher than 100 is not necessarily a sufficient standard for declaring that females do not experience disadvantage, because females could have mortality rates that are lower than those of males but still not as low as would be expected given girls genetic and biological

advantage. In certain historical population where discrimination against girl children was believed to be negligible, sex differentials in infant, child and under-five mortality increased as the level of mortality declined (Hill and Upchurch, 1995). For example, in a model developed by Hill and Upchurch based on data from North-Western European countries (figure I.1), a discriminationfree SR1 is estimated to be about 121 at a high level of mortality (when 5q 0 male is around 200 per thousand) but to increase to 130 as mortality declines to the lowest level in their model (defined as 5q 0 male equal to 25 per thousand). Likewise, the expected SR4 at these same mortality levels increases from 106 to 123 as mortality declines. Therefore, a finding in our analysis of constant or declining sex differentials, in the context of declining mortality in a given country, could indicate that the benefits of improved survival are not accruing equally to girls. Conversely, sex ratios higher than the neutral levels described by Hill and Upchurch could imply that males

Figure I.1. Historical change in the sex ratio of mortality as under-five mortality declined, selected developed countries
140

Female advantage

Infant Child Under-five

120 Male/female ratio of mortality

100

Male advantage

80

Adapted from Hill and Upchurch (1995)

60 350

300

250

200

150

100

50

Deaths under age 5 per 1,000 live births

Decline in under-five mortality

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

experience higher mortality to a degree disproportionate to their biological disadvantage. It should be noted that present day developing countries may have epidemiological or nutritional profiles that differ from the historical settings upon which the model was based, and thus the model should not be construed as a standard, yet it provides a useful reference point to compare sex differentials in countries at various levels of mortality and will be referred to below in the discussion of results. C. CHALLENGES IN ESTIMATING CHILDHOOD
MORTALITY BY SEX

Reliably estimating even overall trends in childhood mortalitythat is, without taking into account differences by sexis a difficult task in developing countries. In the absence of complete and reliable vital registration systems, estimation of mortality rates for children primarily relies upon special questions in population censuses and household sample surveys. These questions elicit information from women respondents about their childbearing history, either in detail or in summary, and the survival status of their children. Estimates based on these questions are subject to sampling errors (for surveys) and non-sampling errors (for both surveys and censuses) with the outcome that multiple inquiries may produce quite different estimates for the same time period. Since 2004, the Inter-agency Group for Child Mortality Estimation (IGME) has attempted to reconcile inconsistent estimates of overall (both-sexes) under-five mortality for each country using different regression models to produce a best estimate of trends since 1960 (UNICEF and others, 2007, 2011). IGME also produces timeseries of infant mortality estimates for both sexes combined.

The problem of sampling error is compounded when mortality estimates are disaggregated. Even in a fairly large sample, the number of child deaths is relatively small. Disaggregating estimates of mortality by sex or any other factor reduces the number of deaths, leading to larger sampling errors which can make it difficult to establish whether differentials and trends are statistically significant. Furthermore, non-sampling biases in the data may affect estimates for males and females differently. For example, there may be differential under-reporting of boys and girls who died shortly after birth. For several censuses and surveys, the estimates of childhood mortality produced are not made available by sex. In some cases, data are simply not collected by sex. This particularly pertains to summary data on the total number of children ever born, and the number who are still living, collected in censuses and some sample surveys. Directly estimating 5q0 and 1q0 by sex would require using only those sources that collected and published data by sex, which would potentially produce a both-sexes estimate inconsistent with both-sexes estimates published in United Nations compendia that are based upon a larger number of sources. For this reason, the present study does not attempt new estimates of mortality levels. Rather, levels from existing sources are adopted and a new time series of the ratio of male to female mortality is applied. __________
NOTES
1 Australia, Belgium, Canada, Denmark, England and Wales, Finland, France, Sweden, Italy, Japan, Netherlands, Norway, Spain, Switzerland, and the United States.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

TABLE I.1. NUMBER OF COUNTRIES OR AREAS AND PERCENTAGE OF POPULATION COVERED IN THE STUDY
Included Not included Less than 1 million Insufficient population in 2009* data

Grand total

Trend estimate

Weighted average

Total

A. Number of countries or areas World Less developed regions....................................... Sub-Saharan Africa..................................... Northern Africa and Western Asia.............. Eastern and South-Eastern Asia (excluding Japan) .................................................... Southern Asia.............................................. CIS Asia...................................................... Latin America and the Caribbean ............... Developing Oceania (excluding Australia and New Zealand) ................................. More developed regions...................................... 230 174 50 22 17 9 8 45 23 56 122 83 28 11 9 5 8 22 0 39 27 26 13 4 6 2 0 0 1 1 149 109 41 15 15 7 8 22 1 40 5 5 0 4 0 0 0 1 0 0 76 60 9 3 2 2 0 22 22 16

B. Population in 2009 (thousands) World.................................................................. Less developed regions....................................... Sub-Saharan Africa..................................... Northern Africa and Western Asia.............. Eastern and South-Eastern Asia (excluding Japan) .................................................... Southern Asia.............................................. CIS Asia...................................................... Latin America and the Caribbean ............... Developing Oceania (excluding Australia and New Zealand) ................................. More developed regions...................................... 6 829 360 5 596 079 800 528 421 622 2 010 885 1 693 953 76 845 582 314 9 931 1 233 282 6 324 853 5 097 806 669 212 348 046 1 837 828 1 590 600 76 845 575 275 0 1 227 047 449 488 445 721 127 322 37 202 172 120 102 346 0 0 6 732 3 767 6 774 341 5 543 527 796 534 385 248 2 009 948 1 692 946 76 845 575 275 6 732 1 230 814 36 918 36 918 0 34 199 0 0 0 2 719 0 0 18 102 15 634 3 995 2 176 938 1 007 0 4 320 3 199 2 468

C. Percentage of population World.................................................................. Less developed regions....................................... Sub-Saharan Africa..................................... Northern Africa and Western Asia.............. Eastern and South-Eastern Asia (excluding Japan) .................................................... Southern Asia.............................................. CIS Asia...................................................... Latin America and the Caribbean ............... Developing Oceania (excluding Australia and New Zealand) ................................. More developed regions...................................... 92.6 91.1 83.5 82.6 91.4 93.9 100.0 98.8 0.0 99.5 6.6 8.0 15.9 8.8 8.6 6.0 0.0 0.0 67.8 0.3 99.2 99.1 99.4 91.5 100.0 99.9 100.0 98.8 67.8 99.8 0.5 0.7 0.0 8.1 0.0 0.0 0.0 0.5 0.0 0.0 0.3 0.3 0.6 0.4 0.0 0.1 0.0 0.7 32.2 0.2

NOTE: * Out of the 76 countries or areas with a population of less than 1 million in 2009, 34 had a population of less than 100,000, for which estimates of childhood mortality for both sexes combined were not published in the 2008 Revision of World Population Prospects.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

II. DATA AND METHODS


A. DATA SOURCES The three indicators of childhood mortality can be estimated directly or indirectly from demographic data sources. Direct estimates of 1q0, 4q1 and 5q0 are calculated from reported deaths and information on the population exposed to the risk of death and do not require the use of models for their derivation. Direct estimates may be based either on data from a vital registration system or on survey questions posed to adult women about their childbearing histories. To estimate infant mortality (1q0) by sex from vital registration data, information is required on the number of male and female live births occurring in a given period, and the number of boys and girls dying before age one during the same period. The estimation of child mortality (4q1) requires information on the number of girls and boys dying between the exact ages of one and five in a given period, plus the population aged one to four at the mid-point of the period, classified by sex. Data derived from the complete registration of births and deaths are the ideal basis for the estimation of mortality since they cover the full set of events of interest and permit the estimation of trends. Unfortunately, in most developing countries the coverage and completeness of registration by vital registration systems are insufficient to produce accurate estimates of the level of childhood mortality. However, in the absence of evidence that reporting of births and deaths differs by sex of the child in a way that would affect the ratio of male to female mortality, such ratios derived from vital registration may usefully inform trends of sex differentials. Direct estimates of mortality in childhood can also be obtained from sample surveys that record the birth histories of women in the childbearing ages. Birth histories comprise the date of each live birth and the age of death of children who have died before the survey date. Period-specific probabilities of dying calculated from birth histories are based on reported deaths and the numbers of children at risk of dying during a specific period, such as the 5 years
6

preceding the survey (Rutstein and Rojas, 2006). Almost all direct estimates based on survey data and presented in this report are calculated in this manner. Indirect estimates of mortality in childhood can be derived from summary data on the total number of children ever born and number surviving to women in the reproductive ages. The method used to derive indirect estimates (also known as the Brass method) is described in detail in United Nations (1990). A large number of censuses and surveys have collected the required data, although the data are not always collected or published by sex (that is, the questionnaires do not always ask about sons and daughters separately, or, if they do, the separate tabulations may not be published). The Brass method translates proportions of children surviving classified by age of mother at the time of data collection into measures of survival to various childhood ages, which in turn can be transformed into standard indicators of childhood mortality using model life tables. Under-five mortality is the preferred indicator to be derived via the Brass method, because 5q0 is more robust to the choice of model life table than 1q0 which can vary considerably according to the model selected. For this reason, indirect methods do not provide a satisfactory basis for estimating infant and child mortality separately, since the sex differentials obtained for these indicators are more affected by the mortality model used than are differentials in 5q0. Estimates of childhood mortality from sample surveys may be affected by several problems related to the quality of the basic data, the most important which include errors in the dating of births and deaths; omission of events from the birth history; and sampling errors related to the probabilistic nature of the sample used. Incorrect assignment of dates to eventsfor example, the heaping of date of death on 12 months of age can have an effect particularly on the relative levels of 1q0 and 4q1. Fortunately for the purposes of the present study, unless such misdating occurs differentially for the deaths of boys and girls, it is unlikely to have a major impact on the sex differentials in either of these

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

indicators. Omission of events, however, could potentially have a substantial effect on the sex differentials examined in this report. Earlier analyses evaluated potential omission of girls or boys by examining the sex ratio of 1q0 and determining whether it fell into a range defined by the sex ratio calculated at levels 7-22 of the Coale-Demeny West model life tables (Rutstein, 1985; Sullivan and others, 1990; Curtis, 1995). However, this test does not appear to be sensitive enough. A simulation performed in the context of the present study shows that omission from a sample of births and deaths of just a very small number of girls who died in the neonatal period has a noticeable impact on the sex ratio of 1q0, inflating apparent male excess mortality. Thus a decrease in the sex ratio of 1q0 over time as seen in a number of developing countries in this analysiscould actually be due to relatively small improvements in the reporting of girls who died. Assessment of reporting errors is complicated by the potentially large effects of sampling error. Compared to most measures estimated by sample surveys, deaths of children are relatively rare events. The sample sizes of typical household surveys are not large enough to produce very precise estimates of childhood mortality, even for both sexes combined at the national level. In a study of 50 Demographic and Health Surveys (DHS), Curtis (1995) showed that relative standard errors for estimated infant and under-five mortality over a five-year period for both sexes at the national level, ranged from 0.04 to 0.08, implying that the estimates were likely to under- or over estimate mortality by a minimum of 4 per cent and a maximum of 8 per cent. For child mortality, relative standard errors were higher, in the range of 0.06 to 0.15, because fewer deaths occur at ages 1 to 4. Standard errors of DHS mortality estimates by sex were not calculated for the present report, but it is likely that trends produced by this analysis would not satisfy tests of statistical significance. One or more of the above-described errors in the basic data can compromise the accuracy of survey-based estimates and complicate the assessment of trends. For example, the estimated male-female ratio of infant mortality from the Haiti 2000 DHS was 141 for 1991-1995 and 93

for 1996-2000, while with respect to child mortality the corresponding ratios were 88 and 105. If taken at face value, the estimated ratios would imply that the situation in Haiti changed from one in which there was excess male mortality under age one and excess female mortality between ages 1 and 4 to a reverse situation in only five years. Since such changes are implausible it seems more likely that the estimated variations are the result of some combination of error patterns affecting the basic data. The estimates derived here smooth out such fluctuations through the application of regression techniques described in section II.B. The dataset used here expands upon that developed for the United Nations previous publication on sex differentials in childhood mortality (United Nations 1995, 1996a, 1996b). The DHS microdatasets have been processed to produce a time series from each survey of direct estimates of five-year mortality rates by sex, extending back to the period 20-24 years before each survey. In addition, tabulations of children ever born and children surviving by age of the mother were calculated by sex of the child for each DHS to produce indirect estimates of 5q0. An important new source of indirect estimates by sex was the Multiple Indicator Cluster Surveys (MICS), conducted by UNICEF, which yielded additional sets of indirect estimates, many for countries that had very limited data by sex from other sources. For other survey families, including the World Fertility Survey (WFS), Reproductive Health Survey (RHS), and Pan-Arab Project for Family Health (PAPFAM), among others, as well as for surveys not affiliated with the major survey programmes, the data used here are any direct or indirect estimates available in published sources, or calculated from tabulations available therein. Indirect estimates of 5q0 from a number of censuses were also added to the database. In addition, the amount of vital registration data used was greatly expanded. A large dataset of infant and under-five mortality by sex calculated from vital registration data was provided by the World Health Organization. These data were supplemented with registration data from the Human Mortality Database, the United Nations Demographic Yearbook, and other sources of life
7

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

tables. The sex differentials in 1q0 and 5q0 calculated from vital registration data were used without adjustment, even when overall births and child deaths were known to be underregistered, on the assumption that underregistration in vital registration systems does not differ by sex of the child. More study is required to assess whether this assumption is valid. For most countries, however, sex differentials estimated from vital registration are consistent with those calculated from survey data and often have considerably less variability. In the Country Profiles of this report, the full set of data on SR5 and SR1 from direct survey estimates, indirect survey estimates, and vital registration are shown graphically. Data points that were not used in the estimates, due either to being assigned zero weight in the weighting scheme or to other reasons (see next section), are shown in gray in the Country Profiles, while data points that were included are shown in black. B. ESTIMATING TRENDS IN SEX DIFFERENTIALS IN CHILDHOOD MORTALITY The estimation of sex differentials in underfive, infant and child mortality proceeded in three basic steps: 1. Estimate trends in the sex differential of
5q0;

strongly. In addition, low or zero weights are assigned to indirect estimates that are based on reports of women in the early and late childbearing years on the assumption that these estimates may be of lower quality or subject to systematic biases. The fitted trend was assessed for the influence of outlying points, and the outliers were excluded and the trend refitted as necessary. The resulting predicted SR5t was used in a later step to disaggregate the best estimate for both-sexes under-five mortality at time t. Initially the loess regression method was tested for all countries. This method fits a series of polynomials to localized subsets of the data centred on each point of the dataset. The weight of each data point in the localized regression is determined by its distance from the centre. A bandwidth, denoted alpha, selected by the user, determines the proportion of the dataset used to fit each local regression. A number of different alpha values were tested to impose varying degrees of smoothing. For countries where estimates were based on a time series of vital registration data, it was found that the loess with an alpha of 0.75 captured changes in trend without being overly sensitive to short-term variation. For countries where the primary sources of data were sample surveys, however, the degree of smoothing required to achieve plausible results with the loess was so strong that the results differed little from a simpler linear regression. The linear regression line had the additional benefit of being more straightforward to adjust for SR1, as described below. Therefore, for many developing countries the results are based on linear regression (hereafter referred to as the linear method). In countries with very few data pointsfor example, a single birth history survey, or perhaps several surveys but only a single data point published from each surveythe fitted trends from the linear method could be quite erratic. In this case, a simple weighted average of all available SR5 was computed. The Country Profiles provide information on which method linear regression, loess regression, or weighted averagewas used to produce estimates of sex differentials.

2. Estimate, and adjust if appropriate, trends in the sex differential of 1q0; 3. Apply these trends to both-sexes estimates of 5q0 and 1q0 to derive estimates and sex differentials of 4q1. In the first step, a trend line was fitted to all available SR5 estimates using weighted least squares regression, weighted loess regression, or a weighted average. The weights for data points from surveys, censuses, and vital registration were determined using the weighting scheme adopted by the IGME (UNICEF and others, 2007; Hill and others, 1999). This weighting scheme assigns lower weights to direct estimates from maternity histories that refer to time periods 15 years or more before the survey, on the assumption that recall errors may affect distant periods more
8

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

The second step of the estimation process was to produce a time series of SR1. As was noted in the previous section on data, SR1 from indirect estimates are influenced by the choice of model life table used and thus are not desirable for purposes of fitting trends. Yet, using only direct data for SR1 while using both direct and indirect data for SR5 could cause inconsistency between the two time series in that data sources with only indirect estimates are excluded in the SR1 estimation. Therefore, in order to exploit all information available, both direct and indirect estimates of SR5 were used to adjust direct estimates of SR1. A preliminary trend line, SR1t*, was fitted to all estimated SR1 coming from direct data using the same method (loess, linear or average) that had been used for SR5t. For all loess countries1 and for linear or weighted average countries where no indirect data had been used in fitting SR5t for the country, SR1t * was adopted as the final estimate SR1t. If indirect data had been used in fitting SR5t, then in order to maintain the consistency of SR1t with SR5t an adjusted SR5t* was fitted to SR5 points coming from direct data only.2 The ratio of SR5t/ SR5t* was used to adjust SR1t*, producing the final estimate SR1t. The final step was to apply the predicted SR5t and SR1t to estimates of 5q0 and 1q0 for both sexes to produce time series of infant and under-five mortality levels by sex. Estimates of under-five and infant mortality for both sexes combined are available from two United Nations sources, World Population Prospects: The 2008 Revision, produced by the Population Division, and State of the Worlds Children 2009, produced by UNICEF. The estimates from these two sources are generally quite similar for 5q0the indicator coordinated by the IGMEbut could differ somewhat more for 1q0, usually because of the use of different model life tables. The both-sexes estimates for 5q0 and 1q0 from World Population Prospects were used in this report for most developing countries (noting that for 5q0 the estimates referring to periods prior to 1980 are unpublished). The choice of which series of bothsexes estimates to use does not affect the estimated time trends in SR5 or SR1, as those come from the data, but it does affect estimated trends in SR4 because the trend in child mortality

derived from estimated 5q0 and 1q0 is dependent on the relative levels of 5q0 and 1q0 as well as the sex differentials in each. There were only a few cases where the choice of both-sexes estimate made an appreciable difference in SR4 (Pakistan and Peru being two notable examples). For countries of the more developed regions, estimates from State of the Worlds Children were used because levels of 5q0 and 1q0 from this set of estimates are taken directly from annual vital registration. The trends by sex presented in this report are not intended as a replacement for the estimates from World Population Prospects, but suggest methodological refinements that could be implemented in future Revisions. Levels of 5q0 by sex were derived from the both-sexes estimates using the formulas
5 0 malet

5q 0botht (1 SRB) /( SRB 1 / SR5t ) (5) 5q 0 malet / SR5t (6)

and
5 0 femalet

where SRB is the sex ratio at birth as estimated for 2000-2005 in the 2008 Revision of World Population Prospects.3 Corresponding formulas were applied for infant mortality. Then, 4q1male and 4q1female were derived via the relationship in equation (1). The resulting 4q1male and 4q1female were used to compute estimates of SR4t. These derived estimates of SR4t were compared to direct survey data on SR4 and generally found to be quite consistent. For countries where weighted averages of SR5 and SR1 were employed, these ratios were applied to the whole series of both-sexes estimates. It should be noted that applying constant SR5 and SR1 to changing both-sexes estimates results in SR4 that change over time. However, these changes in SR4 should not be interpreted as trends and will not be presented as such. The approach to the estimation of sex differentials in infant and under-five mortality developed here has the advantage of making use of all the information available and ensuring consistency in the levels of infant and under-five mortality by sex. However, in certain cases the
9

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

decision was taken to systematically exclude certain data sources. For a number of countries, inconsistencies between survey data and vital registration data led to a decision to use estimates from vital registration only. This decision was taken for many countries that were formerly in the USSR. Concerns about under-registration of vital events in these countries have motivated the use of survey data to produce United Nations estimates of the levels of both-sexes childhood mortality. When attempting to estimate sex differentials from these survey data, however, it was found that these data appeared to have high sampling error and produced steep estimated SR5 and SR1 trends that were at odds with the more gradual trends evident in the vital registration data. The decision to use only registration data to estimate sex differentials was also taken for India. Examination of sex ratios of infant mortality from the Sample Registration System (SRS) and from the National Family Health Surveys (NFHS) revealed systematic differences in SR1 between the two sources, with SR1 estimates from the NFHS being consistently higher than those from the SRS. For child mortality, in contrast, the two sources produced consistent estimates. The discrepancy in SR1 could be due either to defects in the sample registration system that understate male mortality, or to omission from the survey birth histories of girls who died, thus inflating survey estimates of excess male mortality. Figure II.1, comparing the time series of SR1 and SR4 estimates from each NFHS to the SRS data, reveals that the most recent point from each survey is close to the SRS ratio for the same time period, but that the NFHS ratios increase further

back in time from the survey date. Estimates of SR4 from the two sources are in fairly close agreement. The assessment was made that the difference in SR1 was most likely due to underreporting in the NFHS birth histories of babies who died shortly after birth, with daughters who died more likely to be omitted than sons who died (Pandey and others, 1998). A final caveat refers to the availability of data for the 2000s. In many cases the last available data point refers to 2005 or earlier and the estimates for the latter part of the decade are a projection of the earlier trend. __________
NOTES
1 Indirect data was used with loess estimation in only three countries: Bangladesh, China and Egypt. An adjustment procedure analogous to the procedure used in linear and weighted average countries was tested on these countries. It produced irregularities in the results for China due to differing inflection points in the SR1 and SR5 trends and little change in the results for Egypt. For Bangladesh, the results for SR4 changed moderately, with a similar trend but smaller rise in the 2000s. 2 A test was conducted in which survey points were reweighted when indirect points were excluded. This was undertaken because the weighting scheme assigns half weight to direct and indirect points coming from a single survey, in order not to overweight the survey. But when the indirect points are excludedthat is, for all SR1 fits and also for the direct-only SR5* used to make the adjustment factorthese half-weights actually down-weight the survey in comparison to other sources of direct data. In general, this did not make any difference in the direction of the SR1 or SR5* trend, but occasionally influenced the level of these indicators. 3 For most countries, the sex ratio at birth in World Population Prospects is held constant across time. For those countries where it is changing, the time-specific SRBs could be used. But it would not make much difference in the results. For example, in China, which has the most extreme change in SRB between the 1970s and the 2000s, using the 1970s SRB (1.07) instead of the 2000-2005 SRB (1.21) to derive 5q0 male for the 1970s results in 5q0 male that is different by only 0.12 per 1,000.

10

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure II.1. Sex ratios of infant and child mortality from National Family Health Surveys (NFHS) and Sample Registration System (SRS), India

Infant mortality
140 130 Ratio of male to female infant mortality 120 110 100 90 80 70 60 50 1965

1970

1975

1980

1985 Year

1990

1995

2000

2005

2010

2005-6 NFHS

1998-9 NFHS

1992-3 NFHS

SRS

Child mortality
140 130 120 110 100 90 80 70 60 50 1965

Ratio of male to female child mortality

1970

1975

1980

1985 Year

1990

1995

2000

2005

2010

2005-6 NFHS

1998-9 NFHS

1992-3 NFHS

SRS

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

11

III. RESULTS
To capture geographical clustering found in earlier studies of sex differentials in childhood mortality, countries in the less developed regions are grouped as follows for aggregated analyses of levels and trends: (1) Sub-Saharan Africa, comprising Eastern Africa, Middle Africa, Southern Africa and Western Africa; (2) Northern Africa and Western Asia (excluding Armenia, Azerbaijan and Georgia); (3) Eastern and SouthEastern Asia (excluding Japan); (4) Southern Asia; (5) CIS Asia, comprising the 8 countries in Asia that were formerly part of the Union of Soviet Socialist Republics; (6) Latin America and the Caribbean. Developing countries of Oceania do not appear in the aggregations because only one country, Papua New Guinea, had a population exceeding 1 million in 2009, and trend estimates were not available for this country. The more developed regions are considered as a single group. As shown in table I.1 above (p. 5), at least 98 per cent of the population is covered in most of the regions considered in this analysis. The exceptions are Northern Africa and Western Asia, for which only 91.5 per cent coverage was achieved due to insufficient data in several countries, the largest of which was Saudi Arabia; and the developing countries of Oceania, where 32 per cent of the population resides in countries with population below 1 million. Results for all countries selected for analysis are presented in tables III.1 (trend countries) and III.2 (weighted average countries). The tables display estimates of infant, child and under-five mortality for males, females and both sexes combined, as well as the sex differential for each indicator. The sex differential is expressed as the ratio of male mortality to female mortality, multiplied by 100. Estimates refer to four decades: the 1970s, 1980s, 1990s and 2000s (referring to the first decade of the millennium). In the case of countries for which estimated sex differentials were applied to both-sexes estimates from World Population Prospects, the mortality estimates presented for each decade were computed as the average of two quinquennial estimates (e.g. 19701975 and 1975-1980). For countries where sex ratio estimates were applied to both-sexes estimates from State of the Worlds Children, the mortality estimates in tables III.1 and III.2 refer to mid-decade (i.e. 1975, 1985, 1995 and 2005). Additionally, the results for each country, including both levels of mortality by sex and sex ratios of mortality, are shown graphically in the Country Profiles. A. DISTRIBUTION OF COUNTRIES BY SEX DIFFERENTIALS IN CHILDHOOD MORTALITY The regional analysis will first examine the distribution of countries according to sex ratios infant, child, and under-five mortality. Such distributional analysis considers each country individually, regardless of population size. In this section, only the 122 countries with trends available are included in the discussion. The distributions of countries across regions in the most recent decade will be presented first, followed by the distributions within regions across time periods. Figure III.1 provides a snapshot of the distribution of countries by sex differentials in infant, child, and under-five mortality in the first decade of the 2000s for the seven regional groupings. In each display, the interquartile range of the distribution is depicted as a box, whose upper and lower limits are the upper and lower quartiles, and the lines that extend above and below the box have as extremes the maximum and minimum values of the distribution. The dark line within the box represents the median of the distribution (for reference, the medians of the distributions shown in figures III.1 through III.9 are given in table III.3). The lower quartile, the median and the upper quartile divide the distribution into four parts, each with the same number of observations. Consequently, half of the observed values fall between the upper and lower quartiles and the median is an indicator of the centre of the distribution.

12

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 13

TABLE III.1 ESTIMATES OF MALE, FEMALE AND BOTH SEXES INFANT, CHILD AND UNDER-FIVE MORTALITY, AND SEX DIFFERENTIALS IN INFANT, CHILD AND UNDER-FIVE MORTALITY, BY COUNTRY AND DECADE, FOR COUNTRIES WITH TREND INFORMATION ON SEX DIFFERENTIALS, 1970S-2000S
Infant mortality (deaths under age 1 per 1,000 live births) Region, country or area Decade Male Female Both sexes Child mortality (probability of dying at ages1-4, per 1,000) Male Female Both sexes Under-five mortality (deaths under age 5 per 1,000 live births) Male Female Both sexes Ratio of male to female mortality (per 100)

Infant

Child

Under-five

Sub-Saharan Africa Eastern Africa Ethiopia ..................................

Kenya .....................................

Madagascar.............................

Malawi....................................

Mauritius ................................

Mozambique...........................

Rwanda...................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

151 147 120 93 91 73 73 74 131 119 100 81 185 154 125 94 52 29 21 17 164 152 131 100 142 128 132 110

123 119 96 74 81 63 61 60 123 102 80 59 165 138 113 86 41 22 16 13 140 133 118 93 124 113 118 99

137 133 108 84 86 68 67 67 127 110 90 70 175 146 119 90 47 26 19 15 152 143 125 97 133 120 125 104

112 116 89 61 58 46 46 46 97 82 62 43 147 121 86 50 15 9.2 5.0 3.2 118 124 108 80 101 85 100 67

102 109 87 62 53 42 42 43 98 79 58 40 141 114 78 44 16 8.0 4.3 2.8 121 121 102 72 90 78 92 64

107 113 88 61 56 44 44 45 98 81 60 42 144 118 82 47 16 8.6 4.7 3.0 120 122 105 76 96 81 96 65

246 246 198 148 144 116 115 117 216 191 156 120 305 257 201 140 67 38 26 20 263 257 225 172 229 202 218 169

213 215 174 131 130 103 101 100 210 173 133 97 283 236 182 126 57 30 20 16 244 238 208 158 204 182 199 156

229 231 186 140 137 109 108 109 213 182 145 109 294 247 192 133 62 34 23 18 254 248 217 165 216 192 209 163

122 124 125 126 112 116 120 124 107 116 126 136 112 112 111 110 126 131 133 131 117 114 111 108 114 113 112 111

109 107 103 97 110 109 108 107 99 103 107 109 104 107 110 115 98 114 116 115 98 102 106 110 112 110 108 105

115 115 114 113 111 113 114 116 103 110 117 125 108 109 110 111 118 127 129 128 108 108 108 108 112 111 110 109

14 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Region, country or area Decade Male Female Both sexes Child mortality (probability of dying at ages1-4, per 1,000) Male Female Both sexes Under-five mortality (deaths under age 5 per 1,000 live births) Male Female Both sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Uganda ...................................

United Republic of Tanzania ..

Zambia.................................... United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Zimbabwe...............................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

107 112 101 87 120 107 100 73 109 105 114 108 90 66 62 65 126 97 98 98 137 116 118 117 158 140 138 142 99 76 62 48

101 100 85 69 107 96 90 66 98 92 98 91 67 53 54 62 105 79 79 78 121 102 104 102 137 120 118 120 89 64 49 36

104 106 93 78 113 102 95 69 104 98 106 99 78 60 58 63 116 88 89 88 129 109 111 109 148 130 128 131 94 70 55 42

82 87 77 61 93 81 72 49 70 74 85 83 50 38 40 48 86 68 61 62 105 89 89 88 127 100 92 93 47 32 25 22

72 76 66 52 85 77 70 50 76 74 79 71 54 37 35 37 86 69 64 65 106 87 86 84 117 95 90 94 43 29 22 19

77 82 71 56 89 79 71 49 73 74 82 77 52 37 37 42 86 68 63 64 105 88 88 86 122 97 91 94 45 31 24 21

180 189 170 142 201 180 164 118 171 171 190 181 136 101 99 109 201 158 153 154 227 194 197 194 265 226 217 222 141 106 85 70

166 168 145 117 182 165 153 112 166 159 169 156 117 88 87 97 183 143 138 138 214 181 181 177 238 204 197 203 128 91 70 55

173 179 158 130 192 173 159 115 169 165 180 169 126 95 93 103 192 150 146 146 221 188 189 186 251 215 208 212 134 99 78 62

106 112 119 126 112 112 111 111 112 114 116 118 134 124 115 105 120 122 124 126 113 114 114 115 115 116 118 119 110 118 126 134

114 115 116 117 109 106 103 99 91 100 108 117 94 102 114 129 99 98 96 95 99 101 103 105 108 105 102 99 110 111 113 117

108 113 117 122 110 109 107 106 103 108 112 117 116 115 114 113 110 111 111 112 106 108 109 110 111 111 110 110 110 116 122 128

Middle Africa Cameroon ...............................

Central African Republic........

Chad .......................................

Southern Africa Namibia ..................................

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 15

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

South Africa ...........................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

82 62 59 59 149 132 112 94 152 125 103 86 134 116 109 100 110 95 75 80 179 158 137 113 163 156 135 106 167 150 133 117

65 50 48 49 129 116 99 84 127 108 93 81 108 93 86 79 94 79 61 63 162 140 119 95 132 129 114 92 142 129 116 103

74 57 54 54 139 124 106 89 140 117 98 83 121 105 98 90 102 87 68 72 170 149 128 104 148 143 125 99 155 140 125 110

32 24 22 29 111 85 62 41 141 118 107 85 91 62 54 44 70 57 49 50 156 123 93 62 125 117 92 57 192 154 130 106

31 22 18 23 109 87 66 46 128 113 108 92 82 58 50 41 73 56 44 43 162 126 93 62 113 107 86 55 194 152 125 97

32 23 20 26 110 86 64 43 135 116 108 88 86 60 52 43 72 57 47 47 159 125 93 62 119 112 89 56 193 153 127 102

112 85 79 86 243 206 167 131 272 228 199 163 212 171 157 140 172 146 120 126 307 262 217 168 267 254 215 157 327 281 246 210

94 71 66 71 224 193 159 126 238 209 192 165 182 145 132 117 161 130 102 103 298 248 201 152 230 222 191 142 309 262 226 190

103 78 73 79 234 200 163 129 256 219 195 164 197 158 144 128 167 139 111 115 302 255 209 160 249 239 203 150 318 271 236 200

126 124 122 119 115 114 113 111 120 115 111 106 123 125 126 127 117 120 123 126 111 113 116 118 123 120 118 115 117 116 115 114

105 112 120 129 102 98 94 88 111 104 98 92 110 108 108 107 96 102 111 119 96 98 99 100 111 109 107 104 99 101 105 108

119 120 121 122 109 107 105 103 114 109 104 99 117 118 119 120 107 112 117 123 103 106 108 111 116 114 113 111 106 107 109 111

Western Africa Benin ......................................

Burkina Faso...........................

Cte d'Ivoire ...........................

Ghana .....................................

Guinea ....................................

Liberia ....................................

Mali ........................................

16 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

Mauritania ..............................

Niger.......................................

Nigeria.................................... United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Senegal ...................................

Sierra Leone ...........................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

140 89 81 81 172 169 147 103 153 141 140 120 111 90 75 65 .. 162 165 113

126 77 67 64 151 149 131 93 132 122 121 103 95 77 64 55 .. 140 145 101

133 83 74 73 161 159 139 98 143 132 130 112 103 83 69 60 .. 151 155 107

73 65 55 54 182 166 146 103 122 113 109 91 160 107 83 72 .. 129 134 64

80 65 53 49 197 176 151 103 118 111 110 93 165 106 78 64 .. 113 117 56

76 65 54 52 189 171 149 103 120 112 109 92 162 107 80 68 .. 121 125 60

203 148 132 131 322 307 272 195 256 238 234 200 253 188 152 133 .. 270 277 170

196 136 116 110 318 300 262 186 235 220 217 187 244 175 136 116 .. 237 245 151

199 142 124 121 320 303 267 191 246 229 226 193 249 181 144 124 .. 254 261 161

112 116 121 126 114 113 112 111 116 116 116 116 117 117 118 119 .. 116 114 112

91 100 105 111 92 94 97 99 103 101 100 98 97 101 106 113 .. 115 115 115

104 109 114 119 101 102 103 105 109 108 108 107 104 107 111 115 .. 114 113 112

Northern Africa and Western Asia Northern Africa Algeria....................................

Egypt ......................................

Morocco .................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

121 78 54 37 130 90 58 41 122 86 57 38

116 71 47 31 126 86 53 33 109 74 48 30

119 75 50 34 128 88 56 37 116 80 52 34

25 18 6.7 3.2 45 26 12 7.1 54 37 16 7.1

30 18 6.3 2.4 56 33 15 6.2 62 40 17 7.3

27 18 6.5 2.8 51 29 13 6.7 58 39 17 7.2

143 94 60 40 169 114 70 48 169 120 73 44

143 88 53 34 175 116 67 39 165 111 64 37

143 91 57 37 172 115 68 44 167 116 68 41

104 109 114 119 103 105 109 122 112 116 120 125

82 96 107 132 81 81 84 116 88 95 96 98

100 107 113 120 97 98 104 121 103 109 114 119

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 17

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

Sudan......................................

Tunisia....................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

127 111 92 76 108 61 34 24 72 55 51 39 23 13 7.7 4.7 73 49 33 24 38 22 13 10 136 87 50 31 182 124 92 69

106 94 80 67 99 52 27 18 63 46 41 30 19 11 6.7 4.1 74 45 28 19 35 19 11 8.8 116 76 44 28 157 107 79 58

117 103 86 71 103 57 30 21 68 50 46 35 21 12 7.2 4.4 74 47 30 21 37 20 12 9.4 127 82 47 29 170 116 86 64

88 77 64 48 29 13 5.1 3.2 28 17 15 9.0 3.9 2.3 1.7 1.4 15 8.5 4.8 2.8 4.6 2.7 1.6 1.2 35 21 9.5 4.6 99 59 37 23

87 76 63 47 37 14 4.6 2.3 26 15 13 7.7 3.5 2.2 1.5 1.0 16 8.7 4.8 2.8 4.9 2.3 1.2 1.0 39 23 10 4.6 105 63 41 26

87 76 63 48 33 14 4.9 2.8 27 16 14 8.4 3.7 2.2 1.6 1.2 16 8.6 4.8 2.8 4.7 2.5 1.4 1.1 37 22 9.8 4.6 102 61 39 25

204 179 150 120 133 73 39 27 98 71 65 48 27 15 9.4 6.1 87 57 38 27 43 24 15 11 166 107 59 36 263 176 126 91

184 163 137 111 132 65 31 20 87 61 53 38 23 13 8.2 5.1 89 53 33 21 39 21 12 9.7 151 97 53 32 245 163 116 83

194 171 144 116 133 69 35 24 93 66 59 43 25 14 8.8 5.6 88 55 35 24 41 23 14 11 159 102 56 34 254 170 121 87

120 118 115 113 109 119 128 137 115 119 124 128 119 115 114 116 99 109 118 128 110 116 117 115 117 116 114 113 116 117 117 118

101 101 102 102 78 94 112 141 109 112 115 117 112 106 116 130 95 97 99 98 94 123 137 122 89 93 95 100 95 93 91 88

111 110 109 108 101 113 125 137 113 117 121 126 118 113 114 119 98 107 115 124 108 117 119 116 110 110 111 111 107 108 108 109

Western Asia Iraq .........................................

Israel .......................................

Jordan .....................................

Kuwait ....................................

Turkey ....................................

Yemen ....................................

18 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

Eastern and South-Eastern Asia Eastern Asia China ......................................

China, Hong Kong SAR .........

Republic of Korea...................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

60 36 26 21 16 8.7 4.8 3.9 48 23 8.4 5.0 244 118 95 75 131 88 56 33 43 25 15 10 83 64 44 29

53 36 33 28 13 7.6 4.3 3.5 44 21 7.7 4.6 199 96 77 60 101 70 46 28 33 20 12 8.6 67 49 33 21

57 36 29 24 15 8.2 4.5 3.7 46 22 8.1 4.8 222 107 86 67 116 79 52 30 38 23 13 9.5 75 57 38 25

28 19 8.9 6.4 3.1 2.0 1.2 1.1 16 6.6 3.1 1.7 155 64 44 33 62 35 18 7.0 14 7.6 4.4 3.0 31 20 9.9 5.1

31 21 9.5 6.6 3.0 1.8 1.1 .9 15 5.8 2.6 1.3 158 64 42 30 60 34 17 6.3 14 7.3 3.9 2.4 33 20 9.8 4.8

29 20 9.2 6.5 3.1 1.9 1.1 1.0 15 6.2 2.8 1.5 157 64 43 31 61 35 17 6.7 14 7.4 4.1 2.7 32 20 9.9 5.0

86 54 34 27 20 11 6.0 5.0 63 29 11 6.6 360 175 135 105 184 120 73 40 56 32 19 13 111 82 53 34

82 56 42 34 16 9.3 5.3 4.5 58 27 10 5.8 325 154 116 88 155 102 62 34 46 27 16 11 97 69 42 26

84 55 38 31 18 10 5.7 4.8 61 28 11 6.3 343 165 126 96 170 111 68 37 51 30 17 12 104 76 48 30

112 100 79 76 123 116 112 111 108 109 109 110 122 123 124 125 130 126 121 117 129 126 123 121 124 129 133 138

91 91 93 97 105 111 113 115 107 114 120 129 97 101 105 111 102 104 106 113 101 105 112 126 95 100 102 106

105 96 82 80 119 115 112 112 108 110 112 114 111 114 117 120 119 118 117 116 121 121 120 122 115 120 126 132

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

South-Eastern Asia Cambodia ...............................

Indonesia ................................

Malaysia .................................

Philippines ..............................

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 19

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

Singapore................................

Thailand..................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

17 10 4.5 2.6 58 34 18 9.0 160 125 87 53 113 93 74 57 155 120 86 51 113 100 87 73 53 33 24 18 .. 54 45 31

13 8.1 3.7 2.0 46 27 15 7.5 134 106 76 49 115 93 74 59 141 109 78 46 103 89 75 61 44 27 19 15 .. 47 36 23

15 9.1 4.1 2.3 52 31 16 8.2 147 115 82 51 114 93 74 58 148 115 82 48 108 95 81 67 49 30 22 17 .. 51 41 27

3.5 2.2 1.3 .8 26 11 6.4 4.3 76 52 32 17 56 34 27 21 78 55 33 14 60 50 40 30 19 8.8 4.9 4.5 .. 8.8 7.2 2.7

3.4 2.0 1.1 .6 25 11 5.5 3.4 96 70 41 17 74 50 42 38 95 66 40 17 71 55 42 30 22 9.2 4.9 4.0 .. 10 7.7 3.0

3.5 2.1 1.2 .7 26 11 6.0 3.9 86 61 37 17 64 42 34 29 86 61 37 16 66 52 41 30 20 9.0 4.9 4.2 .. 9.4 7.4 2.8

20 12 5.8 3.3 83 45 24 13 223 170 116 69 162 124 99 77 220 169 116 64 167 145 124 100 71 42 28 23 .. 62 52 34

16 10 4.8 2.7 70 38 20 11 217 169 114 65 180 138 113 95 222 168 115 62 167 139 114 89 65 36 24 19 .. 56 43 26

18 11 5.3 3.0 77 41 22 12 220 169 115 67 171 131 106 86 221 168 116 63 167 142 119 95 68 39 26 21 .. 59 48 30

130 124 122 126 125 123 122 120 119 118 114 110 98 100 100 97 110 110 111 111 110 113 116 120 119 121 123 125 .. 115 126 137

105 113 117 116 106 109 118 125 79 74 80 100 75 69 63 56 82 83 83 80 85 90 95 100 90 96 100 111 .. 86 93 83

125 121 120 124 118 119 120 121 103 101 102 107 90 89 87 81 99 100 101 103 100 104 109 113 110 115 118 122 .. 110 121 131

Southern Asia Bangladesh .............................

India........................................

Nepal ......................................

Pakistan ..................................

Sri Lanka ................................

CIS Asia Armenia ..................................

20 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

Azerbaijan ..............................

Georgia ...................................

Kazakhstan .............................

Kyrgyzstan..............................

Tajikistan ................................

Turkmenistan..........................

Uzbekistan ..............................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

.. 94 76 49 .. 54 39 31 .. 62 54 33 .. 83 61 44 .. 113 93 69 .. 94 76 58 92 78 65 56

.. 80 66 44 .. 40 30 25 .. 50 40 25 .. 66 46 34 .. 91 74 54 .. 78 60 44 69 58 48 41

.. 88 71 47 .. 47 35 28 .. 56 47 29 .. 75 54 39 .. 102 84 62 .. 86 68 51 81 68 57 49

.. 24 20 12 .. 8.6 5.3 3.7 .. 12 11 6.2 .. 15 12 8.9 .. 36 27 20 .. 28 21 15 20 16 13 11

.. 24 19 10 .. 8.4 5.2 3.6 .. 11 9.6 5.0 .. 18 12 8.2 .. 39 28 20 .. 26 19 14 17 14 12 9.8

.. 24 20 11 .. 8.5 5.2 3.7 .. 11 10 5.6 .. 16 12 8.5 .. 37 27 20 .. 27 20 15 18 15 12 10

.. 116 95 60 .. 62 44 35 .. 73 64 39 .. 97 73 52 .. 145 117 87 .. 119 95 73 110 93 77 66

.. 102 84 54 .. 48 35 28 .. 60 50 30 .. 83 58 42 .. 127 101 73 .. 101 78 57 85 72 59 51

.. 110 90 57 .. 55 40 32 .. 67 57 34 .. 90 65 47 .. 136 109 80 .. 110 87 65 98 82 69 59

.. 118 115 112 .. 134 130 127 .. 126 133 131 .. 126 133 129 .. 124 125 127 .. 121 127 133 133 134 135 136

.. 100 106 114 .. 102 102 105 .. 107 119 125 .. 88 100 109 .. 93 94 97 .. 107 109 111 113 113 112 112

.. 113 113 112 .. 128 126 124 .. 122 130 130 .. 118 126 125 .. 114 117 119 .. 117 122 127 129 130 130 131

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Latin America and the Caribbean Caribbean Cuba .......................................

1970s 1980s 1990s 2000s

34 19 14 6.3

27 14 11 5.0

30 17 12 5.6

5.5 3.9 3.0 2.2

5.0 3.3 2.5 1.9

5.3 3.6 2.7 2.1

39 23 17 8.5

32 18 13 6.9

36 20 15 7.7

127 132 132 126

111 119 119 116

124 129 129 123

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 21

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

Dominican Republic ...............

Haiti........................................

Puerto Rico .............................

Trinidad and Tobago ..............

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

99 75 49 35 146 125 91 72 25 17 12 8.1 42 33 32 31 46 20 15 11 109 71 39 26 104 79 54 38 104 66 44 33

82 63 40 29 119 103 75 60 19 14 10 7.3 34 27 25 24 37 16 12 9.1 90 59 33 22 89 67 46 31 80 52 35 27

91 69 45 32 133 114 83 66 23 16 11 7.7 38 30 28 27 41 18 13 10 100 66 36 24 97 73 50 34 92 59 39 30

36 13 7.5 4.3 75 56 37 24 3.6 2.9 2.2 1.7 12 8.5 7.1 7.8 11 3.9 2.3 1.8 52 38 7.5 4.7 60 37 17 10 63 32 16 12

32 12 7.1 4.0 76 58 39 26 3.3 2.3 1.7 1.3 10 7.6 6.3 6.7 10 3.3 1.9 1.4 51 35 7.0 3.8 66 39 18 9.8 58 31 16 12

34 13 7.3 4.1 75 57 38 25 3.4 2.6 2.0 1.5 11 8.0 6.7 7.2 11 3.6 2.1 1.6 51 36 7.2 4.2 63 38 17 9.9 60 32 16 12

131 87 56 39 210 174 124 95 29 20 14 9.8 53 42 39 38 57 24 17 13 155 106 47 31 158 113 70 47 160 96 59 45

112 74 47 33 186 155 110 84 23 16 12 8.6 44 34 31 31 47 19 14 11 136 92 39 25 149 103 63 41 134 81 50 39

122 81 52 36 198 165 117 90 26 18 13 9.2 49 38 35 35 52 22 15 12 146 99 43 28 153 108 67 44 147 89 55 42

120 121 121 121 122 122 122 121 131 127 119 111 121 123 125 127 126 128 126 123 121 121 120 120 116 117 119 121 129 127 126 125

110 105 107 108 98 96 95 93 111 126 128 128 111 112 113 116 109 119 123 128 102 109 109 122 92 95 96 102 107 102 97 96

117 118 119 120 112 112 112 112 128 127 120 114 119 121 123 125 122 126 125 123 114 116 118 120 106 109 113 116 119 118 117 116

Central America Costa Rica...............................

El Salvador .............................

Guatemala...............................

Honduras ................................

22 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

Mexico....................................

Nicaragua................................

Panama ................................... United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

69 47 34 21 103 80 45 27 44 33 28 21 48 33 26 16 158 110 77 54 93 64 42 28 62 23 14 8.4 71 44 29 23

57 39 27 16 85 65 36 21 36 28 23 17 39 26 20 13 124 89 65 47 76 51 34 23 52 19 12 6.8 58 34 22 17

63 43 30 19 94 72 41 24 40 31 25 19 44 30 23 14 141 100 71 51 85 58 38 25 57 21 13 7.6 65 39 26 20

26 10 6.5 4.2 61 36 13 5.3 22 10 7.2 6.5 9.5 5.6 3.5 2.4 98 52 25 18 37 17 12 7.0 11 3.9 2.6 1.8 28 15 11 8.8

26 10 6.0 3.6 53 31 12 4.8 21 9.9 6.7 5.6 8.9 5.0 3.0 2.1 100 53 24 15 33 15 10 5.9 10 3.2 2.1 1.5 27 14 8.3 6.3

26 10 6.2 3.9 57 34 13 5.1 21 10 6.9 6.1 9.2 5.3 3.3 2.3 99 53 24 17 35 16 11 6.5 11 3.6 2.3 1.7 27 15 9.5 7.6

93 57 40 25 157 113 58 32 64 43 35 28 57 38 29 18 240 156 100 71 127 80 54 35 73 27 17 10 97 58 39 31

81 49 33 20 133 94 47 26 56 37 29 23 48 31 23 15 212 137 87 62 106 65 44 28 61 22 14 8.3 83 48 30 23

87 53 36 22 146 104 53 29 60 40 32 25 52 35 26 16 226 147 94 66 117 73 49 32 67 25 15 9.2 90 53 35 27

120 122 124 126 121 124 127 130 121 121 121 122 121 125 125 122 127 123 118 114 123 125 125 123 120 121 122 124 122 127 131 136

100 101 108 119 115 115 113 110 102 103 108 115 107 113 116 115 98 100 104 119 114 116 118 117 112 122 120 113 104 114 127 140

114 117 121 125 118 120 123 126 114 116 118 120 118 123 124 121 114 114 114 115 120 123 123 122 118 121 122 122 116 123 130 137

South America Argentina ................................

Bolivia ....................................

Brazil ......................................

Chile .......................................

Colombia ................................

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 23

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

Ecuador...................................

Paraguay .................................

Peru ........................................

Uruguay ..................................

Venezuela (Bolivarian Rep. of)

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

97 69 43 26 54 51 45 38 112 81 47 29 49 31 20 15 48 34 24 20

80 55 34 20 49 44 36 29 97 68 39 23 39 25 16 12 39 27 19 16

89 62 39 23 52 48 41 34 105 75 43 26 44 28 18 14 44 30 22 18

41 24 11 5.0 20 17 12 7.1 58 32 26 11 6.0 3.8 3.1 3.6 16 8.0 6.5 5.6

43 24 11 4.8 19 15 11 6.6 57 33 25 11 5.5 3.4 2.5 2.7 16 7.7 5.8 4.7

42 24 11 4.9 20 16 11 6.9 58 33 26 11 5.8 3.6 2.8 3.2 16 7.8 6.1 5.2

134 91 54 31 74 67 56 45 164 111 72 39 55 35 23 19 63 41 31 26

120 78 44 24 67 58 47 36 148 99 63 33 45 28 18 15 55 34 25 20

127 84 49 28 71 63 52 40 156 105 68 36 50 32 21 17 59 38 28 23

121 125 128 132 110 117 124 132 117 120 123 126 126 126 128 129 123 126 127 129

94 98 100 103 108 110 110 107 100 98 103 98 110 111 121 131 98 105 113 119

112 117 121 126 110 115 121 127 110 113 115 117 124 124 127 130 116 121 124 126

More developed regions Eastern Europe Belarus....................................

Bulgaria ..................................

Czech Republic.......................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

26 24 21 15 27 18 17 12 22 14 7.9 4.0

19 18 16 11 21 14 14 10 16 10 6.0 3.0

23 21 19 13 24 16 16 11 19 12 7.0 3.5

4.6 4.1 3.3 1.8 4.6 4.4 4.2 2.4 3.5 2.1 1.7 1.0

3.8 3.3 2.6 1.4 4.0 3.7 3.5 2.0 2.6 1.7 1.4 .8

4.2 3.7 3.0 1.6 4.3 4.1 3.9 2.2 3.1 1.9 1.5 .9

31 28 24 16 31 22 21 15 26 16 9.6 4.9

23 21 18 12 25 17 17 12 19 12 7.4 3.8

27 25 21 14 28 20 19 13 22 14 8.5 4.4

135 136 136 136 128 129 127 122 136 134 132 131

121 124 127 126 114 121 120 118 131 127 123 119

132 134 135 135 126 127 126 121 135 133 130 128

24 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

Hungary ..................................

Poland.....................................

Republic of Moldova ..............

Romania .................................

Russian Federation .................

Slovakia..................................

Ukraine ...................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

34 21 12 7.0 28 20 13 6.9 .. 37 30 21 38 28 24 16 34 29 26 17 27 18 11 7.6 29 23 20 17 12 9.0 5.9 4.6

27 16 9.9 5.8 22 16 11 5.8 .. 29 23 16 32 22 19 13 26 21 19 13 20 13 8.9 6.2 21 17 15 12 8.5 6.7 4.7 3.8

31 19 11 6.4 25 18 12 6.4 .. 33 27 18 35 25 22 15 30 25 23 15 24 16 10 6.9 25 20 18 15 10 7.9 5.3 4.2

3.1 2.4 2.0 1.4 3.9 2.8 1.9 1.2 .. 8.5 7.3 5.5 8.7 7.8 5.4 2.9 7.2 5.4 4.7 2.4 4.9 2.7 2.0 1.7 5.2 3.8 3.0 2.3 2.5 1.9 1.3 .9

2.6 1.9 1.6 1.1 3.1 2.2 1.5 1.0 .. 6.8 5.8 4.4 7.7 6.7 4.5 2.3 5.9 4.3 3.7 1.9 3.9 2.2 1.6 1.4 4.6 3.3 2.6 1.9 1.9 1.5 1.1 .7

2.9 2.1 1.8 1.2 3.5 2.5 1.7 1.1 .. 7.7 6.6 4.9 8.2 7.3 5.0 2.6 6.5 4.9 4.2 2.1 4.4 2.4 1.8 1.5 4.9 3.5 2.8 2.1 2.2 1.7 1.2 .8

37 23 14 8.3 32 23 15 8.2 .. 46 37 26 46 35 29 19 41 34 31 19 32 20 13 9.2 34 27 23 19 14 11 7.2 5.5

30 18 11 6.9 25 18 12 6.8 .. 35 29 20 39 29 24 15 31 25 23 15 24 16 10 7.5 26 20 18 14 10 8.3 5.7 4.5

34 21 13 7.6 28 20 14 7.5 .. 41 33 23 43 32 27 17 36 30 27 17 28 18 12 8.4 30 24 21 17 12 9.6 6.5 5.0

126 126 123 120 131 130 124 119 .. 130 130 129 120 124 125 126 133 135 134 131 132 132 127 122 135 136 136 135 138 133 127 122

119 126 129 128 125 127 126 125 .. 126 126 125 113 116 120 126 122 125 126 128 125 121 122 122 115 116 117 119 129 124 120 119

125 126 124 121 130 129 125 120 .. 129 129 128 118 122 124 126 131 133 132 131 130 130 126 122 132 133 133 133 137 132 126 121

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Northern Europe Denmark .................................

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 25

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

Estonia....................................

Finland....................................

Ireland.....................................

Latvia......................................

Lithuania.................................

Norway ...................................

Sweden ...................................

United Kingdom .....................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

21 17 14 6.3 6.9 4.8 3.4 18 9.9 6.7 4.7 23 15 17 9.0 22 14 13 7.3 12 9.2 5.1 3.6 9.9 7.2 4.6 3.1 17 11 6.8 5.6

15 13 11 4.8 5.5 3.8 2.6 15 7.9 5.4 3.9 17 11 14 7.9 17 11 11 6.2 8.9 7.1 4.0 2.8 7.7 5.7 3.7 2.5 13 8.4 5.4 4.5

18 15 13 5.6 9.9 6.2 4.3 3.0 16 8.9 6.1 4.3 20 13 16 8.5 20 13 12 6.8 10 8.2 4.6 3.2 8.8 6.5 4.2 2.8 16 9.7 6.1 5.1

3.2 4.9 3.5 1.8 2.7 1.2 .9 .8 3.5 2.1 1.3 .9 3.8 5.1 4.0 2.4 3.4 4.5 3.3 2.0 3.0 2.1 1.3 .9 1.9 1.2 .8 .9 2.8 1.9 1.2 1.0

2.3 3.6 2.7 1.4 1.9 1.0 .7 .6 2.8 1.7 1.1 .7 2.9 3.8 2.9 1.6 2.9 3.6 2.5 1.4 2.1 1.5 1.1 .7 1.5 1.0 .6 .7 2.3 1.5 1.0 .8

2.7 4.3 3.1 1.6 2.3 1.1 .8 .7 3.2 1.9 1.2 .8 3.4 4.5 3.5 2.0 3.2 4.1 2.9 1.7 2.5 1.8 1.2 .8 1.7 1.1 .7 .8 2.5 1.7 1.1 .9

24 22 18 8.1 14 8.1 5.7 4.2 22 12 8.0 5.6 27 20 21 11 26 19 17 9.3 15 11 6.5 4.4 12 8.4 5.4 3.9 20 13 8.0 6.6

18 16 13 6.2 11 6.5 4.5 3.2 17 9.6 6.5 4.6 20 15 17 9.6 20 15 13 7.6 11 8.7 5.1 3.5 9.2 6.7 4.4 3.3 16 10 6.4 5.3

21 19 16 7.2 12 7.3 5.1 3.7 20 11 7.3 5.1 24 17 19 11 23 17 15 8.5 13 10 5.8 4.0 11 7.6 4.9 3.6 18 11 7.2 6.0

135 136 133 131 128 125 127 130 125 125 123 121 136 133 123 114 132 130 124 117 130 129 127 126 128 126 124 122 129 129 127 124

137 138 130 124 138 130 127 128 124 127 123 119 130 132 135 148 116 126 134 143 144 135 127 121 128 123 118 115 121 122 122 123

135 136 132 130 129 126 127 130 125 125 123 121 135 132 125 119 130 129 126 122 133 130 127 125 128 126 123 120 128 128 126 124

26 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

Southern Europe Albania ...................................

Croatia ....................................

Greece..................................... United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Italy ........................................

Portugal ..................................

Serbia......................................

Slovenia..................................

Spain.......................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

.. 49 29 16 .. 18 9.6 6.0 24 14 8.0 4.2 22 12 6.8 3.8 40 18 8.3 4.0 .. 38 19 9.0 .. 14 6.9 3.7 18 10 6.0 4.2

.. 45 27 14 .. 13 7.6 5.6 20 11 6.8 3.6 18 9.3 5.7 3.3 32 15 6.8 3.4 .. 29 14 6.7 .. 11 5.1 3.3 14 8.1 4.9 3.4

.. 47 28 15 .. 16 8.6 5.8 23 13 7.4 3.9 20 11 6.3 3.6 36 17 7.6 3.7 .. 34 17 7.9 .. 12 6.0 3.5 16 9.2 5.5 3.8

.. 14 6.1 2.5 .. 2.7 1.5 1.2 3.1 1.7 1.1 .7 2.6 1.5 1.3 .6 8.7 4.4 2.7 1.1 .. 6.6 2.5 1.3 .. 2.4 1.4 1.1 3.6 2.2 1.5 1.0

.. 14 5.6 1.8 .. 2.0 1.1 .8 2.8 1.5 .9 .7 2.3 1.3 1.1 .6 7.5 3.5 2.1 .9 .. 6.4 2.4 1.1 .. 1.8 1.1 .7 2.9 1.8 1.3 .8

.. 14 5.8 2.2 .. 2.3 1.3 1.0 3.0 1.6 1.0 .7 2.4 1.4 1.2 .6 8.1 4.0 2.4 1.0 .. 6.5 2.4 1.2 .. 2.1 1.2 .9 3.3 2.0 1.4 .9

.. 62 35 18 .. 21 11 7.2 28 16 9.1 4.9 25 13 8.1 4.5 48 23 11 5.1 .. 45 21 10 .. 16 8.2 4.8 22 12 7.6 5.1

.. 58 32 16 .. 15 8.6 6.4 23 13 7.7 4.3 20 11 6.9 3.9 39 18 8.9 4.2 .. 35 17 7.8 .. 13 6.1 4.0 17 9.9 6.2 4.3

.. 60 34 17 .. 18 9.9 6.8 25 14 8.4 4.6 23 12 7.5 4.2 44 20 10 4.7 .. 40 19 9.1 .. 14 7.2 4.4 20 11 6.9 4.7

.. 110 111 112 .. 135 127 108 120 121 119 116 125 124 120 115 124 126 122 118 .. 132 133 135 .. 127 136 112 127 125 123 121

.. 97 110 136 .. 136 137 147 113 117 117 111 115 114 111 103 116 127 129 131 .. 104 104 112 .. 130 128 154 122 123 120 116

.. 106 111 115 .. 135 128 113 119 120 118 115 124 123 118 113 122 126 124 121 .. 127 129 131 .. 128 134 119 126 125 122 120

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 27

TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Region, country or area

Decade

The former Yugoslav Republic of Macedonia.......................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

.. 44 25 14 23 12 6.3 4.4 18 11 7.3 4.5 14 9.8 6.1 4.1 20 10 5.9 4.3 12 8.9 6.4 5.0 13 8.1 5.8 4.7 16 8.9 6.3 5.8

.. 41 22 11 17 9.2 5.0 3.6 14 8.3 5.6 3.5 11 7.4 4.7 3.2 15 8.0 4.6 3.5 9.0 6.8 5.0 4.0 9.7 6.3 4.6 3.9 12 7.1 5.1 4.9

.. 43 23 13 20 11 5.7 4.0 16 9.7 6.5 4.0 12 8.6 5.4 3.7 18 9.3 5.3 3.9 10 7.9 5.7 4.5 11 7.2 5.2 4.3 14 8.0 5.7 5.4

.. 7.3 2.8 1.0 3.5 2.1 1.3 .9 3.2 2.3 1.3 1.1 2.9 2.0 1.3 .9 3.3 2.1 1.3 .9 3.0 2.0 1.3 1.0 3.0 2.2 1.5 .9 3.4 2.0 1.3 1.0

.. 7.2 2.6 1.0 2.8 1.7 1.1 .7 2.7 1.9 1.1 .9 2.3 1.6 1.1 .7 2.6 1.7 1.1 .7 2.3 1.6 1.1 .8 2.3 1.7 1.1 .7 2.7 1.6 1.1 .8

.. 7.3 2.7 1.0 3.2 1.9 1.2 .8 2.9 2.1 1.2 1.0 2.6 1.8 1.2 .8 3.0 1.9 1.2 .8 2.6 1.8 1.2 .9 2.6 1.9 1.3 .8 3.0 1.8 1.2 .9

.. 51 28 15 26 14 7.7 5.3 21 13 8.7 5.6 17 12 7.4 5.0 23 13 7.2 5.2 15 11 7.7 6.0 16 10 7.2 5.6 19 11 7.6 6.8

.. 48 24 12 20 11 6.1 4.3 16 10 6.7 4.4 13 9.0 5.7 3.9 18 9.7 5.7 4.2 11 8.4 6.1 4.8 12 7.9 5.7 4.6 15 8.7 6.2 5.7

.. 50 26 14 23 13 6.9 4.8 19 12 7.7 5.0 15 10 6.6 4.5 21 11 6.5 4.7 13 9.7 6.9 5.4 14 9.1 6.5 5.1 17 9.8 6.9 6.3

.. 107 115 120 132 129 125 124 132 134 131 127 131 132 130 128 131 130 127 123 131 130 128 124 132 130 125 120 127 125 122 119

.. 101 107 106 128 128 126 124 117 119 123 130 126 128 127 126 126 123 122 116 131 127 125 124 132 130 127 126 124 124 122 122

.. 106 114 119 131 128 125 124 130 131 130 127 130 131 130 127 130 129 126 122 131 130 127 124 132 130 126 121 126 125 122 119

Western Europe Austria ....................................

Belgium ..................................

France .....................................

Germany .................................

Netherlands.............................

Switzerland.............................

Northern America Canada....................................

28 TABLE III.1 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Both Male Female sexes Child mortality (probability of dying at ages1-4, per 1,000) Both Male Female sexes Under-five mortality (deaths under age 5 per 1,000 live births) Both Male Female sexes Ratio of male to female mortality (per 100) Infant Child Under-five Region, country or area Decade

United States of America........

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

18 12 8.6 7.5 16 11 6.4 5.5 17 13 7.8 5.8 11 6.0 4.4 3.0

14 9.4 7.0 6.1 12 8.2 5.1 4.5 13 10 6.2 4.7 8.6 5.0 3.8 2.6

16 11 7.8 6.8 14 9.4 5.8 5.0 15 12 7.0 5.3 9.9 5.5 4.1 2.8

3.1 2.4 1.8 1.3 3.3 2.2 1.5 1.0 3.7 2.8 1.8 1.2 3.9 2.3 1.7 1.0

2.5 1.9 1.4 1.1 2.6 1.7 1.1 .8 2.9 2.1 1.4 1.0 3.0 1.7 1.3 .8

2.8 2.1 1.6 1.2 2.9 1.9 1.3 .9 3.3 2.4 1.6 1.1 3.4 2.0 1.5 .9

21 14 10 8.8 19 13 7.9 6.5 21 16 9.5 7.0 15 8.3 6.1 4.0

17 11 8.4 7.2 15 9.9 6.3 5.3 16 12 7.6 5.8 12 6.7 5.1 3.4

19 13 9.4 8.0 17 11 7.1 5.9 18 14 8.6 6.4 13 7.5 5.6 3.7

127 125 123 122 128 128 125 123 132 129 126 124 128 121 117 114

125 126 125 124 126 129 129 130 127 132 124 111 129 129 125 120

127 125 124 122 128 128 126 124 131 130 126 121 128 123 119 115

Other more developed countries Australia .................................

New Zealand........................... United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Japan.......................................

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 29

TABLE III.2. ESTIMATES OF MALE, FEMALE AND BOTH SEXES INFANT, CHILD AND UNDER-FIVE MORTALITY, AND SEX DIFFERENTIALS IN INFANT, CHILD AND UNDER-FIVE MORTALITY, BY COUNTRY AND DECADE, FOR COUNTRIES WITH WEIGHTED AVERAGE ESTIMATES OF SEX DIFFERENTIALS, 1970S-2000S
Infant mortality (deaths under age 1 per 1,000 live births) Region, country or area Decade Male Female Both sexes Child mortality (probability of dying at ages1-4, per 1,000) Male Female Both sexes Under-five mortality (deaths under age 5 per 1,000 live births) Male Female Both sexes Ratio of male to female mortality (per 100)

Infant

Child

Under-five

Sub-Saharan Africa Eastern Africa Burundi .........................................

Eritrea............................................

Somalia .........................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

141 124 130 109 143 121 90 64 163 142 142 118 .. .. .. .. 82 69 75 85 136 122 124 117 120 81 67 63

122 108 113 95 116 98 73 52 140 123 122 102 .. .. .. .. 69 58 63 71 128 116 117 111 88 59 49 46

132 116 122 102 130 110 81 58 152 132 132 110 .. .. .. .. 76 64 69 78 132 119 121 114 104 70 58 55

112 97 98 79 84 66 44 25 124 106 106 83 .. .. .. .. 49 40 44 51 108 104 103 99 83 52 36 32

112 98 99 80 77 61 41 24 114 98 98 77 .. .. .. .. 52 42 46 54 96 93 92 89 76 49 35 32

112 98 98 79 80 64 42 25 119 102 102 80 .. .. .. .. 51 41 45 52 102 98 98 94 79 50 35 32

237 210 215 179 215 180 130 87 267 233 232 191 294 281 264 231 127 106 115 131 229 213 214 205 193 128 100 94

221 196 201 167 184 154 111 75 239 209 208 171 268 257 242 211 117 98 106 121 212 198 198 190 157 104 82 76

229 203 208 173 200 167 120 81 253 221 220 181 277 265 249 218 122 102 110 126 220 206 206 198 175 117 91 85

115 115 115 115 123 123 123 123 116 116 116 116 .. .. .. .. 119 119 119 119 106 106 106 106 137 137 137 137

99 99 99 98 110 109 107 104 108 108 108 107 .. .. .. .. 95 94 95 95 112 112 112 112 109 107 103 103

107 107 107 107 117 117 117 117 112 112 112 112 110 110 110 110 109 109 109 109 108 108 108 108 123 123 123 123

Middle Africa Angola.......................................... .

Congo............................................

Democratic Rep. of the Congo ......

Gabon............................................

30 TABLE III.2 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Region, country or area Decade Male Female Both sexes Child mortality (probability of dying at ages1-4, per 1,000) Male Female Both sexes Under-five mortality (deaths under age 5 per 1,000 live births) Male Female Both sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Southern Africa Botswana.......................................

Lesotho..........................................

Swaziland......................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

94 67 64 55 123 94 74 79 129 91 80 83 .. .. .. .. .. .. .. .. 137 117 105 85

71 51 49 42 110 84 66 70 102 72 64 65 .. .. .. .. .. .. .. .. 109 93 84 68

82 59 57 49 116 89 70 74 116 81 72 74 .. .. .. .. .. .. .. .. 123 105 95 76

39 27 26 28 69 48 39 43 59 38 33 43 .. .. .. .. .. .. .. .. 88 63 48 32

35 24 24 25 53 38 31 34 62 41 35 44 .. .. .. .. .. .. .. .. 83 61 48 32

37 26 25 27 61 43 35 38 61 39 34 43 .. .. .. .. .. .. .. .. 86 62 48 32

129 92 89 82 183 138 111 118 181 125 110 122 289 208 163 133 310 275 254 224 213 173 148 114

103 74 71 66 157 118 95 101 158 109 96 106 253 182 143 116 261 231 214 189 183 148 127 98

116 83 80 74 170 128 103 110 169 117 104 114 267 192 151 123 282 249 231 203 198 161 138 106

132 132 132 132 112 112 112 112 127 127 127 127 .. .. .. .. .. .. .. .. 125 125 125 125

111 110 110 113 129 129 128 128 95 94 93 97 .. .. .. .. .. .. .. .. 107 104 102 98

124 124 124 124 117 117 117 117 115 115 115 115 114 114 114 114 119 119 119 119 116 116 116 116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Western Africa Gambia..........................................

Guinea-Bissau ...............................

Togo ..............................................

Northern Africa and Western Asia Northern Africa Libyan Arab Jamahiriya ................

1970s 1980s 1990s 2000s

92 47 29 21

81 41 25 18

87 44 27 19

16 6.8 2.9 1.4

20 8.7 4.2 2.4

18 7.7 3.6 1.9

107 53 32 22

99 49 30 20

103 51 31 21

114 114 114 114

82 78 69 60

108 108 108 108

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 31

TABLE III.2 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Region, country or area Decade Male Female Both sexes Child mortality (probability of dying at ages1-4, per 1,000) Male Female Both sexes Under-five mortality (deaths under age 5 per 1,000 live births) Male Female Both sexes Ratio of male to female mortality (per 100)

Infant

Child

Under-five

Western Asia Occupied Palestinian Territory......

Syrian Arab Republic....................

United Arab Emirates....................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

78 46 28 20 81 50 30 19 53 30 15 11

69 40 25 18 67 41 25 16 42 24 12 8.8

74 43 26 19 74 45 27 17 48 27 14 10

22 11 5.8 3.7 32 13 5.4 2.5 11 5.4 1.9 1.2

17 8.4 4.3 2.7 31 13 5.8 2.9 9.5 4.9 1.8 1.2

20 9.8 5.1 3.2 31 13 5.6 2.7 10 5.1 1.8 1.2

99 56 33 24 110 62 35 21 63 36 17 12

85 48 29 21 95 54 30 18 51 29 14 10

92 52 31 22 103 58 33 20 57 32 15 11

113 113 113 113 122 122 122 122 125 125 125 125

130 132 134 137 104 99 92 86 112 110 105 103

116 116 116 116 116 116 116 116 123 123 123 123

Eastern and South-Eastern Asia Eastern Asia Dem. Peoples Rep. of Korea........

Mongolia....................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

41 29 47 51 .. 91 70 44 149 125 87 60 114 97 93 87

38 27 43 47 .. 68 52 33 124 104 73 50 86 73 70 66

40 28 45 49 .. 80 61 39 136 115 80 55 100 86 82 77

12 7.1 15 17 .. 38 25 11 78 61 35 19 66 50 47 42

11 6.1 13 14 .. 31 21 9.2 77 60 36 20 59 46 43 38

12 6.6 14 16 .. 35 23 9.9 77 60 35 19 63 48 45 40

53 36 61 67 .. 126 93 54 215 178 119 77 172 143 136 126

48 33 56 61 .. 97 71 42 191 158 106 69 139 116 110 102

51 34 59 64 .. 112 82 48 203 168 113 73 156 130 123 114

109 109 109 109 .. 135 135 135 120 120 120 120 133 133 133 133

115 116 115 115 .. 123 120 115 102 101 98 94 112 110 109 109

110 110 110 110 .. 130 130 130 113 113 113 113 124 124 124 124

South-Eastern Asia Lao Peoples Democratic Rep.......

Myanmar .......................................

32 TABLE III.2 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Region, country or area Decade Male Female Both sexes Child mortality (probability of dying at ages1-4, per 1,000) Male Female Both sexes Under-five mortality (deaths under age 5 per 1,000 live births) Male Female Both sexes Ratio of male to female mortality (per 100) Infant Child Under-five

Timor-Leste...................................

Viet Nam.......................................

1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s

237 190 125 79 105 70 37 23 208 185 175 167 110 81 51 33 112 82 71 57

198 159 104 66 83 55 29 18 197 175 166 158 104 76 48 31 100 73 63 50

218 175 115 73 95 62 33 21 203 180 171 163 107 79 49 32 106 78 67 54

138 102 59 29 71 39 13 4.7 124 109 102 96 46 29 13 6.7 60 38 32 23

139 105 62 32 57 31 11 4.0 127 111 104 98 33 20 8.3 4.0 50 32 27 19

138 104 60 31 64 35 12 4.4 126 110 103 97 40 25 11 5.4 55 35 29 21

341 273 176 106 169 106 50 28 307 273 259 247 151 107 63 40 165 117 101 78

309 247 159 96 135 84 40 22 299 266 253 240 134 95 56 35 145 103 89 69

326 260 168 101 152 95 45 25 303 270 256 244 143 101 59 37 156 110 95 74

120 120 120 120 127 127 127 127 106 106 106 106 106 106 106 106 112 112 112 112

99 98 95 91 125 124 121 118 98 98 98 98 139 143 157 171 118 118 118 118

110 110 110 110 125 125 125 125 103 103 103 103 113 113 113 113 114 114 114 114

Southern Asia Afghanistan ...................................

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Iran (Islamic Republic of) .............

Developing Oceania Papua New Guinea........................

More developed regions Southern Europe Bosnia and Herzegovina ...............

1970s 1980s 1990s 2000s

.. 25 21 15

.. 20 16 12

.. 23 19 13

.. 3.3 2.8 2.8

.. 2.4 2.0 2.1

.. 2.9 2.4 2.4

.. 28 24 18

.. 22 18 14

.. 25 21 16

.. 126 126 126

.. 139 139 135

.. 128 128 128

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 33

TABLE III.3. MEDIAN SEX RATIOS OF INFANT, CHILD AND UNDER-FIVE MORTALITY BY REGION, 1970S-2000S
Median ratio of male to female mortality (per 100) Infant Number of countries Change 1970s2000s 2000s Child Change 1970s2000s 2000s Under-five Change 1970s2000s 2000s

1970s*

1980s

1990s

1970s*

1980s

1990s

1970s* 1980s

1990s

World..................................................... Less developed regions.......................... Sub-Saharan Africa ......................... Northern Africa and Western Asia .. Eastern and South-Eastern Asia....... Southern Asia .................................. CIS Asia .......................................... Latin America and the Caribbean .... More developed regions ........................

122 83 28 11 9 5 8 22 39

122 119 116 112 124 110 .. 121 130

123 119 116 116 123 113 124 124 129

123 121 117 117 122 114 127 124 126

122 122 118 119 120 111 131 124 123

0 3 3 7 -4 1 7 2 -7

109 101 102 94 102 82 .. 107 125

109 103 104 96 105 83 100 110 125

112 107 107 102 112 83 104 110 125

116 111 107 116 115 100 111 115 124

7 10 5 22 13 18 11 8 -1

116 111 109 107 120 100 .. 116 130

118 114 110 110 118 101 117 120 128

120 117 112 114 118 103 122 121 126

121 119 112 119 117 108 127 122 122

4 8 2 12 -3 8 10 6 -7

NOTE: * Estimates for the 1970s exclude the following 14 countries that are included for subsequent decades: Albania, Armenia, Azerbaijan, Croatia, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Serbia, Sierra Leone, Slovenia, Tajikistan, the former Yugoslav Republic of Macedonia, and Turkmenistan.

In the first decade of the 2000s, the seven regions had median values of SR1 ranging from 111 in Southern Asia to 131 in CIS Asia (figure III.1, first panel). In five of the seven regions, no country had SR1 lower than 100. However, the two most populous countries in the world, India and China, had estimated SR1 lower than 100, that is, female infant mortality that exceeded male infant mortality. The cases of China and India, which together are home to nearly a third of the worlds infants, will be discussed at length in chapter IV. The second panel of figure III.1, showing the distribution of SR4 in the world regions, illustrates clearly the disadvantaged situation of young girls in Southern Asia compared to the rest of the world. The highest SR4 in Southern Asia in the 2000s, that of Sri Lanka (111), was equal to or lower than the median values for all regions except Sub-Saharan Africa, while India had the lowest SR4 in the world, at 58. However, excess female child mortality was not confined to Southern Asia. Every developing region had at least one country with SR4 lower than 100, and, in all, 22 of the 83 developing countries depicted here were estimated to have SR4 lower than 100 in the 2000s. In general, within individual regions there was larger variation in SR4 than in SR1. In almost all countries, infant mortality is the largest component of under-five mortality, and the third panel of figure III.1 shows that the distribution of SR5 closely mirrors that of SR1. China and India had the lowest SR5 in the world, at 75 and 83, respectively. One additional country, Burkina Faso, had SR5 slightly below 100 in the 2000s according to these estimates, although the latest data for this country refer to the period centred on 2001 and thus the estimates for the rest of the 2000s are based on projected trends. The distribution of countries in the more developed regions appears in the rightmost plots of figure III.1. Median SR1 in the developed countries has been falling in recent decades and in the 2000s median SR1 in these countries was similar to that of the developing countries. For child mortality, the more developed regions had a higher median SR4 than all of the less developed regions. Variation in both SR1 and SR4 in the

more developed regions, as expressed through the interquartile range, was smaller than in the developing regions. Figure III.2 shows changes in the distribution of sex differentials over time in all 83 developing countries under consideration. This figure highlights two of the major findings of this report. First, the distribution of countries according to SR1 has changed moderately since the 1970s, with the median increasing from 119 to 122 (table III.3) and the interquartile range increasing only slightly, from 11 to 12. Secondly, figure III.2 reveals that progress has been achieved in many countries in raising the survival of girl children relative to boys at ages 1 to 4 (second panel). Median SR4 in the developing countries rose from 102 in the 1970s to 111 in the 2000s. The number of countries found to have SR4 lower than 100 declined from 34 for the 1970s to 22 for the 2000s. The less developed regions show differing trends over time in the distribution of sex ratios, illustrated in figures III.3 through III.8 (the median values depicted in these figures are shown in table III.3). CIS Asia and Northern Africa and Western Asia experienced the greatest rises in the median value of SR1 between the first and last estimation periods, while Sub-Saharan Africa and Latin America and the Caribbean experienced only slight increases (in Latin America and the Caribbean, median SR1 actually fell slightly between the 1990s and 2000s). Meanwhile, the median SR1 declined in Eastern and SouthEastern Asia. In Southern Asia, median SR1 rose somewhat between the 1970s and the 1990s and then fell in the 2000s. Median SR1 also declined in the countries of the more developed regions (table III.3 and figure III.9). The second panels of figures III.3 through III.9 display changes in the distribution of countries by SR4 and reveal that in most developing regions the entire distribution of SR4 has shifted markedly upward. Median SR4 rose in all of the developing regions of the world (table III.3). The smallest change in median SR4 among the developing regions occurred in Sub-Saharan Africa, while the largest increases were found in

34

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.1. Distribution of countries by sex differential in the 2000s, by region

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

Sub-Saharan N. Africa and Eastern and Africa W. Asia S.E. Asia

Southern Asia

CIS Asia

Latin America and Caribbean

More developed

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

Sub-Saharan N. Africa and Eastern and Africa W. Asia S.E. Asia

Southern Asia

CIS Asia

Latin America and Caribbean

More developed

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

Sub-Saharan N. Africa and Eastern and Africa W. Asia S.E. Asia

Southern Asia

CIS Asia

Latin America and Caribbean

More developed

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

35

Figure III.2. Distribution of countries by sex differential by decade: Less developed regions

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

36

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.3. Distribution of countries by sex differential by decade: Sub-Saharan Africa

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

37

Figure III.4. Distribution of countries by sex differential by decade: Northern Africa and Western Asia

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

38

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.5. Distribution of countries by sex differential by decade: Eastern and South-Eastern Asia

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

39

Figure III.6. Distribution of countries by sex differential by decade: Southern Asia

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

40

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.7. Distribution of countries by sex differential by decade: CIS Asia

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

41

Figure III.8. Distribution of countries by sex differential by decade: Latin America and the Caribbean

Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

42

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.9. Distribution of countries by sex differential by decade: More developed regions
Infant mortality
Ratio of male to female infant mortality 80 100 120 140 160 60

1970s

1980s Decade

1990s

2000s

Child mortality
Ratio of male to female child mortality 100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

Ratio of male to female under-five mortality

Under-five mortality
100 120 140 160 60 80

1970s

1980s Decade

1990s

2000s

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

43

Northern Africa and Western Asia, and in Southern Asia. In the more developed regions, median SR4 changed little from the 1970s to the 2000s. Examination of the distribution of SR5 (figures III.3 through III.9, third panels) shows that the largest increase in median SR5 occurred in Northern Africa and Western Asia and in CIS Asia, while Southern Asia and Latin America and the Caribbean experienced intermediate increases and sub-Saharan Africa had the smallest increase (table III.3). In Eastern and South-Eastern Asia and in the more developed countries, median SR5 decreased over the estimation period. B. REGIONAL AVERAGES OF SEX DIFFERENTIALS The regional distributions of sex differentials that were described in table III.3 and figures III.3 through III.9 show the nature of variation with each country considered as a unit, but they do not portray the proportion of the worlds children who are subject to various levels of sex differentials in mortality. Also, distributional analysis does not permit relating sex differentials to the level of mortality. For these purposes, the sex-specific estimates of mortality derived for each country were aggregated to compute regional average estimates of sex-specific mortality levels and of SR1, SR4 and SR5. Country estimates were weighted using total births by sex for each country for that decade from the 2008 Revision of World Population Prospects. Thus, the experiences of very populous countries influence most prominently the averages. Regional averages are presented in table III.4 and in figures III.10 through III.12. The figures show the relationships between the sex ratios of infant, child and underfive mortality (plotted on the y-axes) and the

overall level of under-five mortality (plotted on the x-axis). Hence, the line for each region shows how the sex ratio has changed as mortality declined in each region from the 1970s to the 2000s. For comparison, the dashed line in each figure shows the relationship between the sex ratio and the level of mortality from the model described by Hill and Upchurch (1995). Figure III.10 shows that in sub-Saharan Africa, Latin America and the Caribbean, and Northern Africa and Western Asia the ratio of male to female infant mortality has increased as mortality has declined. However, the level of female advantage has remained consistently below that of the model. In CIS Asia, in contrast, average SR1 is currently higher than what was experienced in the developed countries at the same level of mortality. The average trends in SR1 for Eastern and South-eastern Asia and for Southern Asia stand out from those of other regions. In Southern Asia, average SR1 remained low throughout the period under study. The average SR1 for Eastern and South-eastern Asia dropped from 118 in the 1970s, a level similar to other developing regions in that decade, to 90 in the 2000s. The large populations and low sex ratios of infant mortality in China and India strongly influence the averages for their respective regions, as well as the averages for less developed regions as a whole. Because of the strong weight of these two countries, table III.4 includes averages for the less developed regions, Eastern and South-Eastern Asia, and Southern Asia that exclude China and India. For the less developed regions as a whole, average SR1 fell from 111 in the 1970s to 107 in the 2000s. However, when China and India are excluded, average SR1 for the less developed regions stayed constant, remaining at 118 over the four decades.

44

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality 45

TABLE III.4. REGIONAL AVERAGE ESTIMATES OF MALE, FEMALE AND BOTH SEXES INFANT, CHILD AND UNDER-FIVE MORTALITY, AND SEX RATIOS OF INFANT, CHILD AND UNDER-FIVE MORTALITY, 1970S-2000S (COUNTRIES WEIGHTED BY NUMBER OF BIRTHS)
Infant mortality (deaths under age 1 per 1,000 live births) Decade World 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s Male 89 71 59 48 92 75 63 52 101 79 65 53 115 91 75 61 20 15 12 8.1 135 123 113 97 124 87 62 45 Female 80 64 55 45 78 63 54 44 91 72 61 50 97 78 64 52 15 11 9.0 6.5 116 105 97 82 112 78 54 38 Both sexes 85 68 57 47 85 69 59 48 96 76 63 52 106 85 70 57 18 13 10 7.3 126 114 105 90 118 83 58 42 Child mortality (probability of dying at ages 1-4, per 1,000) Male 45 34 28 23 48 38 34 28 52 38 31 26 62 48 41 33 4.0 2.9 2.2 1.4 104 94 85 68 47 33 22 14 Female 50 38 32 27 49 39 34 27 58 43 35 30 64 50 41 33 3.2 2.4 1.8 1.1 100 91 82 66 52 35 22 14 Both sexes 48 36 30 25 48 39 34 27 55 41 33 28 63 49 41 33 3.6 2.7 2.0 1.3 102 92 83 67 50 34 22 14 Under-five mortality (deaths under age 5 per 1,000 live births) Male 129 101 84 69 133 109 93 77 147 113 93 77 168 134 112 92 24 18 14 9.5 224 204 188 158 165 117 82 59 Female 125 99 84 70 121 99 84 69 143 111 93 78 154 122 101 82 19 14 11 7.6 204 185 170 143 158 109 74 51 Both sexes 127 100 84 70 127 104 89 73 145 112 93 77 161 128 107 87 21 16 12 8.6 214 195 179 150 162 113 78 55 Ratio of male to female mortality (per 100)

Infant 111 110 108 107 118 118 118 118 111 110 107 107 118 118 118 118 129 129 128 126 116 117 117 118 111 112 115 119

Child 90 89 87 86 97 98 100 102 89 88 87 86 97 98 100 102 123 122 124 124 103 104 103 103 90 94 97 102

Under-five 103 102 100 99 110 110 111 112 103 102 100 99 109 110 111 112 128 128 127 125 110 110 110 111 104 107 110 114

World excluding China and India

Development group Less developed regions

Less developed regions excluding China and India

More developed regions

Region Sub-Saharan Africa

Northern Africa and Western Asia

46 TABLE III.4 (continued)


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s 1970s 1980s 1990s 2000s Male 72 45 31 23 102 68 44 28 118 97 77 58 135 110 85 62 .. 83 68 51 82 57 40 27 Female 61 41 34 26 81 55 36 23 116 94 74 58 118 95 74 54 .. 66 53 39 67 46 32 22 Both sexes 67 43 32 25 92 62 40 25 117 95 76 58 127 103 79 58 .. 75 60 45 75 52 36 24 Child mortality (probability of dying at ages 1-4, per 1,000) Male 34 21 10 6.5 47 26 14 6.7 58 38 29 22 67 49 35 23 .. 20 15 11 34 18 12 7.0 Female 35 22 11 6.4 46 26 13 6.0 76 53 42 34 82 61 40 23 .. 19 14 10 32 16 11 6.2 Both sexes 34 22 10 6.4 47 26 13 6.3 67 45 35 28 75 55 37 23 .. 19 15 10 33 17 11 6.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 103 65 41 30 143 93 57 34 170 132 103 79 193 153 117 83 .. 101 81 61 113 73 51 34 Female 94 62 44 32 122 79 48 28 183 141 113 90 190 150 111 75 .. 83 66 48 97 62 43 28 Both sexes 99 64 42 31 133 86 53 31 176 136 108 84 191 152 114 79 .. 93 74 55 105 68 47 31 Ratio of male to female mortality (per 100) Infant 118 109 93 90 127 125 124 123 102 104 103 101 115 115 115 116 .. 127 128 130 122 124 124 124 Child 95 94 97 101 101 103 105 112 77 72 69 64 81 81 87 99 .. 102 105 110 105 106 110 113 Under-five 109 104 94 92 117 118 119 120 93 93 92 88 102 102 105 111 .. 121 123 126 116 119 120 122 Eastern and South-Eastern Asia Eastern and South-Eastern Asia excluding China

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Southern Asia

Southern Asia excluding India

CIS Asia

Latin America and the Caribbean

NOTE: * Estimates for the 1970s exclude the following 14 countries that are included for subsequent decades: Albania, Armenia, Azerbaijan, Croatia, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Serbia, Sierra Leone, Slovenia, Tajikistan, the former Yugoslav Republic of Macedonia, and Turkmenistan.

Figure III.10. Sex ratio of infant mortality by level of under-five mortality, regional average, 1970s-2000s

Female advantage

140 CIS Asia Male/female ratio of infant mortality

More developed

120

Sub-Saharan Africa All less developed 100

N. Africa/ W. Asia

Lat. America/ Carib

Male advantage

Southern Asia

E./S.E. Asia

80

60 350

300

250 200 150 100 Deaths under age 5 per 1,000 live births

50

Decline in under-five mortality


Note: Dashed line is the historical sex ratio of infant mortality for selected developed countries from Hill and Upchurch (1995)

Figure III.11. Sex ratio of child mortality by level of under-five mortality, regional average, 1970s-2000s

Female advantage

140 More developed Male/female ratio of child mortality 120 Lat. America/ Carib 100 Sub-Saharan Africa N. Africa/ W. Asia E./S.E. Asia All less developed CIS Asia

Male advantage

80

Southern Asia 60 350 300 250 200 150 100 50 0 Deaths under age 5 per 1,000 live births

Decline in under-five mortality


Note: Dashed line is the historical sex ratio of child mortality for selected developed countries from Hill and Upchurch (1995)

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

47

Figure III.12. Sex ratio of under-five mortality by level of under-five mortality, regional average, 1970s-2000s
140

Female advantage

Male/female ratio of under-five mortality

CIS Asia 120 N. Africa/ W. Asia Sub-Saharan Africa 100 All less developed

More developed Lat. America/ Carib E./S.E. Asia

Male advantage

80

Southern Asia

60 350

300

250 200 150 100 Deaths under age 5 per 1,000 live births

50

Decline in under-five mortality

Note: Dashed line is the historical sex ratio of under-five mortality for selected developed countries from Hill and Upchurch (1995).

Among children aged 1-4, Southern Asia again stands out among the regions (figure III.11). As overall mortality declined between the 1970s and the 2000s, the relative survival of girls aged 1-4 in Southern Asia became progressively lower, with SR4 declining to 64 in the 2000s. Expressed differently, young girls in Southern Asia had mortality that was more than 50 per cent higher than that of boys in this period. However, this trend was largely determined by the weight of India in the regional average. In the remaining countries of Southern Asia, average SR4 increased (table III.4). Figure III.11 reveals that in most other developing regions, average SR4 increased as mortality declined, although sex ratios remained lower than those found historically in developed countries at corresponding levels of mortality. An exception is Sub-Saharan Africa, where average SR4 declined slightly over the period examined. For the less developed regions as a whole, girls have higher probability than boys of dying at ages 1-4 and SR4 has changed little from the 1970s to the 2000s. When China and India are excluded from the average it is evident that in the rest of the
48

developing world, average SR4 has risen from 97 in the 1970s to 102 in the 2000s (table III.4). That is, in the rest of the developing countries girls at ages 1-4 have on average gone from a situation of excess mortality to having a small relative advantage over boys, but this advantage is still lower than the experience of developed countries. Figure III.12 summarizes the relationship between the level and sex ratio of under-five mortality across the regions, reflecting the relative weight of infant and child mortality. In Southern Asia, the large disadvantage of females at ages 14 meant that females had higher under-five mortality throughout the estimation period (SR5 lower than 100) even though their infant mortality was slightly lower than males. For Eastern and South-Eastern Asia the excess mortality of female infants in the 1990s and 2000s is reflected in low ratios of under-five mortality as well. On average in the developing regions, boys had slightly lower under-five mortality than girls in the first decade of the 2000s. In the developing regions excluding China and India, however, under-five mortality was 12 per cent higher for boys than for girls.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

C. COUNTRY LEVELS AND TRENDS The situation of individual countries will now be reviewed based upon the estimates provided in tables III.1 and III.2. The focus will be on directions in the trends of SR1, SR4 and SR5 for those countries where trend estimates could be produced. In addition, those countries where there is evidence of excess infant or child mortality among females or males will be highlighted. 1. Less developed regions Table III.5 categorizes countries in the less developed regions according to the direction of their trends in SR1 and SR4 between the 1970s and the 2000s. In the table, countries are divided first according to whether SR1 increased or decreased over that period. The determination of the trend direction is made by the difference between the estimates for the 1970s and the 2000s. For countries where the loess method was used, the estimation method could indicate changes in the direction of the trend of SR1 or SR4 within the period. For example, in several Latin American countries SR1 has peaked and begun to decline, but the level for the 2000s is still higher than the level for the 1970s. Countries where a change in the direction of the trend has occurred are indicated with an asterisk. Among the 83 developing countries for which data were sufficient to conduct the analysis, 52 had rising SR1 and 31 had falling SR1. These two groups are then subdivided by the direction of the trend in SR4. Among the 52 countries with rising SR1, 40 also had increasing SR4, while 12 had decreasing SR4. Among the 31 countries with falling SR1, 23 had increasing SR4 while 8 had decreasing SR4. Tables III.6, III.7 and III.8 call attention to countries where excess female child mortality SR4 lower than 100was found for part or all of the estimation period. The countries listed in table III.6 are those where estimated SR4 has increased

from below 100 to above 100, that is, where girl children have reached parity with boys in survival at ages 1-4 during the estimation period. This has occurred in 25 of the countries under consideration. Table III.7 shows countries in which SR4, whether rising or falling, has remained below 100 for the entire estimation period. A total of 14 countries exhibited SR4 below 100 for the entire period from the 1970s to the 2000s. In 6 of these countriesArmenia, Cameroon, Haiti, India, Nepal and YemenSR4 was declining, suggesting deterioration in the relative survival of girl children, while in the other 8 countries SR4 was rising but had not yet reached parity with boys. Table III.8 displays countries where estimated SR4 has fallen from above 100 to below 100. This trend was found in 6 countries in Africa (Benin, Burkina Faso, Chad, Ethiopia, Nigeria, and United Republic of Tanzania) and also in Honduras. In these countries, and in other countries where SR4 is falling, even if it has not fallen below 100, evaluation is warranted to assess whether girls are facing obstacles in access to preventive or curative medical care. Tables III.5 through III.8 reveal that the countries do not fall neatly into categories by region. In fact, many regions contain countries in all four of the categories shown in table III.5. In Sub-Saharan Africa, countries are relatively evenly divided between the four categories. Western Africa had the most countries (five) with evidence of excess female child mortality in the 2000s (tables III.7 and III.8), but excess female child mortality was found also in several countries of Eastern Africa and Middle Africa. Western Africa also had four countries where SR4 crossed from below 100 to above 100 (table III.6), so the relative survival of female children has become higher than that of males in some parts of that region while worsening in others.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

49

TABLE III.5. CLASSIFICATION OF COUNTRIES BY CHANGES IN THE SEX RATIO OF INFANT MORTALITY (SR1) AND SEX RATIO OF CHILD MORTALITY (SR4) BETWEEN THE 1970S AND THE 2000S, LESS DEVELOPED REGIONS
Change in SR between the 1970s and the 2000s Increase in SR1 Region Increase in SR4 Decrease in SR4 Decrease in SR1 Increase in SR4 Decrease in SR4

Sub-Saharan Africa Eastern Africa.........................

Middle Africa. ........................ Southern Africa ...................... Western Africa........................

Madagascar Mauritius* Uganda Zambia Central African Rep. Namibia Ghana Guinea Mauritania Senegal Algeria Egypt Morocco Tunisia Iraq Kuwait* Jordan Republic of Korea Cambodia Philippines

Ethiopia Kenya Cameroon Chad Cote dIvoire Nigeria

Malawi Mozambique Zimbabwe

Rwanda United Rep. of Tanzania

South Africa Mali Niger

Benin Burkina Faso Liberia Sierra Leone

Northern Africa and Western Asia Northern Africa ......................

Sudan

Western Asia. .........................

Yemen

Israel* Turkey

Eastern and South-Eastern Asia Eastern Asia............................ South-Eastern Asia .................

Southern Asia................................ CIS Asia........................................

Pakistan Sri Lanka Georgia Kazakhstan* Kyrgyzstan* Tajikistan Turkmenistan Cuba* Trinidad and Tobago Guatemala Mexico Panama* Argentina* Brazil* Chile Colombia Ecuador Uruguay Venezuela

Nepal Armenia Uzbekistan

China China, Hong Kong SAR Indonesia Malaysia Singapore* Thailand Bangladesh Azerbaijan

India*

Latin America and the Caribbean Caribbean................................ Central America......................

Nicaragua

Dominican Republic Puerto Rico Costa Rica* El Salvador Bolivia Peru

Haiti Honduras

South America ........................

Paraguay

NOTES: * Indicates a change in the trend of SR1 or SR4 from increasing to decreasing.
Indicates a change in the trend of SR4 from increasing to decreasing or vice versa. (See table III.1 or country profile).

50

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

TABLE III.6. COUNTRIES IN WHICH THE SEX RATIO OF CHILD MORTALITY HAS INCREASED FROM BELOW 100 TO ABOVE 100 BETWEEN THE 1970S AND THE 2000S
Region Country

Sub-Saharan Africa Eastern Africa ...............................................

Middle Africa................................................ Western Africa ..............................................

Madagascar Mauritius Mozambique Zambia Zimbabwe Central African Republic Ghana Mali Mauritania Senegal Algeria Egypt Tunisia Kuwait Cambodia Philippines Bangladesh Sri Lanka Azerbaijan Georgia Kyrgyzstan Guatemala Bolivia Ecuador Venezuela

Northern Africa and Western Asia Northern Africa .............................................

Western Asia ................................................. Eastern and South-Eastern Asia South-Eastern Asia........................................ Southern Asia ...................................................... CIS Asia ..............................................................

Latin America and the Caribbean Central America ............................................ South America...............................................

Europe Southern Europe............................................ Albania

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

51

TABLE III.7. COUNTRIES IN WHICH THE SEX RATIO OF CHILD MORTALITY HAS REMAINED BELOW 100 FROM THE 1970S TO THE 2000S
Region Country

Sub-Saharan Africa Middle Africa ............................................................ Western Africa........................................................... Northern Africa and Western Asia Northern Africa ......................................................... Western Asia .............................................................

Cameroon Guinea Niger Morocco Jordan Turkey Yemen China India Nepal Pakistan Armenia Tajikistan

Eastern and South-Eastern Asia Eastern Asia............................................................... Southern Asia ............................................................

CIS Asia........................................................................... Latin America and the Caribbean Caribbean...................................................................

Haiti

TABLE III.8. COUNTRIES IN WHICH THE SEX RATIO OF CHILD MORTALITY HAS DECLINED FROM ABOVE 100 TO BELOW 100 FROM THE 1970S TO THE 2000S
Region Country

Sub-Saharan Africa Eastern Africa........................................... Middle Africa ........................................... Western Africa.......................................... Ethiopia United Rep. of Tanzania Chad Benin Burkina Faso Nigeria Honduras

Latin America and the Caribbean Central America........................................

In Northern Africa, four countries examinedAlgeria, Egypt, Morocco and Tunisiawere found to have increases in both SR1 and SR4. These four countries, which were identified in Genes or Gender as having relatively low SR1 in the 1970s and 1980s, registered some of the largest increases in SR1 in the world, each with more than a 14 percentage point increase between the 1970s and the 2000s. Algeria, Egypt and Tunisia also had very large estimated increases in SR4 and crossed from female
52

disadvantage in survival in the 1970s to female advantage by the 2000s. In Morocco, in contrast, SR4 increased during the estimation but remained below 100 in the 2000s. Thus, it can be concluded that several countries of Northern Africa have made great strides in increasing the relative survival of female infants and young girls. Sudan had a moderate decrease in SR1 and little change in SR4, although it should be noted that the last data point included in the analysis referred to the year 1995.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Western Asia likewise experienced increases in SR4 in most countries. Only Yemen showed decreasing SR4. However, SR4 remained below 100 in Jordan, Turkey and Yemen, and rose from below to above 100 only in Kuwait. In Iraq and Israel SR4 was higher than 100 throughout the estimation period. In regard to infant mortality, SR1 increased in most of the countries of Western Asia. Jordan, notably, was the only country in the world other than India or China for which a finding of SR1 lower than 100 was obtained for any period (99 in the 1970s), but it subsequently experienced a rapid rise in SR1 to 128 in the 2000s. In Eastern and South-Eastern Asia, the dominant finding in table III.5 is that all countries exhibited rising SR4. For infant mortality, in contrast, 6 out of 9 countries in the region had declining trends in SR1. Most notably, SR1 in China fell from 112 in the 1970s to 76 in the 2000s, a decline unmatched by any country in the world. In the other countries, declines in SR1 were more moderate. The five countries in Southern Asia for which trends could be estimated fell into all four categories shown in table III.5. The decline of SR4 in India was the steepest in the developing world, going from 75 in the 1970s to 56 in the 2000s. Nepal also registered declining SR4. Bangladesh, Pakistan, and Sri Lanka, in contrast, had SR4 that was rising, suggesting improvement in the relative survival of girls in these countries. SR4 in Bangladesh and Sri Lanka was estimated to have surpassed 100 by the 2000s. The majority of countries in CIS Asia, for which trends were estimated beginning in the 1980s due to poor data availability for earlier years, had rising SR1 and SR4 between the 1980s and the 2000s. Only Armenia had declining SR4, while Azerbaijan had declining SR1. Two countries in the region, Armenia and Tajikistan, had excess female child mortality throughout the whole estimation period. In Azerbaijan, Georgia, and Kyrgyzstan, SR4 was estimated to have risen from below 100 to above 100.

In Latin America and the Caribbean, SR4 was found to be rising throughout the region. Out of 22 countries in the region, all but 4 registered increases in this indicator. In four countries (Bolivia, Ecuador, Guatemala and Venezuela), SR4 increased from below 100 to above 100, while in Honduras, it decreased from above 100 to below 100. In the 2000s, excess female child mortality in the region was found only in Haiti, Honduras and Peru, although it should be noted that in Guatemala and Ecuador SR4 exceeded 100 by only 2 or 3 percentage points in the 2000s. In terms of trends in SR1 the countries of Latin America and the Caribbean were more evenly divided, with 14 countries showing increases in SR1 between the 1970s and 2000s and 8 countries registering declines in SR1. Notably, a number of Latin American countries, including Argentina, Brazil, Costa Rica, and Cuba, while having higher SR1 in the 2000s than in the 1970s, had experienced a peak and then decline in this indicator, similar to the findings to be discussed below for more developed regions. Lastly, table III.9 highlights countries where there is evidence of considerable excess male mortality among infants. Countries are listed in table III.9 if SR1 in the 2000s was estimated at 130 or higher. The list includes countries from Africa, Asia, and Latin America as well as some countries in Europe, most of which are among the countries with economies in transition. The countries listed in the table have infant mortality rates for both sexes ranging from 81 deaths per 1,000 live births in Madagascar to below 10 deaths in some European countries. In comparative perspective, levels of SR1 around 130 were common in the rest of the developed countries in the 1970s, but SR1 has since declined on average in the more developed regions, a development that will be described in the following section and discussed at length in section IV.B. Thus, in the countries of table III.9 that have relatively low mortality, a finding of SR1 around 130 is not unforeseen. In countries with relatively high mortality, however, further investigation would be required to determine whether such a high SR1 truly indicates unusually high relative mortality for boys, or problems with the quality of the data.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

53

TABLE III.9. COUNTRIES IN WHICH THE SEX RATIO OF INFANT MORTALITY WAS HIGHER THAN 130 IN THE 2000S
Region Country

Sub-Saharan Africa Eastern Africa............................................. Southern Africa .......................................... Northern Africa and Western Asia Northern Africa .......................................... Eastern and South-Eastern Asia South-Eastern Asia ..................................... CIS Asia............................................................

Madagascar Mauritius Namibia Tunisia Philippines Armenia Georgia Kazakhstan Turkmenistan Uzbekistan Colombia Ecuador Paraguay Belarus Czech Republic Russian Federation Ukraine Estonia Finland Serbia

Latin America and the Caribbean South America ............................................

More developed regions Eastern Europe............................................

Northern Europe ......................................... Southern Europe .........................................

2. More developed regions Table III.10 summarizes trends in SR1 and SR4 for countries in the more developed regions. In contrast to the developing countries, where SR1 was rising in most cases, the table shows that the majority (34 out of 39) of the more developed countries with trend data had declining SR1 in recent decades. In a number of countries, the change in the direction of the SR1 trend has occurred since the 1970s, that is, the trend in SR1 has changed from increasing to decreasing over the estimation period (indicated by an asterisk in table III.10). One country, Finland, had an opposite change in the direction of SR1, from decreasing to increasing. Among the developed countries, levels of SR1 in the 2000s were highest (130 or higher) in the European states of the former USSR, namely

Belarus, Ukraine, Estonia and the Russian Federation. SR1 levels below 120 were found in Albania, Croatia, Greece, Italy, Japan, Latvia, Lithuania, Poland, Portugal and Slovenia. Trends in SR4 in the developed countries showed considerably more variation than trends in SR1. Of the 38 countries with trend data, 17 had rising SR4 while in the other 21 countries SR4 was declining. Several countries, indicated with a dagger () in table III.10 experienced a change in the direction of SR4 trend at some point in the estimation period. With few exceptions, found primarily in Southern and Eastern Europe, levels of SR4 in the developed countries exceeded 120, considerably higher than the levels found in developing countries and consistent with earlier models of sex differentials in child mortality (Hill and Upchurch, 1995).

54

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

TABLE III.10. CLASSIFICATION OF COUNTRIES BY TRENDS IN THE SEX RATIO OF INFANT MORTALITY (SR1) AND SEX RATIO OF CHILD MORTALITY (SR4), MORE DEVELOPED REGIONS
Change in SR between the 1970s and the 2000s Increase in SR1 Region Increase in SR4 Decrease in SR4 Decrease in SR1 Increase in SR4 Decrease in SR4

Europe Eastern Europe Belarus* Romania Hungary* Russian Fed.* Ukraine* Bulgaria* Czech Republic Poland Rep. of Moldova Slovakia Denmark Estonia* Ireland Norway Sweden Greece* Italy Spain Austria Germany Netherlands Switzerland Canada New Zealand Japan

Northern Europe

Finland

Latvia Lithuania UK

Southern Europe

Albania Serbia TFYR Macedonia

Croatia Portugal* Slovenia* Belgium* France*

Western Europe

Northern America Other more developed countries NOTES: * Indicates a change in the trend of SR1 from increasing to decreasing.

United States Australia

Indicates a change in the trend of SR4 from increasing to decreasing or vice versa. (See table III.1 or country profile).

3. Weighted average countries In addition to the countries for which trend estimates of SR1 and SR5 were possible, estimates were produced for 22 developing countries and one developed country for which SR1 and SR5 were calculated using a simple weighted average of all available data points. For 3 additional countries, data were available to produce weighted averages for SR5 only. Results for the weighted average countries are shown in table III.2. When the values of SR1 and SR5 were held constant across time, the value of SR4 varied based on the relative weight of 1q0 and 4q1 as components of 5q0. In most cases this resulted in implied SR4 declining over time. However, these implied SR4 should not be interpreted as actual trends. Despite this caveat, the SR4 estimates for these countries can give an indication of whether female child mortality exceeds or is less than that of males.

In all weighted average countries in the less developed regions, both SR1 and SR5 were greater than 100. Therefore, in table III.11, these countries are divided according to whether SR4 estimated for the 2000s was higher or lower than 100. For the most part, results for the weighted average countries were quite consistent with results for neighbouring countries, that is, weighted average countries with SR4 below 100 or above 100 were in regions with trend countries that also had such levels. The main exceptions were Lao Democratic Peoples Republic and Timor-Leste in South-Eastern Asia. Some countries in South-Eastern Asia have seen SR4 rise from below 100 to above 100, and none of the trend countries in the region had SR4 below 100 in the 2000s. The paucity of data for these two countries prevents construction of trend estimates that might provide a view into whether SR4 has risen in them as well.
55

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

TABLE III.11. IMPLIED SEX RATIO OF CHILD MORTALITY (SR4) IN THE 2000S
FOR COUNTRIES WITH WEIGHTED AVERAGE ESTIMATES

SR4 Region Above 100 Below 100

Sub-Saharan Africa Eastern Africa.................................... Eritrea Somalia Middle Africa .................................... Dem. Rep. of the Congo Gabon Southern Africa ................................. Botswana Lesotho Western Africa .................................. Northern Africa and Western Asia Northern Africa ................................. Western Asia ..................................... United Arab Emirates Eastern and South-Eastern Asia Eastern Asia....................................... Dem. Peoples Rep. of Korea Mongolia South-Eastern Asia ............................ Myanmar Viet Nam Southern Asia .......................................... Iran Developing Oceania................................. Papua New Guinea More developed regions Southern Europe ................................ Bosnia and Herzegovina

Burundi Congo Swaziland Togo Libyan Arab Jamahiriya

Lao Peoples Dem. Rep. Timor-Leste Afghanistan

D. RELATIONSHIP BETWEEN SEX DIFFERENTIALS


AND LEVELS OF MORTALITY FOR COUNTRIES WITHIN A GIVEN REGION

In the absence of adequate data on sex differentials in infant and child mortality, it would be desirable to be able to predict these sex differentials according to other factors such as the level of mortality or the geographical region to which a country belongs. To this end, the relationship between the level of under-five mortality and SR1, SR4, and SR5 was examined using the estimates produced for this study. Figures III.13, III.14 and III.15 show with scatterplots this relationship for SR1, SR4 and SR5, respectively, and correlation coefficients are given in table III.12. Only countries for which trends were available were used in the analysis. Each available country-decade point is shown. That is, for countries with estimates available for the 1970s, 1980s, 1990s and 2000s, four points are shown in the figure.
56

When all countries from the less developed regions are considered together, the relationship between the level of under-five mortality and the sex differential in infant mortality is negative but weak (figure III.13, first panel). Thus, while in general the sex differential in infant mortality rises as overall mortality declines, a wide range of sex differentials can coexist with a given level of under-five mortality. On a regional basis, the correlation was strongest in Sub-Saharan Africa, where the correlation coefficient was -0.49. Eastern and South-Eastern Asia and the more developed regions registered positive correlations between the level of 5q0 and SR1, but these relationships were not statistically significant. The correlation between the sex differential of child mortality and the level of under-five mortality for all countries from the less developed regions is -0.38, somewhat stronger than that for infant mortality (figure III.14, first panel). The strongest correlations between 5q0 and SR4 were

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

found in Northern Africa and Western Asia and in Latin America and the Caribbean, which both had correlations of -0.60, confirming that the countries of these two regions have generally shown the expected increase in relative survival of girls as mortality has declined. Correlations between the sex differentials in SR5 and the level of under-five mortality (figure III.15) were stronger than those described for SR1 and SR4. For the less developed regions as a whole, the correlation coefficient between SR5 and 5q0 was -0.53. At the regional level, relatively strong correlations were found in SubSaharan Africa (-0.67), Latin America and the Caribbean (-0.66), and Northern Africa and Western Asia (-0.61).

Figures III.13 through III.15 suggest that the level of under-five mortality together with regional affiliation may give some insight into how sex differentials may change as mortality declines, though there can be a high degree of variation within regions. While a regional model could assist demographers in disaggregating bothsexes estimates for countries where no data by sex are available, it is crucial to increase the collection and publication of mortality data by sex in order to gain country-specific insights for such countries.

TABLE III.12. CORRELATION BETWEEN THE LEVEL OF UNDER-FIVE MORTALITY AND SEX DIFFERENTIALS IN INFANT, CHILD AND UNDER-FIVE MORTALITY
Correlation between 5q0 and SR1 SR4 SR5

Less developed regions Sub-Saharan Africa....................................... Northern Africa and Western Asia................ Eastern and South-Eastern Asia.................... Southern Asia................................................ CIS Asia........................................................ Latin America and the Caribbean ................. More developed regions........................................

-0.33 ** -0.49 ** -0.33 * 0.19 -0.31 -0.33 -0.30 ** 0.10

-0.38 ** -0.40 ** -0.60 ** -0.49 ** -0.45 * -0.22 -0.60 ** -0.33 **

-0.54 ** -0.67 ** -0.61 ** -0.07 -0.49 * -0.49 * -0.66 ** 0.00

NOTE: ** significant at the p<0.01 level; * significant at the p<0.05 level.

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

57

Figure III.13 Sex ratio of infant mortality by level of under-five mortality, for countries by region, 1970s-2000s

Less developed regions


160 160

Sub-Saharan Africa

Ratio of male to female infant mortality

Ratio of male to female infant mortality

140

140

S S S S S S

100

80

60

350

300 250 200 150 100

50

60

80

100

S SS SS S S SS S S S S S SS S S S S S S S S S S SS S SS S S SS S S S S S SSSS SS S S SS S SSSSS SS S S S S S S S S S SS S S S SSS S S S S S S S S S SS SS S S S S S S S SS S

SS S

120

120

300

250

200

150

100

50

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

Northern Africa and Western Asia


160 160

Eastern and South-eastern Asia

Ratio of male to female infant mortality

Ratio of male to female infant mortality

140

140

M MM M M M M MM M M M M MM M M M M M M M M M M M MMM M M M M MM M M M M M M

E E E E E E E EE E E E E E EE E E EE E E E E E E E E E E E

120

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E E

60

250

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50

60 350 300 250 200 150

100

50

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

58

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.13. Sex ratio of infant mortality by level of under-five mortality, for countries by region, 1970s-2000s (continued)

Southern Asia
160 160

CIS Asia

Ratio of male to female infant mortality

Ratio of male to female infant mortality

140

140

T TT T T

TT T T T T T T T

120

A A

A A A A A

A A A A A

A A A A

100

80

60

200

150

100

50

60

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A A A

T T T

T T T T T T

140

120

100

80

60

40

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

Latin America and the Caribbean


160 160

More developed regions

Ratio of male to female infant mortality

Ratio of male to female infant mortality

140

140

120

L L L

120

L L L L

L LL L LL LL L L L LL L L LL L LLL L L L L L L LL L L L L L L L L L LL L L LL LLL L LL LLL LL L L LL L L L LL L L L L L L L L L L L

100

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D D D D D D DDD D D D D D D DD D D D D D D D D DD D D DD D DD DD D D D D D DDDD DD D D D D D DD DD DD D D D D D D D D DD DD DD D DD D D DDDDDDD DDD D D D DDD DD DD D D D D DD D DD D D DDD D D DDDDD D D DD D D D D D DDD DD D D D D D D D D D

60

50

40

30

20

10

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

59

Figure III.14. Sex ratio of child mortality by level of under-five mortality, for countries by region, 1970s-2000s

Less developed regions


160 160

Sub-Saharan Africa

Ratio of male to female child mortality

Ratio of male to female child mortality

140

140

S S SS

120

120 60 80 100

S S S SS SSS S SS S S S S SS S S S S SS S S S S S SS S S S SSS S S SSS S S S S S SS S S S SS S SSS S S SS SS S S S S SS S SS S S S S SS SS S S S S S S SS S S SS S S S S S S S S S S

60 350

80

100

300 250 200 150 100

50

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100

50

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

Northern Africa and Western Asia


160 160

Eastern and South-eastern Asia

Ratio of male to female child mortality

Ratio of male to female child mortality

140

M M

M M

140

MM M M M M M MM M M M

M M

M M MM M

80

60

250

200

150

100

50

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M M MM M M M MM M M M M M M M M

E E

E E E E E E E E EEE E E E E EEE E E E EE E E E E E E E E

120

100

100

120 350 300 250 200 150

100

50

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

60

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.14. Sex ratio of child mortality by level of under-five mortality, for countries by region, 1970s-2000s (continued)

Southern Asia
160 160

Transition Asia

Ratio of male to female child mortality

Ratio of male to female child mortality

140

140

120

120

T T T T T T T T TT T T T TT T T T

T T

100

100

T T

A A A A A

A A A

T T T

80

A A A

60

200

150

100

50

60 140

80

A A

A A

120

100

80

60

40

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

Latin America and the Caribbean


160 160

More developed regions

Ratio of male to female child mortality

Ratio of male to female child mortality

L L L L LL L LL L L L L LL LL L L L LL LL L L L LL L LL L LL L L LL L L L L L L L L LL L L L LL L L L L LL L L L L L L LLL LL LL L L L

100

100

L L L L L

D D D D D DDD D D D D D D D DDD DDD D D D D DD D D D DD DDDD D DD D D D DD D DD D D D DD D D DDDDD D D DD D D D D DD D D D D DDDD D D DDDD DD D D DD D D DD D D DD D DD D D D D D DD DD D D D DD D D D DD D DD D D D D D D D D DD D D D D D D D D

140

120

80

60

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50

60 60

80

120

140

50

40

30

20

10

Level of under-five mortality, both sexes

Level of under-five mortality, both sexes

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

61

Figure III.15. Sex ratio of under-five mortality by level of under-five mortality, for countries by region, 1970s-2000s

Less developed regions


160 160

Sub-Saharan Africa

Ratio of male to female under-five mortality

Ratio of male to female under-five mortality

140

140

100

80

60

350

300 250 200 150 100

50

60

80

100

S S S S SS S S S S S SS SS S SS S S S S S S S S S S SS SS SS S S S S S SS S S S S S SS SSSS SS SSSS SSS S S SS SS S S S SSSSSS S SSSSS S SS S S S S S SS S S S S S S S S S S S S S

120

120

S S S

300

250

200

150

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.15. Sex ratio of under-five mortality by level of under-five mortality, for countries by region, 1970s-2000s (continued)

Southern Asia
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L L LLL L L L LL L LL L L LL L L L LLL LLL L L L L L L LL L LL L L L L L L L LLL L L LLLL LL L L LL L L L LL L L LL L L LL L L L L

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

63

E. COMPARISON OF TRENDS IN SEX DIFFERENTIALS FOR SELECTED COUNTRIES TO THE HISTORICAL EXPERIENCE OF DEVELOPED COUNTRIES It is informative to examine where the results for each country fall in terms of a model that relates sex differentials in mortality to the level of mortality, as was done on a regional basis in figures III.10 to III.12. While the results of such an analysis will not be presented for all countries, figure III.16 presents this comparison for three countries Senegal, Philippines, and Benin which were selected to show various situations in the developing countries. For the three countries, SR1, SR4 and SR5 for each decade are plotted against the estimated male 5q0 for that decade (with male 5q0 plotted on a decreasing scale). The sex ratios predicted by the Hill-Upchurch model at each level of male 5q0 are plotted with dashed lines. In the case of Senegal, figure III.16 shows that among children aged 1-4, relative survival of girls was low in the 1970s, but SR4 had reached the level predicted by the model by the 2000s. SR1, on the other hand, increased only slightly in Senegal, far less than the model predicts for the amount of mortality decline achieved. In the Philippines, to show another situation, SR1 had increased to a level above that predicted by the

model, while SR4 had increased but still remained far below the model prediction. Finally, in Benin both SR1 and SR4 fell between the 1970s and 2000s, moving progressively further from the levels suggested by the model, meaning that the gains in survival for both infants and children benefitted boys more than girls. For the most part, levels of SR1, SR4 and SR5 estimated for developing countries, even when higher than 100, are lower than predicted by the Hill-Upchurch model at a given level of mortality. The model implies that any country that has declining mortality combined with declining or constant (or even slowly increasing) sex ratios has increasing female disadvantage. Given the large number of developing countries with declining SR1, more research is required to determine if a different model of sex differentials in childhood mortality would be more appropriate for identifying sex-based disadvantage in mortality in the epidemiological context of todays developing countries. Nevertheless, the location of a countrys sex ratiosparticularly SR4along the curves implied by the HillUpchurch model could give an indication of where attention might be needed to ensure that the benefits of health interventions and access to medical care are reaching girls, whether in the institutional or the familial context.

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure III.16. Sex ratios of infant, child and under-five mortality compared to sex ratios from the Hill-Upchurch model, Senegal, Philippines and Benin, 1970s-2000s

Senegal
Ratio of male to female mortality 140 80 100 120

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

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IV. DISCUSSION
A. SOURCES OF SEX DIFFERENTIALS
IN CHILDHOOD MORTALITY

Girl newborns enjoy a genetic and biological advantage in survival over boy newborns due to a lesser vulnerability to perinatal conditions (including birth trauma, intrauterine hypoxia and birth asphyxia, prematurity, respiratory distress syndrome and neonatal tetanus), congenital anomalies, and infectious diseases including intestinal infections and lower respiratory infections (Waldron, 1998). However, beyond early infancy, girls do not enjoy the same advantage in relation to certain infectious diseases, which are the primary causes of death in later infancy and early childhood when overall mortality is high. Girls may in fact be more vulnerable to some infectious diseases, particularly measles (Garenne, 1982; Garenne and Lafon, 1998). Accordingly, an analysis of sexspecific mortality from developed countries relating to periods prior to 1930 (Tabutin and Willems, 1998) found that male mortality exceeded that of females in the first year of life, but there was evidence of excess female mortality from ages 3-14. Studies of developing countries in later years (United Nations, 1998; Tabutin and others, 2001; Mahy, 2003) typically found either excess female mortality over the age range 1-4, or no appreciable difference between males and females. As living conditions improve, an epidemiological transition occurs whereby infectious diseases recede as a cause of death. Among infants, perinatal and congenital causes form an increasing share of total mortality, while external causes, more typically affecting boys, form an increasing share of mortality for children between ages 1 and 5 (Tabutin and Willems, 1998). Hence, as overall levels of mortality fall, female advantage in infant and child mortality would normally increase assuming no sex-specific changes in behaviour (Tabutin and Willems, 1998; Hill and Upchurch, 1995). The female advantage in survival, however, can be eroded if girls are deprived relative to boys in access to health care or to proper nutrition.

It should be noted that excess female child mortality in some parts of the world occurs in the context of other manifestations of gender discrimination and son preference, including abortion of female foetuses as reflected in heavily male sex ratios at birth in parts of Asia. A wide and growing literature addresses the question of prenatal discrimination (i.e., sex-selective abortion) and the phenomenon of missing females more generally (recent contributions include Attan and Guilmoto, 2007; Das Gupta and others, 2009). B. TRENDS IN THE SEX RATIO OF INFANT
MORTALITY

The results of this analysis confirm and extend findings of declining sex ratios of infant mortality in developed countries as reported by Drevenstedt and others (2008). Male disadvantage in infant mortality in the 15 countries included in their study rose throughout the first part of the twentieth century as the share of infectious diseases declined so that perinatal conditions and congenital anomalies accounted for an increasing portion of infant deaths. In addition to the shift in cause composition, the sex ratios of deaths within the infectious disease and perinatal categories rose as well. Male disadvantage peaked in approximately 1970. Since then, Drevenstedt and colleagues credit several major developments with lowering SR1. The first is changes in delivery practice, namely the rise in Caesarean section deliveries, which have lowered deaths due to perinatal complications. Others include improved neonatal intensive care practices, which bettered the survival of very premature babies, and treatments to decrease respiratory distress in premature infants, in particular continuous positive airway pressure, antenatal steroids and surfactant therapy. The Hill-Upchurch model did not address the sex ratio at under-five mortality rates below 25 per 1000 and so offers no predictions of sex ratios at low levels of mortality. The estimates here for many countries of Northern and Western Europe, upon which the model was based, confirm that sex ratios for these countries were quite consistent

66

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

with the model in the 1970s and then began to decline. One finding of the present analysis is that Southern European countries, which historically had lower SR1 than Northern and Western European countries (Tabutin and Willems, 1998), are experiencing the same downturn in SR1 but at a lower level of SR1. A number of developing countries with data coming from vital registration have also experienced a peak and decline in SR1, suggesting that the changes in technology or cause-of-death composition that lead to declining SR1 at low levels of mortality have spread to better-off developing countries. Table III.9 showed a number of countries in the developing regions and Europe with relatively high SR1. The finding of SR1 levels higher than 130 in developing and transition countries with moderate mortality levels could suggest that the advances in newborn care that appear to have attenuated excess male infant mortality in most of the developed world have not yet reached these countries. Among developing countries that have relatively high mortality, declining SR1 was estimated in a number of cases, contrary to expectations based on the historical experience of developed countries at such levels of mortality. No ready explanation is available for this phenomenon. Further examination of data quality issues, such as differential under-reporting in sample surveys of infants who died in the more distant past, as well as further study of sex differentials in neonatal and postneonatal mortality, may shed some light on this finding and suggest how SR1 should be projected in developing countries. C. COUNTRIES AND REGIONS This section will highlight and discuss selected findings for certain countries and regions. The first portion of the discussion will focus on the cases of China and India. These two countries accounted for over one-third of the worlds births from the 1970s to the 2000s and therefore the trends in these two countries have a major influence on worldwide trends in sex differentials.

These two countries have been the focus of an extensive literature on female disadvantage, both on childhood mortality in particular and on missing females more generally. Below, we assess the evidence base upon which our estimates for these two countries rest. We subsequently highlight available evidence on the causes and mechanisms of sex differentials in mortality in these two countries. 1. China A major challenge in assessing sex differentials in childhood mortality in China is the issue of data quality. There is no nationally representative system of vital registration to produce estimates against which the census and survey estimates may be compared. Some degree of underreporting is believed to affect data both on births and on infant and child deaths, leading to underestimates of the overall levels of fertility and of infant and child mortality. Such underreporting is likely more prevalent for girls. However, the general conclusion in the literature (as summarized by Banister, 2004) is that trends in the sex ratios of births and of infant mortality are broadly correct and cannot be explained away by differential underreporting. The presence of excess female mortality in China, particularly among infants, has long been known (Lee and Wang, 1999). In the 1950s1980s, however, it appeared that the situation of female infants had improved (Banister, 2004). The sex ratio of infant mortality was lower than that found in developed countries, but infant girls had lower mortality than boys: for 1985 the Genes or Gender study reported an estimated SR1 of 106. Beginning with the 1990 census, however, the rapid decline of SR1 was noted in the literature (Li and Feldman, 1995; Li and Zhu, 1999). Data from the 1990 census, the 1995 intercensal survey, and the 2000 census showed progressively declining SR1 (figure IV.1). The 2005 intercensal survey was the first source to suggest a slight upturn in SR1 (Das Gupta and others, 2009). The loess curve fit used in the present analysis results in an estimated decline in SR1 from 112 in the 1970s to 75 in the 2000s. In other words, female infants in China went from having mortality rates that were 11 per cent lower than those of infant boys to
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Figure IV.1. Sex ratio of infant mortality, China


140 130 120 110 100 90 80 70 60 50 1970

Ratio of male to female infant mortality

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Census 1982 1973-75 survey One per Thousand Survey 2005

Census 1990 One per Thousand Survey 1987 1988 Survey of Fertility and Birth Control

Census 2000 One per Thousand Survey 1995

having mortality rates 33 per cent higher than boys. It is too early to know whether the small increase in SR1 reported in the 2005 intercensal survey represents a reversal in the trend and thus there is not a firm basis for projecting the sex ratio of infant mortality into the future. Data on SR4 from the above named sources showed female disadvantage but at a relatively constant level, with SR4 ranging between about 90 and 100 in the censuses and surveys conducted since the early 1970s. Data by single year of age (Li, 2007) show that excess female mortality in the 1-4 age group is concentrated primarily at age 1, while the sex ratio of mortality at ages 2-4 has improved since 1990 in favour of females. Banister (2004) provides an extensive review of the history and the possible causes of discrimination against daughters in China. Discrimination against girls was an outcome of a rigid patrilineal kinship system (see also Das Gupta, 2009). Sons were necessary to continue the
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family lineage and to perform ancestor ceremonies. Moreover, daughters left their natal families at marriage and any investments made to them benefited their husbands families rather than their own parents. Before the advent of technology that allowed determination of the sex of the foetus, abnormally high population sex ratios could be taken as evidence of excess female mortality. Sex ratios by age in the 1953 census of China were normal at birth but rose with age, indicating that while infanticide was no longer occurring in the early 1950s, in the 1930s and 1940s significant percentages of girls had still met untimely deaths in childhood whether through infanticide or through lethal neglect or maltreatment in later childhood. Subsequently, Banister estimates, the period between 1964 and 1977 saw relatively low excess mortality among female children. The 1982 census revealed a higher population sex ratio of infants (107.6), at the same time that press reports suggested a resurgence of

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

female infanticide in response to the one-child policy. In the mid-1980s, ultrasound technology became widely available. Thus, attribution for the increasing sex ratios of young children found in the 1990s and 2000s could not easily be separated into that due to sex-selective abortion and that due to excess female mortality. However, beginning with the 1990 census, reported infant mortality for females was higher than that for males. Both absolute levels of female infant mortality and their disadvantage relative to boys increased through period up to 2000. Infant mortality estimates from the 1990 census indicated that discrimination against girls most affected those who had one or more older sisters (Li and Feldman, 1995). While the sex ratio of infant mortality in 1989 for children with no surviving older siblings (125) or with one older brother (135) was close to international averages, SR1 was 95 for children with one older sister and 81 for children with two older sisters. Interestingly, among children with two older brothers SR1 was quite high, 164, suggesting that families discriminated against younger boy siblings where there were already boys in the family. However, the numbers of births upon which these rates are based are not available. The disadvantage of higher parity girls, especially those with no older brothers, was corroborated by a national survey of rural areas in 2001 (Chen and others, 2007). High relative risks of death for second-born girls were also found in two local studies of infant mortality in selected rural counties (Li and others, 2004; Wu and others, 2003). Both of these local studies found that excess deaths among girls were concentrated in the early neonatal period, particularly on the first day of life and particularly among children who died at home. This suggests that a major proximal cause of excess female infant mortality is failure to seek timely access to medical care for newborn girls when life-threatening conditions arise shortly after birth. Moreover, mothers are more likely to seek prenatal care and skilled delivery assistance for first births than for higherparity births (Chu and others 2007) and some studies have found that for second births mothers were more likely to seek prenatal care and delivery assistance when the first child had been a

girl than when the first child had been a boy (Song and Burgard, 2008; Short and Zhang, 2004). According to data from the National Health and Nutrition Survey, nutritional status (measured by height-for-age) did not differ significantly between boys and girls (Bredenkamp, 2009). Attan (2009) examined trends between the 1990 and 2000 censuses in sex ratios at birth and sex ratios of infant mortality to assess the relative importance of two main practices currently used to discriminate against girlssex-selective abortion, and neglect of girls in preventive and curative health carewith the intent to illuminate different family strategies and the circumstances that lead to discrimination against females. There was a linear correlation at the provincial level between sex ratio at birth and excess female infant mortality that was present in 1990 and increased by 2000. Thus, prenatal sex selection and female neglect were increasing in tandem, rather than the first substituting for the second as had been suggested in earlier literature (Goodkind 1996). She also found that average education of males seemed to be associated with sex-selective abortion, while extreme poverty was associated with lethal neglect. Considering the impact of Chinas birth planning policy, Attan did not find a relationship at the provincial level between the authorized fertility level and the sex ratio at birth or excess female infant mortality. In contrast, an analysis by Cai (2005) at the prefectural level that grouped prefectures by authorized fertility level (total fertility rates of 1-1.3, 1.3-1.6, 1.6-2, or greater than 2) found that as the difference between actual realized fertility and authorized fertility increased, so did the degree of excess female infant mortality, suggesting that settings with the strongest tension between desired and authorized fertility were the context for parental behaviours that were detrimental to daughters survival. To address the structural factors that promote son preference and bias against daughters, the Chinese government has promulgated laws promoting gender equality in inheritance, education and employment, along with social insurance schemes intended to reduce the elderly persons dependence on their sons for economic support (Li, 2007; Pande and others, 2009). China
69

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

has also banned the use of ultrasound for the determination of foetal sex, although enforcement has proven difficult. In 2006, China implemented the Care for Girls campaign that addresses both structural and proximal causes of excess female mortality and sex-selective abortion. This set of policies, which was piloted in 24 counties from 2003-2005, aims to lower the sex ratio at birth and excess female child mortality by raising the status of girls in the country. The six prongs of the campaign include organization and leadership; cracking down on pre-natal sex determination that is not medically necessary and on sex-selective induced abortion; improving family planning and reproductive health services; enacting preferential policies to help girls in families without a son, and to improve the girl-childs survival environment and womens development in the domains of education, medical care, employment, old-age support and political participation; efforts to change son-preferential ideology through publicity campaigns related to laws and regulations, parenthood and reproductive health; and improvements to statistical reporting systems with emphasis on reporting of vital events by sex (Li, 2007). Evaluation of the pilot stage of the Care for Girls campaign found that sex ratio at birth in the 24 pilot counties declined from 133.8 in 2000 to 119.6 in 2005. However, evaluations of the effect on infant and child mortality rates in the pilot areas do not appear to have been carried out. As of early 2010, an evaluation of the national campaign was planned to be carried out in 2011, after results of the 2010 census became available. 2. India India is the only country other than China where SR1 was estimated to be below 100 in the 2000s. In contrast to China, where female disadvantage in mortality is concentrated in the early days of life, the female mortality disadvantage in India begins slightly later and extends through the early childhood years. While the present analysis does not explicitly consider subdivided age groups within infant mortality, it can be seen from estimates of neonatal and postneonatal mortality from the three National Family Health Surveys (NFHS) that sex ratios of neonatal mortality exceed 100, while sex ratios of post-neonatal mortality are lower than 100 (figure
70

IV.2). Estimates of neonatal and postneonatal mortality by sex are not available from the Sample Registration System (SRS). However, the time series of infant mortality estimates from SRS used to fit the trend in this analysis produces SR1 that rises slightly between the 1970s and the 1980s, from 98 to 100, then declines to 97 in the 2000s. The disadvantage of females in the postneonatal period thus outweighs any advantage in the neonatal period when considering overall mortality in the first year of life. The results of the estimation exercise show a marked decline in SR4, from 75 in the 1970s to 56 in the 2000s. The estimated trend in SR4 is quite close to the trend in data from the NFHS and SRS. Whereas for SR1, NFHS and SRS suggest different trends estimates from the two sources for SR4 are in close agreement (as was shown earlier in figure II.1). The estimate of 56 is slightly below the most recent available data for SR4, which refer to approximately 2004, because of the projection of the downward trend to 2010. Similarly to China, parts of India are characterized by a strict patrilineal family organization, where girls are married outside of their family, often at considerable cost to their parents, and subsequently have little contact with their natal family (Das Gupta, 2009). Adult sons, on the other hand, are expected to provide support to their parents. In this environment, sons are far more highly prized than daughters. There is little incentive for parents to invest in daughters who will leave the family, although there is debate about whether the outcome is conscious discrimination against daughters by parents, or cultural beliefs and practices that perpetuate female disadvantage. When early censuses of India identified highly masculine sex ratios in the population in the northern parts of the country, the deficit of females was attributed to higher mortality of females than males throughout the life course (Miller, 1997). In recent decades, excess female child mortality has been highest in the north and north-central regions of India, but evidence of excess female child mortality has been found at the state level in all major states of India in at least one of the NFHS rounds (Arokiasamy, 2007).

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Figure IV.2. Sex ratio of neonatal and postneonatal mortality from National Family Health Surveys (NFHS), India

Neonatal mortality (first month of life)


140 130 Ratio of male to female neonatal mortality 120 110 100 90 80 70 60 50 1965

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

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There is an extensive literature, which will not be reviewed here in its entirety, assessing the prevalence and regional distribution of excess female child mortality in India as well as attempts to explain excess mortality through sex differences in health and nutrition. The higher mortality of girls is correlated with differential treatment in regard to preventive and curative health care as well as feeding and nutrition, although the magnitude of sex differentials in these factors differ in various studies (Arokiasamy, 2007; Basu, 1993; Das Gupta, 1987, Mishra and others, 2004; Pande, 2003 among others). Borooah (2004) finds that girls are disadvantaged in terms of vaccination and nutrition, both by about 5 percentage points. However, far greater differentials are found between childrenboth boys and girlsby literacy status of mother, region, and religion. While correlational studies abound, attempts to quantify the impact of differences in nutrition and health care on actual mortality are rarer in the literature. Oster (2009a) estimated that sex differences in vaccinations explained between 20 per cent and 30 per cent of excess female mortality at ages 1-4, malnutrition accounted for an additional 20 per cent, and differences in treatment for illness played a smaller role. However, only the estimate for vaccinations was based on individual-level data from India that tied the survival status of children to their vaccination status. Estimates for the impact of other factors came from studies in other countries. A key finding of many analyses carried out for India is that disadvantaging treatment does not affect all girls equally. In particular, girls with older sisters are especially disadvantaged. Studies by Pande (2003) and Mishra and others (2004) found that despite strong son preference, most parents in India want at least one daughter (Mishra and others, 2004; Pande, 2003) and differentials in treatment and survival of first-born boys and girls are not large. Girls with older sisters, on the other hand, compared to boys of the same birth order, are less likely to be taken for medical treatment for acute respiratory infections, are more likely to stunted, and are less likely to be fully vaccinated. Both studies also found a degree of disadvantage, though smaller, for boys with older brothers. Part of the disadvantage of
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younger sisters is due to differential stopping behaviour: parents who have reached their preferred number of sons are more likely to stop childbearing, meaning that girls grow up in larger families on average and poverty or limited resources play a role in their higher mortality (Choe and others, 1998; Clark, 2000). While some analysts point to signs that son preference may be declining in India (Das Gupta and others, 2009) and suggest that this may lead to turnarounds in the sex ratio at birth and in sex ratios of child mortality, a recent profile of youth in India based on the 2005-2006 NFHS shows that son preference remains strong among young people in India (Parasuranam and others, 2009). Among young people aged 15-24 who had two children, 75 percent of women and 73 percent of men with two sons wanted no more children, compared with 32 percent of women and 26 percent of men with two daughters. India has put into place a number of policies to address son preference and daughter discrimination. These include policies to equalize inheritance rights for male and female children and make both sons and daughters responsible for the maintenance of elderly parents; direct prohibition of discriminatory practices, particularly sex-selective abortion; and schemes to increase the value of the girl child, including conditional cash transfer programmes and subsidies for care and education. However, Pande and others (2009) suggest that while the policies show that the government understands the structural issues leading to son preference, their impact is limited by uneven implementation at the state or local level and certain weaknesses in designfor example, conditional cash transfer schemes apply only to a certain number of girls in the family, thus excluding the most vulnerable girls, those with several older sisters. 3. Other countries of Southern Asia In contrast to India, data from Bangladesh show evidence of an increase in SR4. Thus, disproportionate mortality among girls appears to be easing in that country. Bangladesh has a large quantity of mortality estimates available from surveys and sample vital registration, and the

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

upward acceleration since the 1990s in the trends of SR5 and implied SR4, as captured by the loess method, seems clearly visible in the plots of data (see Bangladesh country profile). However, the results of the locally-weighted regression are quite sensitive to the alpha value chosen. The results shown were produced using the standard alpha of 0.75. Stronger smoothing with an alpha of 1 would produce substantially different results for the 2000s: SR1 of 110, SR4 of 86, and SR5 of 103. The linear method produces results similar to alpha of 1: SR1 of 109, SR4 of 85, and SR5 of 103. Thus it must be borne in mind that the findings for Bangladesh are consistent with the data but are highly dependent on the methodology chosen. Estimated SR1 in Bangladesh has been declining. It is possible that, as in India, retrospective estimates from surveys give SR1 that is too high due to omission of deceased infant daughters (relative to deceased sons) from the birth history. However, the other available data, from the Sample Vital Registration System, do not give the sort of consistency with SR4 from DHS that was seen in India, so both sources of data are included in the analysis. Alam and others (2007), using data from the Matlab Demographic Surveillance Site, established that SR4 had risen significantly in the period between 1976 and 2000. Moreover, the strong disadvantage in mortality experienced by girls with older sisters had reduced to a statistically insignificant level. The increase in SR4 had been stronger in the area where a maternal and child health and family planning programme was available (the MCH-FP area) versus the comparison area. The authors concluded that access to high-quality free primary health care was a main factor influencing the level of mortality ratios. Female disadvantage in nutrition remained, but was slight, and there was little difference in prevalence of illness and in immunization status. The estimates derived here for Pakistan also show an increasing trend in SR4 and suggest that girls may have neared parity in survival with boys in this country as well. However, the quality of data from recent, recurring national surveys

such as the Pakistan Demographic Survey, the Integrated Household Survey, and the Standards of Living Measurement Surveyis not known, as these surveys are not part of international demographic survey programmes and little information on methodology is given in the reports. Nevertheless, no adjustments were made to the weighting scheme and all available data points from these surveys were included. Another methodological consideration affects the estimated level (but not the trend) of SR4. More so than for most other countries, for Pakistan the choice of WPP2008 or UNICEF both-sexes estimates makes a difference in implied SR4 because the relative weight of 1q0 and 4q1 is different (the United Nations Population Division employs the UN South Asian model while the UNICEF estimates use the CoaleDemeny South model). This has a large impact on the implied SR4: if the UNICEF estimates are used, implied SR4 rises from 75 to 92 between the 1970s and 2000s, compared to a rise from 85 to 100 using the WPP2008 both-sexes estimates. While both estimates suggest progress in reducing female disadvantage in child mortality, it is not possible to definitively state whether parity has been reached. Nepal has experienced a significant decline in overall mortality levels since the 1970s, but SR1 and SR4 have both remained nearly constant. Leone and colleagues (2003) found that son preference in Nepal, as measured by differential stopping behaviour in childbearing by sex of the last child, remains strong, although sex differentials in vaccination were low. The estimates derived here for Sri Lanka suggest that a steady increase has occurred in both SR1 and SR4, such that females now have lower mortality at ages 1-4 than males. However, both indicators are still below the historical levels of developed countries at the same levels of mortality. 4. Northern Africa and Western Asia Earlier studies identified Northern Africa and Western Asia as another region characterized by excess mortality among girl children. The results
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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

of the present analysis show major relative gains in survival among both infant and child girls since the 1970s in Algeria, Egypt, Iraq, Kuwait and Tunisia. In Jordan and Morocco, SR1 increased fairly rapidly, while SR4 increased at a much slower pace and the relative mortality of 1-4 yearold girls remained higher than that of boys. Sudan, Turkey, and Yemen had relative stagnation or decline in sex ratios, although SR4 in Turkey did increase moderately. Determinants of these varying trends have not been identified. A comparative study of survey data from 18 Arab countries found no evidence of female disadvantage in nutritional status, vaccination, or acute respiratory infection (Khawaja and others, 2008). Yount (2001, 2003) identified differential access to curative care as the main factor associated with excess female child mortality in Egypt. Egypt has a large quantity of mortality estimates available from surveys and vital registration, and the upward acceleration since the 1990s in the trends of SR1, SR5, as captured by the loess method, seems clearly visible in the plots of data (see Egypt country profile). However, the results of the loess regression are quite sensitive to the alpha value chosen. The results shown were produced using the standard alpha of 0.75. Using an alpha of 1 would produce quite different results for the 2000s: SR1 of 116, SR4 of 91, and SR5 of 112. The linear method also produces lower results for sex ratios in the 2000s: SR1 of 113, SR4 of 90, and SR5 of 109. Thus, while all three methods confirm an increase in the male/female ratios of mortality, the conclusion that a recent rapid acceleration has occurred should be taken with caution. Updated research on the access of girls to curative health care would be useful for corroborating these findings. 5. Sub-Saharan Africa The variety of trends in SR1 and SR4 in SubSaharan Africa cannot be easily explained. From this analysis we cannot determine to what extent data quality issues are affecting results, but many of the countries with declines in SR4 (for example, Burkina Faso, Rwanda, and United Republic of Tanzania) are among those that have
74

taken a number of surveys, and estimates for these countries should not be overly influenced by data quality problems in any one survey. The decline of SR4 in so many African countries merits further attention. Existing studies have not found differences or changes in medical treatment of boys and girls that would explain such declines (Garenne, 2003), although a study of attitudinal gender preferences in recent DHS surveys found higher levels of son preference in many countries of Western Africa than in other parts of Africa (Fuse, 2010). An additional factor for consideration is the relative prevalence in different African countries of measles, which has been shown to cause higher mortality for females than for males (Garenne, 1992). Recent successes in improving measles vaccination coverage (United Nations, 2010) could be expected to increase relative survival for girls. 6. CIS Asia Trends for the countries of CIS Asia were somewhat unusual compared to other developing regions. With the exception of Azerbaijan, all countries of the region had fairly high SR1, equal to or higher than levels implied by the HillUpchurch model. While SR1 estimates were higher than those for other developing regions, they were similar to the levels found in several European countries of the former U.S.S.R., suggesting that similarities in the health systems of former Soviet republics or other factors are influencing the relative survival disadvantage of male infants. The countries of CIS Asia showed more variation in SR4 than in SR1. While Kazakhstan, Turkmenistan and Uzbekistan had SR4 similar to the historical experience of European countries, SR4 in Kyrgyzstan, Tajikistan, Armenia, Azerbaijan and Georgia based on these estimates were considerably lower. Thus, these countries appear to have an unusual combination of male disadvantage in infant mortality and female disadvantage in child mortality. For the Caucasian countries (Armenia, Azerbaijan and Georgia) a recent rise in the sex ratio at birth has been identified (Mesle and others, 2007) that suggests an emergence or re-emergence of son preference in these countries. A working paper by Lordan

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

and others (2009) identified pro-boy bias in household allocation of health-care resources in Armenia, Azerbaijan, Kyrgyzstan and Tajikistan (the only countries included in their study). While these studies lend credence to the finding here of female disadvantage in child mortality, it should be noted that the SR4 levels derived for these countries are affected by the much higher overall level of mortality estimated by the IGME and the Population Division compared to the levels from vital registration. SR4 coming directly from vital registration (not shown in country profiles) show high variability, with SR4 above 100 in some years and below 100 in others. D. LIMITATIONS OF THE STUDY Despite every effort to be objective in the inclusion and weighting of data, and to include all data, analysis of the preliminary results led to decisions to exclude certain outlying data points or entire data sources, such as those that appeared to have data quality issues with implications for the sex ratios of mortality, and, for some countries, survey estimates that showed high variability compared to data from vital registration. There is, therefore, some degree of subjectivity that could affect the findings. However, exclusion of such data sources improved the coherence of SR1 and SR5 estimates for the affected countries and the consistency of estimates across countries. In deciding upon the method used to fit trends, the choice of the linear or the loess method was usually fairly clear-cut. For those developing countries where the estimates were based primarily on survey data, the level of smoothing needed to produce plausible results with the loess method was so strong that there was little difference from a simpler linear fit. For a few countries however, in particular Bangladesh and Egypt, it seemed that the loess method was picking up real recent trends in the data that the linear fit would miss. However, in both of these cases the loess method produced a rather steep increase in SR4 that would not be desirable to project into the future. While the linear fit captured the increase in SR4 in both of these countries, the implied rise was more gradual. Thus while the conclusion can be drawn that the

mortality disadvantage of young girls in these countries has eased, it cannot be definitively stated that their mortality is now lower than that of boys. The estimates derived here will be useful for incorporation into life tables for the estimation of mortality and population change from the 1970s until today. In this way they represent an advance over earlier studies of sex differentials in child mortality. However, their usefulness for the projection of sex differentials in individual countries may be limited, particularly in cases where increases or decreases are steep and such rapid change cannot sensibly be projected into the future. The results obtained here could be a first step in developing a model based on the experience of countries with low mortality, or on regional trends, to blend with the estimates for purposes of projection. E. CONCLUSIONS It has long been recognized that young girls in some parts of the world experience higher mortality than boys due to patterns of discriminatory behaviours arising from parental or societal preference for sons. In 1994, the Programme of Action of the International Conference on Population and Development (ICPD) condemned excess mortality among girl children, urging the following: Leaders at all levels of the society must speak out and act forcefully against patterns of gender discrimination within the family, based on preference for sons. One of the aims should be to eliminate excess mortality of girls, wherever such a pattern exists (paragraph 4.17). This call was further echoed by the General Assembly at its twenty-seventh special session in 2002: Promote child health and survival and reduce disparities between and within developed and developing countries as quickly as possible, with particular attention to eliminating the pattern of excess and preventable mortality among girl infants and children (A/RES/S-27/2. A World Fit for Children. Annex, para. 37.4).
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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

The present study has offered new estimates of child mortality by sex for 149 countries based on a greatly increased base of data. Unlike prior studies that produced estimates of sex differentials for discrete periods, it generated a continuous time series of sex differentials for 122 of these countries using consistent methods. The results show that while considerable progress has been made in many parts of the world in reducing excess mortality of girls, the pleas of ICPD and A World Fit for Children to eliminate excess mortality of girls have still not been achieved in several countries. In particular, the plight of newborn infant girls in China and of older infant and toddler girls in India should remain in the global spotlight as there is evidence that the relative mortality of these two groups has worsened in recent decades, with a particular concentration of disadvantage among girls who have one or more older sisters. The interaction of strong son preference and declining fertility has continued implications for the health and survival of girls in these countries.

Estimates of under-five mortality levels are receiving intense focus in as the world nears the 2015 target date for the Millennium Development Goals, which call for reducing under-five mortality by two-thirds from its 1990 level, and efforts to strengthen child survival programmes are certain to intensify. In this light, the finding of declining SR1 and SR4 in a number of countries that still have relatively high mortality merits concern, as it suggests that girls are not sharing fully in the recent improvements in survival. Further study is needed to confirm these findings, to identify why girls relative survival is not keeping pace, and to assess interactions with other barriers to care such as poverty or marginalization. As was shown in table III.5, countries with declining SR1 or SR4 often have neighbouring countries where such a phenomenon is not evident. Case studies from countries that have been successful in reducing inequalities in the survival of girls and boys whether this was a conscious policy choice or an indirect outcome of generally expanded access to interventions could provide useful insights and guidance to the planning of child health interventions and health system improvements.

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

REFERENCES
Arokiasamy, Perianayagam (2007). Sex ratio at birth and excess female child mortality in India: trends, differentials and regional patterns. In Watering the Neighbours Garden: The Growing Demographic Female Deficit in Asia, Isabelle Attan and Christophe Z. Guilmoto, eds. Paris: CICRED, pp. 49-72. Alam, Nurul, Jeroen van Ginneken, and Alinda Bosch (2007). Decreases in male and female mortality and missing women in Bangladesh. In Watering the Neighbours Garden: The Growing Demographic Female Deficit in Asia, Isabelle Attan and Christophe Z. Guilmoto, eds. Paris: CICRED, pp. 161-182. Attan, Isabelle (2009). The determinants of discrimination against daughters in China: evidence from a provincial level analysis, Population Studies, vol. 63, No. 1, pp. 87-102. Attan, Isabelle, and Christophe Z. Guilmoto (2007). Watering the Neighbours Garden: The Growing Demographic Female Deficit in Asia, Paris, CICRED. Banister, Judith (2004). Shortage of girls in China today, Journal of Population Research, vol. 21, No. 1, pp. 19-45. Basu, Alaka (1993). How pervasive are sex differentials in childhood nutritional levels in south Asia? Social Biology, vol. 40, No. 1-2, pp. 25-37. Borooah, Vani K. (2004). Gender bias among children in India in their diet and immunisation against disease, Social Science & Medicine, vol. 58, pp. 1719-1731. Bredenkamp, Caryn (2009). Policy-related determinants of child nutritional status in China: the effect of only-child status and access to healthcare, Social Science & Medicine, vol. 69, pp. 1531-1538. Cai, Yong (2005). Regional mortality variation in China. Ph.D. dissertation, University of Washington. Choe, Minja Kim, Ian Diamond, Fiona Alison Steele and Seung Kwon Kim (1998). Son preference, family building process and child mortality. In Too Young to Die: Genes or Gender? United Nations publication, Sales No. 98.XIII.13, pp. 208-222. Chen, Jiajian, Zhenming Xie and Hongyan Liu, (2007). Son preference, use of maternal health care, and infant mortality in rural China, 1989-2000. Population Studies, vol. 61, No. 2, pp. 161-183. Clark, Shelley (2000). Son preference and sex composition of children: evidence from India. Demography, vol. 37, No. 1, pp. 95-108. Curtis, Sin L. (1995). Assessment of the quality of data used for direct estimation of infant and child mortality in DHS-II Surveys 1995, Occasional Papers, No. 3, Calverton, Maryland: Macro International Inc. Das Gupta, Monica (1987). Selective discrimination against female children in rural Punjab, India. Population and Development Review, vol. 13, No. 1, pp. 77-100. _____ (2009). Family systems, political systems, and Asias Missing Girls: the construction of son preference and its unraveling. Policy Research Working Paper No. 5148. Washington, DC, World Bank. Das Gupta, Monica, Woojin Chung, and Li Shuzhuo (2009). Evidence for an incipient decline in numbers of missing girls in China and India, Population and Development Review, vol. 35, No. 2, pp. 401-416. Drevenstedt, Greg L., and others (2008). The rise and fall of excess male infant mortality. Proceedings of the National Academy of Sciences, vol. 105, No. 13, pp. 5016-5021. Fuse, Kana (2008). Cross-national variation in attitudinal measures of gender preference for children: an examination of Demographic and Health Surveys from 40 countries. DHS Working Paper No. 44. Calverton, Maryland: Macro International Inc. Garenne, Michel (2003). Sex differences in health indicators among children in African DHS surveys. Journal of Biosocial Science, vol. 35, pp. 601-614. Garenne, Michel (1982). Variations in the age pattern of infant and child mortality with special reference to a case study in Ngayokheme (rural Senegal). Ph.D. dissertation, University of Pennsylvania. Garenne, Michel, and Monique Lafon (1998). Sexist diseases. Perspectives in Biology and Medicine, vol. 41, No. 2, pp. 176189. Goodkind, Daniel (1996). On substituting sex preferences strategies in East Asia: does prenatal selection reduce postnatal Discrimination? Population and Development Review, vol. 22, No. 1, pp. 111-125. Hill, Kenneth, Rohini Pande, and Mary Mahy (1999). Trends in Child Mortality in the Developing World: 1960 to 1996, New York, UNICEF. Hill, Kenneth and Dawn M. Upchurch (1995). Gender differences in child health: evidence from the Demographic and Health Surveys, Population and Development Review, vol. 21, No. 1, pp. 127-151. Khawaja, Marwan, and others (2008). Disparities in child health in the Arab region during the 1990s, International Journal for Equity in Health, vol. 7, No. 1, p. 24. Lee, James Z., and Wang Feng (1999). One Quarter of Humanity: Malthusian Mythology and Chinese Realities, 1700-2000. Cambridge, Massachusetts, and London, England: Harvard University Press. Leone, Tiziana, Zo Matthews, and Gianpiero Dalla Zuanna (2003). Impact and determinants of sex preference in Nepal. International Family Planning Perspectives, vol. 29, No. 2, pp. 6975. Li, Shuzhuo, and Marcus W. Feldman (1995). Sex differentials in infant and child mortality in China: levels, trends, and variations. Paper No. 0061. Stanford, California: Stanford University. Li, Shuzhuo and Chuzhu Zhu (1999). Gender differences in child survival in rural China: a county study. Paper No. 0080. Xian, Shaanxi Province, Peoples Republic of China: Xian Jiaotong University. Li, Shuzhuo, Chuzhu Zhu, and Marcus W. Feldman (2004). Gender differences in child survival in contemporary rural China: a county study, Journal of Biosocial Science, vol. 36, pp. 83-109. Li, Shuzhuo (2007). Imbalanced sex ratio at birth and comprehensive intervention in China. 4th Asia Pacific Conference on Reproductive and Sexual Health and Rights, 29-31 October 2007, Hyderabad, India. Lordan, Grace, Richard Brown, Eliana Jimenez Soto and William H. Greene (2009). Bargaining, gender and the intra-household allocation of healthcare resources. School of Economics Discussion Paper No. 401. The University of Queensland, Australia Mahy, Mary (2003). Childhood mortality in the developing world: a review of evidence from the Demographic and Health Surveys. DHS Comparative Reports No. 4. Calverton, Maryland: ORC Macro. Mesle, France, Jacques Valiin and Irina Badurashvili (2007) A sharp increase in sex ratio at birth in the Caucasus. Why? How? In Watering the Neighbours Garden: The Growing Demographic Female Deficit in Asia, Isabelle Attan and Christophe Z. Guilmoto, eds. Paris: CICRED, pp. 73-88. Miller, Barbara (1997). The endangered sex: neglect of female children in rural north India (reprint edition). Delhi: Oxford University Press.

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Mishra, Vinod, T. K. Roy, and Robert D. Retherford (2004). Sex differentials in childhood feeding, health care, and nutritional status in India, Population and Development Review, vol. 30, No. 2, pp. 269-295. Oster, Emily (2009). Proximate sources of population sex imbalance in India, Demography, vol. 46, No. 2, pp. 325-359. Pande, Rohini P. (2003). Selective gender differences in childhood nutrition and immunization in rural India: the role of siblings, Demography, vol. 40, No. 3, pp. 395-418. Pande, Rohini, Priya Nanda, Sonvi Kapoor, and others (2009). Counting girls: addressing son preference and daughter discrimination in India and China. Paper presented at the Population Association of America annual meeting, Detroit, 30 April 2 May, 2009. Pandey, Arvind, Minja Kim Choe, Norman Y. Luther, and others (1998). Infant and child mortality in India. National Family Health Survey Subject Reports, No. 11. Mumbai, India and Honolulu, Hawaii: International Institute for Population Sciences and East-West Center Program on Population. Parasuranam, Sulabha, Sunita Kishor, Shri Kant Singh and Y. Vaidehi (2009). A profile of youth in India. National Family Health Survey (NFHS-3), India, 2005-06. Mumbai: International Institute for Population Sciences; Calverton, Maryland, USA: ICF Macro. Rutstein, Shea Oscar (1985). Assessment of the quality of WFS data for direct estimation of child mortality. In Assessment of the quality of data in 41 WFS surveys: a comparative approach, by Noreen Goldman, Shea Oscar Rutstein and Susheela Singh. WFS Comparative Studies, No. 44. Voorburg, Netherlands: International Statistical Institute, pp. 63-79. Rutstein, Shea Oscar, and Guillermo Rojas (2006). Guide to DHS Statistics. In Demographic and Health Surveys, Calverton, Maryland: ORC Macro. Short, Susan E., and Fengyu Zhang (2004). Use of maternal health services in rural China, Population Studies, vol. 58, No. 1, pp. 319. Song, Shige and Sarah Burgard (2008). Social conditions and infant mortality in China: a test of the fundamental cause perspective. California Center for Population Research On-Line Working Paper Series, CCPR-013-08. Sullivan, Jeremiah M., George T. Bicego, and Shea Oscar Rutsein (1990). Assesment of the quality of data used for the direct estimation of infant and child mortality in the Demographic and Health Serveys. In An Assessment of DHS-I Data Quality, DHS Methodological Reports 1. Columbia, Maryland: Institute for

Resource Development/Macro Systems, Inc., pp. 115-137. Tabutin, Dominique, Catherine Gourbin, and Gervais Beninguisse (2001). Surmortalit et sant des petites filles en Afrique. Tendances des annes 1970 aux annes 1990. Paper presented at the International Colloquium Gender, Population and Development in Africa, Session VII - Sant et systmes de genre. Abidjan, July. Tabutin, Dominique, and Michel Willems (1998). Differential mortality by sex from birth to adolescence: the historical experience of the West (1750-1930). Too Young to Die: Genes or Gender? United Nations publication, Sales No. 98.XIII.13. United Nations Children's Fund, World Health Organization, The World Bank and United Nations Population Division (2007). Levels and trends of child mortality in 2006, Estimates developed by the Inter-agency Group for Child Mortality Estimation [Working Paper]. New York. _____ (2011). Level & trends in child mortality. Report 2011. Estimates developed by the Inter-agency Group for Child Mortality Estimation. New York. United Nations (1990). Step-by-step guide to the estimation of child mortality. Population Studies No.107, Sales No. 89.XIII.9. _____ (1995). United Nations database on mortality in childhood by sex: Africa. Database POP/1B/DB/95/2. _____ (1996a) United Nations database on mortality in childhood by sex: Asia. Database POP/1B/DB/96/2. _____ (1996b) United Nations database on mortality in childhood by sex: Latin America and the Caribbean. Database POP/1B/DB/96/2. _____ (1998). Levels and trends of sex differentials in infant, child and under-five mortality. In Too Young to Die: Genes or Gender? Sales No. 98.XIII.13, pp. 84-108. Waldron, Ingrid (1998). Sex differences in infant and early childhood mortality: major causes of death and possible biological causes. In Too Young to Die: Genes or Gender? United Nations publication, Sales No. 98.XIII.13, pp. 64-83. Wu, Zhuochun, and others (2003). Perinatal mortality in rural China: retrospective cohort study, BMJ, vol. 327, No. 1319 (December). Yount, Kathryn M. (2001). Excess mortality of girls in the Middle East in the 1970s and 1980s: patterns, correlates and faps in research, Population Studies, vol. 55, No. 3 (November), pp. 291-308. _____ (2003). Gender bias in the allocation of curative health care in Minia, Egypt, Population Research and Policy Review, No. 22, No. 3, pp. 267-295.

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V. Country Profiles

Afghanistan
Average

Sex ratio of under-five mortality 120


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 120 90 100 110

110 + + 100 90
o Direct + Indirect V VR

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 300


Male Female Both

Deaths per 1000 live births Deaths per 1,000

250

5q0 1q0 4q1

100 1970

150

200

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 208 185 175 167 Female 197 175 166 158 Both sexes 203 180 171 163 Child mortality (probability of dying at ages 1-4, per 1,000) Male 124 109 102 96 Female 127 111 104 98 Both sexes 126 110 103 97 Under-five mortality (deaths under age 5 per 1,000 live births) Male 307 273 259 247 Female 299 266 253 240 Both sexes 303 270 256 244 Ratio of male to female mortality (per 100)

Infant 106 106 106 106

Child 98 98 98 98

Under-five 103 103 103 103

80

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Albania
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+ 140 + + v 120 v +v v v +v v v v vv v + v v vv vv v v v v ++
o Direct + Indirect V VR

v 120 v

v 100

+
Fitted trend

v vv v v v vv v v v v vv v v v v
Fitted trend Adjusted trend

80

100

1970

1980

1990 Date

2000

2010

80 1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex differentials (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 49 29 16 Female .. 45 27 14 Both sexes .. 47 28 15 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 14 6.1 2.5 Female .. 14 5.6 1.8 Both sexes .. 14 5.8 2.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 62 35 18 Female .. 58 32 16 Both sexes .. 60 34 17 Ratio of male to female mortality (per 100)

Infant .. 110 111 112

Child .. 97 110 136

Under-five .. 106 111 115

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

81

Algeria
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

120

v v vvv v v vvv +

+v

120

vv vvv v v vvv

v v vv

100

100

v
o Direct + Indirect V VR

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

120

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 121 78 54 37 Female 116 71 47 31 Both sexes 119 75 50 34 Child mortality (probability of dying at ages 1-4, per 1,000) Male 25 18 6.7 3.2 Female 30 18 6.3 2.4 Both sexes 27 18 6.5 2.8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 143 94 60 40 Female 143 88 53 34 Both sexes 143 91 57 37 Ratio of male to female mortality (per 100)

Infant 104 109 114 119

Child 82 96 107 132

Under-five 100 107 113 120

82

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Angola
Average (Under-five m ortality only)

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Under-five mortality by sex (decade average) Deaths per female 1q0 (per Ratio of male to 1000 live births 100) 100 150 200 250 300 50

140

160

+ 120 + + + + + + +

+ + +

80
o Direct + Indirect V VR

100

60

Weighted av erage +

1970

1980

1990 Date

2000

2010

5q0

Male Female Both

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. .. .. .. Female .. .. .. .. Both sexes .. .. .. .. Child mortality (probability of dying at ages 1-4, per 1,000) Male .. .. .. .. Female .. .. .. .. Both sexes .. .. .. .. Under-five mortality (deaths under age 5 per 1,000 live births) Male 294 281 264 231 Female 268 257 242 211 Both sexes 277 265 249 218 Ratio of male to female mortality (per 100)

Infant .. .. .. ..

Child .. .. .. ..

Under-five 110 110 110 110

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

83

Argentina
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

vv v

vv vv v vv v v vvvv v v vvv v v vvvvvvvv v vv

vv v

v v v v vvvv v vvvv v vv vv vv v v v vv v v vv vv

120

100

80

Fitted trend

80

o Direct + Indirect V VR

100

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 48 33 26 16 Female 39 26 20 13 Both sexes 44 30 23 14 Child mortality (probability of dying at ages 1-4, per 1,000) Male 9.5 5.6 3.5 2.4 Female 8.9 5.0 3.0 2.1 Both sexes 9.2 5.3 3.3 2.3 Under-five mortality (deaths under age 5 per 1,000 live births) Male 57 38 29 18 Female 48 31 23 15 Both sexes 52 35 26 16 Ratio of male to female mortality (per 100)

Infant 121 125 125 122

Child 107 113 116 115

Under-five 118 123 124 121

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United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Armenia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v v v v vv v vvv v vv vvv v v v v v vv v v

+ + v + vv v v + + vv+ vv v v v +v v v v v v vv v v v vv v +
o Direct + Indirect V VR

140

120

100

80

+
Fitted trend

60

60

80

100

120

140

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

70

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

60

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 54 45 31 Female .. 47 36 23 Both sexes .. 51 41 27 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 8.8 7.2 2.7 Female .. 10 7.7 3.0 Both sexes .. 9.4 7.4 2.8 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 62 52 34 Female .. 56 43 26 Both sexes .. 59 48 30 Ratio of male to female mortality (per 100)

Infant .. 115 127 136

Child .. 86 93 92

Under-five .. 110 121 131

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

85

Australia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v v vv v v vv v v vv vv v v v v vv vv v v v v vvv v v v v v v v v v v vv

140 100 80 120

v vv v vvvv vv vvv v v v v v v v v v vv v v v v v vv v vv v v v v vv

o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 16 11 6.4 5.5 Female 12 8.2 5.1 4.5 Both sexes 14 9.4 5.8 5.0 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.3 2.2 1.5 1.0 Female 2.6 1.7 1.1 .8 Both sexes 2.9 1.9 1.3 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 19 13 7.9 6.5 Female 15 10 6.3 5.3 Both sexes 17 11 7.1 5.9 Ratio of male to female mortality (per 100)

Infant 128 128 125 123

Child 126 129 129 130

Under-five 128 128 126 124

86

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Austria
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v v v v v v vv v vv v v v v vv v v v v v v vv v v vv vv v v v v v vv vv

100

80

Fitted trend

80

o Direct + Indirect V VR

100

v v v v v v vv v v v vv v v v v vvv v vv v v v vvv v vv v v vv v v v v v

140

120

120

140

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 23 12 6.3 4.4 Female 17 9.2 5.0 3.6 Both sexes 20 11 5.7 4.0 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.5 2.1 1.3 .9 Female 2.8 1.7 1.1 .7 Both sexes 3.2 1.9 1.2 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 26 14 7.7 5.3 Female 20 11 6.1 4.3 Both sexes 23 13 6.9 4.8 Ratio of male to female mortality (per 100)

Infant 132 129 125 124

Child 128 128 126 124

Under-five 131 128 125 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

87

Azerbaijan
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

160

+ + + + + + v v+ vvvvvvvv v v + v vv v + v v vv + v v + +

120

140

100

v v

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

v v v vvv vv vvv v v v v v vv v vv v v vvv vv


Fitted trend Adjusted trend

120 1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

40

60

80

100 120

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

20

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 94 76 49 Female .. 80 66 44 Both sexes .. 88 71 47 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 24 20 12 Female .. 24 19 10 Both sexes .. 24 20 11 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 116 95 60 Female .. 102 84 54 Both sexes .. 110 90 57 Ratio of male to female mortality (per 100)

Infant .. 118 115 112

Child .. 100 106 114

Under-five .. 113 113 112

88

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Bangladesh
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

+
o Direct + Indirect V VR

140

120

+ + v + v + + + v+ v +v v ++ + v + v + vv + + vv +v + ++ v+v+ v+ + + + vv vv + + vv v + + + + +
Fitted trend

100

80

80

100

++

v v v vv vvvv v v v

v v

v v v vvv v vv v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 160 125 87 53 Female 134 106 76 49 Both sexes 147 115 82 51 Child mortality (probability of dying at ages 1-4, per 1,000) Male 76 52 32 17 Female 96 70 41 17 Both sexes 86 61 37 17 Under-five mortality (deaths under age 5 per 1,000 live births) Male 223 170 116 69 Female 217 169 114 65 Both sexes 220 169 115 67 Ratio of male to female mortality (per 100)

Infant 119 118 114 110

Child 79 74 80 100

Under-five 103 101 102 107

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

89

Belarus
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 v v vv v v v v v v v vvv vvv v v v vv v vvv v v v v v v v vv v v vv v v 140

100 80
o Direct + Indirect V VR

120

v v v vv v vv v v v vv v vv vvv v v vvv v v vvv v v v vv v v vv v v v

140

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

30

Deaths per 1000 live births Deaths per 1,000

15

20

25

Male Female Both

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 26 24 21 15 Female 19 18 16 11 Both sexes 23 21 19 13 Child mortality (probability of dying at ages 1-4, per 1,000) Male 4.6 4.1 3.3 1.8 Female 3.8 3.3 2.6 1.4 Both sexes 4.2 3.7 3.0 1.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 31 28 24 16 Female 23 21 18 12 Both sexes 27 25 21 14 Ratio of male to female mortality (per 100)

Infant 135 136 136 136

Child 121 124 127 126

Under-five 132 134 135 135

90

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Belgium
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v 140 v v v v v v v v v v v v v vv v v v vv v v vv v v v vv vv v v v v v v v v

vv v v v v v v v vv v v v vvvv vv v v v v v v vv vv v vv v vv v v

120

100

80

Fitted trend

80

o Direct + Indirect V VR

100

120

140

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 18 11 7.3 4.5 Female 14 8.3 5.6 3.5 Both sexes 16 10 6.5 4.0 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.2 2.3 1.3 1.1 Female 2.7 1.9 1.1 .9 Both sexes 2.9 2.1 1.2 1.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male 21 13 8.7 5.6 Female 16 10 6.7 4.4 Both sexes 19 12 7.7 5.0 Ratio of male to female mortality (per 100)

Infant 132 134 131 127

Child 117 119 123 130

Under-five 130 131 130 127

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

91

Benin
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

o Direct + Indirect V VR

Fitted trend

140

120

+ + + + + + ++ + + ++ + + ++ + + + + + + 1970 1980 1990 Date 2000 + 2010

+ +

100

80

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

250

Deaths per 1000 live births Deaths per 1,000

100

150

200

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

5q0 1q0 4q1

50

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 149 132 112 94 Female 129 116 99 84 Both sexes 139 124 106 89 Child mortality (probability of dying at ages 1-4, per 1,000) Male 111 85 62 41 Female 109 87 66 46 Both sexes 110 86 64 43 Under-five mortality (deaths under age 5 per 1,000 live births) Male 243 206 167 131 Female 224 193 159 126 Both sexes 234 200 163 129 Ratio of male to female mortality (per 100)

Infant 115 114 113 111

Child 102 98 94 88

Under-five 109 107 105 103

92

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Bolivia (Plurinational State of)


Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

+ + + + + + + + + + + + + + + + + + ++ + + + + + ++ + + + + + + ++ + +
o Direct + Indirect V VR

140

80

100

120

+ + ++

+
Fitted trend

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 158 110 77 54 Female 124 89 65 47 Both sexes 141 100 71 51 Child mortality (probability of dying at ages 1-4, per 1,000) Male 98 52 25 18 Female 100 53 24 15 Both sexes 99 53 24 17 Under-five mortality (deaths under age 5 per 1,000 live births) Male 240 156 100 71 Female 212 137 87 62 Both sexes 226 147 94 66 Ratio of male to female mortality (per 100)

Infant 127 123 118 114

Child 98 100 104 119

Under-five 114 114 114 115

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

93

Bosnia and Herzegovina


Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v 140 v v vv v vvv v vv v

v 140 v vv v v v vv vv v v v v v

120

100

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

120

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1

Deaths per 1000 live births Deaths per 1,000

20

25

Male Female Both

0 1970

10

15

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 25 21 15 Female .. 20 16 12 Both sexes .. 23 19 13 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 3.3 2.8 2.8 Female .. 2.4 2.0 2.1 Both sexes .. 2.9 2.4 2.4 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 28 24 18 Female .. 22 18 14 Both sexes .. 25 21 16 Ratio of male to female mortality (per 100)

Infant .. 126 126 126

Child .. 139 139 135

Under-five .. 128 128 128

94

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Botswana
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

+ + + + + + + + + + + v

120

140

100

80

60

Weighted av erage

1970

1980

1990 Date

2000

2010

60

o Direct + Indirect V VR

80

100

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

20 1970

40

60

80

100

120

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 94 67 64 55 Female 71 51 49 42 Both sexes 82 59 57 49 Child mortality (probability of dying at ages 1-4, per 1,000) Male 39 27 26 28 Female 35 24 24 25 Both sexes 37 26 25 27 Under-five mortality (deaths under age 5 per 1,000 live births) Male 129 92 89 82 Female 103 74 71 66 Both sexes 116 83 80 74 Ratio of male to female mortality (per 100)

Infant 132 132 132 132

Child 111 110 110 113

Under-five 124 124 124 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

95

Brazil
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

v vvvvvvvvvvvvvvvvvvvvvv vvvvv + vvvv +


o Direct + Indirect V VR

120

100

+
Fitted trend

80

80

100

120

v v vvvvvvvvvvvvvvvvvvvv vv v vv vvvv v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

100 120

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

20

40

60

80

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 93 64 42 28 Female 76 51 34 23 Both sexes 85 58 38 25 Child mortality (probability of dying at ages 1-4, per 1,000) Male 37 17 12 7.0 Female 33 15 10 5.9 Both sexes 35 16 11 6.5 Under-five mortality (deaths under age 5 per 1,000 live births) Male 127 80 54 35 Female 106 65 44 28 Both sexes 117 73 49 32 Ratio of male to female mortality (per 100)

Infant 123 125 125 123

Child 114 116 118 117

Under-five 120 123 123 122

96

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Bulgaria
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 100 120 v v v v v v vv vvv v vv v v vvv v v v vv v v vv v v v v v vv vv v v v v 80

140 100 80 120

v v v v v v v v vv v vv v v v vv v v v v v vv v v vv v vv v v v v vv v v v
o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 27 18 17 12 Female 21 14 14 10 Both sexes 24 16 16 11 Child mortality (probability of dying at ages 1-4, per 1,000) Male 4.6 4.4 4.2 2.4 Female 4.0 3.7 3.5 2.0 Both sexes 4.3 4.1 3.9 2.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 31 22 21 15 Female 25 17 17 12 Both sexes 28 20 19 13 Ratio of male to female mortality (per 100)

Infant 128 129 127 122

Child 114 121 120 118

Under-five 126 127 126 121

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

97

Burkina Faso
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

+ +

120

140 + + ++ + + + + + + + + + ++ + + + + + + + ++ Direct +
Fitted trend

100

80

1970

1980

1990 Date

2000

2010

80

o + Indirect V VR

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

200

250

5q0 1q0 4q1

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 152 125 103 86 Female 127 108 93 81 Both sexes 140 117 98 83 Child mortality (probability of dying at ages 1-4, per 1,000) Male 141 118 107 85 Female 128 113 108 92 Both sexes 135 116 108 88 Under-five mortality (deaths under age 5 per 1,000 live births) Male 272 228 199 163 Female 238 209 192 165 Both sexes 256 219 195 164 Ratio of male to female mortality (per 100)

Infant 120 115 111 106

Child 111 104 98 92

Under-five 114 109 104 99

98

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Burundi
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

o Direct + Indirect V VR

140

+ + + + + + + + +

+ + +

100

120

80

+ 1970 1980 1990 Date

Weighted av erage

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1

Deaths per 1000 live births Deaths per 1,000

200

100

150

Male Female Both

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 141 124 130 109 Female 122 108 113 95 Both sexes 132 116 122 102 Child mortality (probability of dying at ages 1-4, per 1,000) Male 112 97 98 79 Female 112 98 99 80 Both sexes 112 98 98 79 Under-five mortality (deaths under age 5 per 1,000 live births) Male 237 210 215 179 Female 221 196 201 167 Both sexes 229 203 208 173 Ratio of male to female mortality (per 100)

Infant 115 115 115 115

Child 99 99 99 98

Under-five 107 107 107 107

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

99

Cambodia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

+ ++ + + + + ++ + + + +
o Direct + Indirect V VR

100

120

+
Fitted trend

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50 100

200

300

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 244 118 95 75 Female 199 96 77 60 Both sexes 222 107 86 67 Child mortality (probability of dying at ages 1-4, per 1,000) Male 155 64 44 33 Female 158 64 42 30 Both sexes 157 64 43 31 Under-five mortality (deaths under age 5 per 1,000 live births) Male 360 175 135 105 Female 325 154 116 88 Both sexes 343 165 126 96 Ratio of male to female mortality (per 100)

Infant 122 123 124 125

Child 97 101 105 111

Under-five 111 114 117 120

100

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Cameroon
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

+ 140 + + 120 + 100 +


o Direct + Indirect V VR

++ + + + ++ + + + + + +

+ + + + ++ + + +
Fitted trend

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

200

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

80

120

160

60

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 126 97 98 98 Female 105 79 79 78 Both sexes 116 88 89 88 Child mortality (probability of dying at ages 1-4, per 1,000) Male 86 68 61 62 Female 86 69 64 65 Both sexes 86 68 63 64 Under-five mortality (deaths under age 5 per 1,000 live births) Male 201 158 153 154 Female 183 143 138 138 Both sexes 192 150 146 146 Ratio of male to female mortality (per 100)

Infant 120 122 124 126

Child 99 98 96 95

Under-five 110 111 111 112

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

101

Canada
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v v v v vvv v v v vv v v v vvv v vvv v vvvv v v v v vvv vv vv v

140 vvv v vvv v v v v vvv vv vv vvv vv vvvv v vvvvv v vv v v v 100 80


o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 16 8.9 6.3 5.8 Female 12 7.1 5.1 4.9 Both sexes 14 8.0 5.7 5.4 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.4 2.0 1.3 1.0 Female 2.7 1.6 1.1 .8 Both sexes 3.0 1.8 1.2 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 19 11 7.6 6.8 Female 15 8.7 6.2 5.7 Both sexes 17 10 6.9 6.3 Ratio of male to female mortality (per 100)

Infant 127 125 122 119

Child 124 124 122 122

Under-five 126 125 122 119

102

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Central African Republic


Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

o Direct + Indirect V VR

+ + + +

120

140

++ + + + + + + ++ + + + + + + ++ + + + + + +
Fitted trend

100

100

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

200

160

5q0 1q0 4q1 Male Female Both

120

80

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 137 116 118 117 Female 121 102 104 102 Both sexes 129 109 111 109 Child mortality (probability of dying at ages 1-4, per 1,000) Male 105 89 89 88 Female 106 87 86 84 Both sexes 105 88 88 86 Under-five mortality (deaths under age 5 per 1,000 live births) Male 227 194 197 194 Female 214 181 181 177 Both sexes 221 188 189 186 Ratio of male to female mortality (per 100)

Infant 113 114 114 115

Child 99 101 103 105

Under-five 106 108 109 110

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

103

Chad
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

120

+ + + + + + ++ + + + + + ++ + + + + +
o Direct + Indirect V VR

100

+
Fitted trend

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

150

200

250

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

100

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 158 140 138 142 Female 137 120 118 120 Both sexes 148 130 128 131 Child mortality (probability of dying at ages 1-4, per 1,000) Male 127 100 92 93 Female 117 95 90 94 Both sexes 122 97 91 94 Under-five mortality (deaths under age 5 per 1,000 live births) Male 265 226 217 222 Female 238 204 197 203 Both sexes 251 215 208 212 Ratio of male to female mortality (per 100)

Infant 115 116 118 119

Child 108 105 102 99

Under-five 111 111 110 110

104

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Chile
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

140

140

v vv v v v v vv vv vv v v vv v vv v vv v v v v v v vv vv vv v v vv v

v vv v vv v vv vv vvv v v v vvv vv v v vv v vv v vv vvv v v v v v

120

100

80

Fitted trend

80

o Direct + Indirect V VR

100

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

70

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

60

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 62 23 14 8.4 Female 52 19 12 6.8 Both sexes 57 21 13 7.6 Child mortality (probability of dying at ages 1-4, per 1,000) Male 11 3.9 2.6 1.8 Female 10 3.2 2.1 1.5 Both sexes 11 3.6 2.3 1.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 73 27 17 10 Female 61 22 14 8.3 Both sexes 67 25 15 9.2 Ratio of male to female mortality (per 100)

Infant 120 121 122 124

Child 112 122 120 113

Under-five 118 121 122 122

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

105

China
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 60 80 100 120 140

100

120

140

+ + + + + +
o Direct + Indirect V VR

60

80

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140


5q0 1q0 4q1

Deaths per 1000 live births Deaths per 1,000

80

60

40

20

1970

1980

1990 Decade

2000

2010

60 1970

80

100

120

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 60 36 26 21 Female 53 36 33 28 Both sexes 57 36 29 24 Child mortality (probability of dying at ages 1-4, per 1,000) Male 28 19 8.9 6.4 Female 31 21 10 6.6 Both sexes 29 20 9.2 6.5 Under-five mortality (deaths under age 5 per 1,000 live births) Male 86 54 34 27 Female 82 56 42 34 Both sexes 84 55 38 31 Ratio of male to female mortality (per 100)

Infant 112 100 79 76

Child 91 91 93 97

Under-five 105 96 82 80

106

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

China, Hong Kong SAR


Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v v v v v v v v v v v vv v v v v vv v vv vv v vv v vv v v v v v v vv v
Fitted trend

140

v v v

v v v v v v vv vv v vvvv vv vvv v vv v v vv v v v o Direct v


+ Indirect V VR

80

100

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

20

Deaths per 1000 live births

5q0 1q0 4q1

Male Female Both

Deaths per 1,000

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 16 8.7 4.8 3.9 Female 13 7.6 4.3 3.5 Both sexes 15 8.2 4.5 3.7 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.1 2.0 1.2 1.1 Female 3.0 1.8 1.1 .9 Both sexes 3.1 1.9 1.1 1.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male 20 11 6.0 5.0 Female 16 9.3 5.3 4.5 Both sexes 18 10 5.7 4.8 Ratio of male to female mortality (per 100)

Infant 123 116 112 111

Child 105 111 113 115

Under-five 119 115 112 112

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

107

Colombia
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

+ + + + ++ ++ vv + vv v v vvvv + ++ v+ + vv + v v vvvvvvv + v v + vv +vv v vvvv v + + + + + + + + + +

+ +

140

160

100

v vvv v v vv v

v vvvvv v vvvvv v vvv v vv vv v v v v

120

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

100

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 71 44 29 23 Female 58 34 22 17 Both sexes 65 39 26 20 Child mortality (probability of dying at ages 1-4, per 1,000) Male 28 15 11 8.8 Female 27 14 8.3 6.3 Both sexes 27 15 9.5 7.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 97 58 39 31 Female 83 48 30 23 Both sexes 90 53 35 27 Ratio of male to female mortality (per 100)

Infant 122 127 131 136

Child 104 114 127 140

Under-five 116 123 130 137

108

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Congo
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

+ 120 + + ++ 100 +
o Direct + Indirect V VR

++

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)

Deaths per 1000 live births Deaths per 1,000

100

120

5q0 1q0 4q1

Male Female Both

40 1970

60

80

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 82 69 75 85 Female 69 58 63 71 Both sexes 76 64 69 78 Child mortality (probability of dying at ages 1-4, per 1,000) Male 49 40 44 51 Female 52 42 46 54 Both sexes 51 41 45 52 Under-five mortality (deaths under age 5 per 1,000 live births) Male 127 106 115 131 Female 117 98 106 121 Both sexes 122 102 110 126 Ratio of male to female mortality (per 100)

Infant 119 119 119 119

Child 95 94 95 95

Under-five 109 109 109 109

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

109

Costa Rica
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v v v v v v vv v v vv v vvv v v v v v v vv vv v v v v v v v vvv v v v v

140 100 80 120

v vv v v v v v vvv v v vvv vv vvv vv vvv v vv v v vv vv vv v v v


o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 46 20 15 11 Female 37 16 12 9.1 Both sexes 41 18 13 10 Child mortality (probability of dying at ages 1-4, per 1,000) Male 11 3.9 2.3 1.8 Female 10 3.3 1.9 1.4 Both sexes 11 3.6 2.1 1.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 57 24 17 13 Female 47 19 14 11 Both sexes 52 22 15 12 Ratio of male to female mortality (per 100)

Infant 126 128 126 123

Child 109 119 123 128

Under-five 122 126 125 123

110

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Cte d'Ivoire
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 140

+ 140 + + 120 ++ + + + +

+ 100

+
o Direct + Indirect V VR

+
Fitted trend

80

1970

1980

1990 Date

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

50

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 134 116 109 100 Female 108 93 86 79 Both sexes 121 105 98 90 Child mortality (probability of dying at ages 1-4, per 1,000) Male 91 62 54 44 Female 82 58 50 41 Both sexes 86 60 52 43 Under-five mortality (deaths under age 5 per 1,000 live births) Male 212 171 157 140 Female 182 145 132 117 Both sexes 197 158 144 128 Ratio of male to female mortality (per 100)

Infant 123 125 126 127

Child 110 108 108 107

Under-five 117 118 119 120

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

111

Croatia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

120

120

v v v vv v vv vv v vv v v vv

v 140 v v vvv vv v vv v v v v v v 100 v v

140

v v vv v v v
Fitted trend

100

v
o Direct + Indirect V VR

v v v vv v

80

80

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 160 80 100 120 140

20

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 18 10 6.0 Female .. 13 7.6 5.6 Both sexes .. 16 8.6 5.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 2.7 1.5 1.2 Female .. 2.0 1.1 .8 Both sexes .. 2.3 1.3 1.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 21 11 7.2 Female .. 15 8.6 6.4 Both sexes .. 18 10 6.8 Ratio of male to female mortality (per 100)

Infant .. 135 127 108

Child .. 136 137 147

Under-five .. 135 128 113

112

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Cuba
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 vv v vv vv v vv vvv vv vv v v vv v v vv v vv v v vv v vv vv v v v 80 100 120 140

140 100 80 120

v vv v vv v v v vvv v v vvvv v v v v vv v v v vvv vv v v v v vv v v

o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

40

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

20

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 34 19 14 6.3 Female 27 14 11 5.0 Both sexes 30 17 12 5.6 Child mortality (probability of dying at ages 1-4, per 1,000) Male 5.5 3.9 3.0 2.2 Female 5.0 3.3 2.5 1.9 Both sexes 5.3 3.6 2.7 2.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 39 23 17 8.5 Female 32 18 13 6.9 Both sexes 36 20 15 7.7 Ratio of male to female mortality (per 100)

Infant 127 132 132 126

Child 111 119 119 116

Under-five 124 129 129 123

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

113

Czech Republic
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 vv vvv v v v v vv v v v v v v vv v vv vv v vv vv v v v v v v v v v v v 80 100 120 140

v v v v v vv v v vvv vv v v v v v v v vv v vv v v v v v v vvv v vv v v
o Direct + Indirect V VR

80

100

120

140

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

25

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 22 14 7.9 4.0 Female 16 10 6.0 3.0 Both sexes 19 12 7.0 3.5 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.5 2.1 1.7 1.0 Female 2.6 1.7 1.4 .8 Both sexes 3.1 1.9 1.5 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 26 16 10 4.9 Female 19 12 7.4 3.8 Both sexes 22 14 8.5 4.4 Ratio of male to female mortality (per 100)

Infant 136 134 132 131

Child 131 127 123 119

Under-five 135 133 130 128

114

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Democratic People's Republic of Korea


Average

Sex ratio of under-five mortality 120


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 120 90 100 110

90
o Direct + Indirect V VR

100

110

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)

Deaths per 1000 live births Deaths per 1,000

40

50

60

10

20

5q0 1q0 4q1

Male Female Both

30 1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 41 29 47 51 Female 38 27 43 47 Both sexes 40 28 45 49 Child mortality (probability of dying at ages 1-4, per 1,000) Male 12 7.1 15 17 Female 11 6.1 13 14 Both sexes 12 6.6 14 16 Under-five mortality (deaths under age 5 per 1,000 live births) Male 53 36 61 67 Female 48 33 56 61 Both sexes 51 34 59 64 Ratio of male to female mortality (per 100)

Infant 109 109 109 109

Child 115 116 115 115

Under-five 110 110 110 110

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

115

Democratic Republic of the Congo


Average

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 120 90 100 110

140

160

+ + +

120

+ + ++ +
o Direct + Indirect V VR

100

+ + + + + +

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 220 180

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

100

140

Male Female Both

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 136 122 124 117 Female 128 116 117 111 Both sexes 132 119 121 114 Child mortality (probability of dying at ages 1-4, per 1,000) Male 108 104 103 99 Female 96 93 92 89 Both sexes 102 98 98 94 Under-five mortality (deaths under age 5 per 1,000 live births) Male 229 213 214 205 Female 212 198 198 190 Both sexes 220 206 206 198 Ratio of male to female mortality (per 100)

Infant 106 106 106 106

Child 112 112 112 112

Under-five 108 108 108 108

116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Denmark
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

120

v v vv v v v v v v v v v vv v v v vv v v v v vv v vv v v v v v v v v v
Fitted trend

v v v v v v vv v v v v v vv v v v v vv v v v v v vv vv v v v vv v v v v v
Fitted trend

100 80
o Direct + Indirect V VR

140

1970

1980

1990 Date

2000

2010

80 1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

14

Deaths per 1000 live births Deaths per 1,000

10

12

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 12 9.0 5.9 4.6 Female 8.5 6.7 4.7 3.8 Both sexes 10 7.9 5.3 4.2 Child mortality (probability of dying at ages 1-4, per 1,000) Male 2.5 1.9 1.3 .9 Female 1.9 1.5 1.1 .7 Both sexes 2.2 1.7 1.2 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 14 11 7.2 5.5 Female 10 8.3 5.7 4.5 Both sexes 12 10 6.5 5.0 Ratio of male to female mortality (per 100)

Infant 138 133 127 122

Child 129 124 120 119

Under-five 137 132 126 121

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

117

Dominican Republic
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+ 140

+ + v

+ + ++ + v ++ + v + + v +v ++ + v + v + v v + + v+ v v vvvvvv vvvv+vv + vv + v +v + + + v v vv v ++ ++ + + v + + + + + o Direct


+ Indirect V VR Fitted trend

v v v v v vvv vv v vvvv v vv vvv v v v v v v v v v v vv v

120

100

80

80

100

120

60

1970

1980

1990 Date

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 99 75 49 35 Female 82 63 40 29 Both sexes 91 69 45 32 Child mortality (probability of dying at ages 1-4, per 1,000) Male 36 13 7.5 4.3 Female 32 12 7.1 4.0 Both sexes 34 13 7.3 4.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 131 87 56 39 Female 112 74 47 33 Both sexes 122 81 52 36 Ratio of male to female mortality (per 100)

Infant 120 121 121 121

Child 110 105 107 108

Under-five 117 118 119 120

118

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Ecuador
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 100 v v v vv vv vvv v v v vvvv v v v v vv vv v v v v v v v vv v v v v v 120

140

+ + v v v v v vv vvv v v v vvvv vv v + + v v vv vvvvv v vv+v v + v vvv v +


o Direct + Indirect V VR

100

120

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 97 69 43 26 Female 80 55 34 20 Both sexes 89 62 39 23 Child mortality (probability of dying at ages 1-4, per 1,000) Male 41 24 11 5.0 Female 43 24 11 4.8 Both sexes 42 24 11 4.9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 134 91 54 31 Female 120 78 44 24 Both sexes 127 84 49 28 Ratio of male to female mortality (per 100)

Infant 121 125 128 132

Child 94 98 100 103

Under-five 112 117 121 126

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

119

Egypt
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

160

Fitted trend

140

+ +

+ + + + ++ + vvv + + + + + ++ + + + + +v + + v + + + + + v + + +vvv + v + + ++ + + + + + vv vvv vvvvvv v + + + + + + +


o Direct + Indirect V VR

120

120

140

+ +

80

vvv vv vv vvvvvvvvvvv

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

100

v v vvv v v v v

100

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 130 90 58 41 Female 126 86 53 33 Both sexes 128 88 56 37 Child mortality (probability of dying at ages 1-4, per 1,000) Male 45 26 12 7.1 Female 56 33 15 6.2 Both sexes 51 29 13 6.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 169 114 70 48 Female 175 116 67 39 Both sexes 172 115 68 44 Ratio of male to female mortality (per 100)

Infant 103 105 109 122

Child 81 81 84 116

Under-five 97 98 104 121

120

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

El Salvador
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

+ ++ v v v + vv vvvv vv v vvvvv + vv v v vv v v v v +

100

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

60

o Direct + Indirect V VR

80

100

v vv v v v v

v v v v vv v

v vv v vv v vvvvv vv vv v v vv v vv v v v v

120

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

150

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

50

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 109 71 39 26 Female 90 59 33 22 Both sexes 100 66 36 24 Child mortality (probability of dying at ages 1-4, per 1,000) Male 52 38 7.5 4.7 Female 51 35 7.0 3.8 Both sexes 51 36 7.2 4.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 155 106 47 31 Female 136 92 39 25 Both sexes 146 99 43 28 Ratio of male to female mortality (per 100)

Infant 121 121 120 120

Child 102 109 109 122

Under-five 114 116 118 120

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

121

Eritrea
Average

Sex ratio of under-five mortality 120


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

90
o Direct + Indirect V VR

100

110

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Male Female Both

Deaths per 1000 live births Deaths per 1,000

50

100

150

200

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 143 121 90 64 Female 116 98 73 52 Both sexes 130 110 81 58 Child mortality (probability of dying at ages 1-4, per 1,000) Male 84 66 44 25 Female 77 61 41 24 Both sexes 80 64 42 25 Under-five mortality (deaths under age 5 per 1,000 live births) Male 215 180 130 87 Female 184 154 111 75 Both sexes 200 167 120 81 Ratio of male to female mortality (per 100)

Infant 123 123 123 123

Child 110 109 107 104

Under-five 117 117 117 117

122

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Estonia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 vv v v v vv v 120 v v vv v v v v v v v vv

v vvv v v vvv v v

v v v v v v vv v v v v v v v vv v v v

vv v v v v

140

140

120

v v

v 100

vv v vv v v v v v v v v

v v v v

100 80
o Direct + Indirect V VR

Fitted trend

80

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 21 17 14 6.3 Female 15 13 11 4.8 Both sexes 18 15 13 5.6 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.2 4.9 3.5 1.8 Female 2.3 3.6 2.7 1.4 Both sexes 2.7 4.3 3.1 1.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 24 22 18 8.1 Female 18 16 13 6.2 Both sexes 21 19 16 7.2 Ratio of male to female mortality (per 100)

Infant 135 136 133 131

Child 137 138 130 124

Under-five 135 136 132 130

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

123

Ethiopia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

+ +

140

+ +

100

+ + + ++ + + + + + + + + ++ + + + +
o Direct + Indirect V VR

120

+
Fitted trend

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

250

Deaths per 1000 live births Deaths per 1,000

Male Female Both

200

5q0 1q0 4q1

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 151 147 120 93 Female 123 119 96 74 Both sexes 137 133 108 84 Child mortality (probability of dying at ages 1-4, per 1,000) Male 112 116 89 61 Female 102 109 87 62 Both sexes 107 113 88 61 Under-five mortality (deaths under age 5 per 1,000 live births) Male 246 246 198 148 Female 213 215 174 131 Both sexes 229 231 186 140 Ratio of male to female mortality (per 100)

Infant 122 124 125 126

Child 109 107 103 97

Under-five 115 115 114 113

124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Finland
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v v

v v v vvvv v v v v v v v vvv v v v v vv v v v v v v vv v vv v v v v v v

140

140 100 120

100

v v vv v v v vv v vv v v v vvv v vv v vv v v v v v v vv v v v v v
Fitted trend

120 80

Fitted trend

1970

1980

1990 Date

2000

2010

80 1970

o Direct + Indirect V VR

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

14

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

12

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 11 6.9 4.8 3.4 Female 8.7 5.5 3.8 2.6 Both sexes 10 6.2 4.3 3.0 Child mortality (probability of dying at ages 1-4, per 1,000) Male 2.7 1.2 .9 .8 Female 1.9 1.0 .7 .6 Both sexes 2.3 1.1 .8 .7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 14 8.1 5.7 4.2 Female 11 6.5 4.5 3.2 Both sexes 12 7.3 5.1 3.7 Ratio of male to female mortality (per 100)

Infant 128 125 127 130

Child 138 130 127 128

Under-five 129 126 127 130

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

125

France
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v vv v vv v v v vv v vvv v v v vvvv vv v v vv v v v v v v v vv vv

140 100 80 120

v v vv v vvvvvvv v vv v v v v vv v v vv v vvv vvvvvv v vv v

o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 14 10 6.1 4.1 Female 11 7.4 4.7 3.2 Both sexes 12 8.6 5.4 3.7 Child mortality (probability of dying at ages 1-4, per 1,000) Male 2.9 2.0 1.3 .9 Female 2.3 1.6 1.1 .7 Both sexes 2.6 1.8 1.2 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 17 12 7.4 5.0 Female 13 9.0 5.7 3.9 Both sexes 15 10 6.6 4.5 Ratio of male to female mortality (per 100)

Infant 131 132 130 128

Child 126 128 127 126

Under-five 130 131 130 127

126

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Gabon
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

+ + + +

+ +

100
o Direct + Indirect V VR

120

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 120 81 67 63 Female 88 59 49 46 Both sexes 104 70 58 55 Child mortality (probability of dying at ages 1-4, per 1,000) Male 83 52 36 32 Female 76 49 35 32 Both sexes 79 50 35 32 Under-five mortality (deaths under age 5 per 1,000 live births) Male 193 128 100 94 Female 157 104 82 76 Both sexes 175 117 91 85 Ratio of male to female mortality (per 100)

Infant 137 137 137 137

Child 109 107 103 103

Under-five 123 123 123 123

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

127

Gambia
Average (Under-five m ortality only)

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Under-five mortality by sex (decade average) Deaths per female 1q0 (per Ratio of male to 1000 live births 100) 200 250 300 50 100 150

140

160

120

+ +
o Direct + Indirect V VR

+ + + + + +

+ + +

100

80

1970

1980

1990 Date

2000

2010

Weighted av erage

5q0

Male Female Both

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. .. .. .. Female .. .. .. .. Both sexes .. .. .. .. Child mortality (probability of dying at ages 1-4, per 1,000) Male .. .. .. .. Female .. .. .. .. Both sexes .. .. .. .. Under-five mortality (deaths under age 5 per 1,000 live births) Male 289 208 163 133 Female 253 182 143 116 Both sexes 267 192 151 123 Ratio of male to female mortality (per 100)

Infant .. .. .. ..

Child .. .. .. ..

Under-five 114 114 114 114

128

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Georgia
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

160

v + v + vv v +v + vv v v vvvvvv + v vv v v + v v v

140

vv v 140 vvv vvv v vvv v v

120

v v v v v v v v v
Fitted trend Adjusted trend

100

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

80 1970

o Direct + Indirect V VR

100

120

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

60

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 54 39 31 Female .. 40 30 25 Both sexes .. 47 35 28 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 8.6 5.3 3.7 Female .. 8.4 5.2 3.6 Both sexes .. 8.5 5.2 3.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 62 44 35 Female .. 48 35 28 Both sexes .. 55 40 32 Ratio of male to female mortality (per 100)

Infant .. 134 130 127

Child .. 102 102 105

Under-five .. 128 126 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

129

Germany
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 vv v vvvv vvvvv v v vv v v v vv vvvvvvvv vv v vv v v v v v

140 v vvvv vvvvv vv vvvvv v vvv vvv v v vvv v v v v v vv vv v 100 80


o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 20 10 5.9 4.3 Female 15 8.0 4.6 3.5 Both sexes 18 9.3 5.3 3.9 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.3 2.1 1.3 .9 Female 2.6 1.7 1.1 .7 Both sexes 3.0 1.9 1.2 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 23 13 7.2 5.2 Female 18 10 5.7 4.2 Both sexes 21 11 6.5 4.7 Ratio of male to female mortality (per 100)

Infant 131 130 127 123

Child 126 123 122 116

Under-five 130 129 126 122

130

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Ghana
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

+ +

+ + + +

140

+ + + +

80

+ ++ + + ++ + + + ++ + + + + + + + + + ++ + + + + +
Fitted trend +

100

120

60

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

140

5q0 1q0 4q1

60

80

100

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 110 95 75 80 Female 94 79 61 63 Both sexes 102 87 68 72 Child mortality (probability of dying at ages 1-4, per 1,000) Male 70 57 49 50 Female 73 56 44 43 Both sexes 72 57 47 47 Under-five mortality (deaths under age 5 per 1,000 live births) Male 172 146 120 126 Female 161 130 102 103 Both sexes 167 139 111 115 Ratio of male to female mortality (per 100)

Infant 117 120 123 126

Child 96 102 111 119

Under-five 107 112 117 123

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

131

Greece
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 vv v v vvvv vvv v v vv v v v v v v v vv v v vv vv v v v v v v v v v vv 120

140 100 vvv v vv v v vv vv v vvvv v v v v v vv vv v vv v vvv vv v vv v v v


o Direct + Indirect V VR Fitted trend

80

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 24 14 8.0 4.2 Female 20 11 6.8 3.6 Both sexes 23 13 7.4 3.9 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.1 1.7 1.1 .7 Female 2.8 1.5 .9 .7 Both sexes 3.0 1.6 1.0 .7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 28 16 9.1 4.9 Female 23 13 7.7 4.3 Both sexes 25 14 8.4 4.6 Ratio of male to female mortality (per 100)

Infant 120 121 119 116

Child 113 117 117 111

Under-five 119 120 118 115

132

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Guatemala
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 vv v v vvvv vv vvvvvv vv v vvv v vv vv v v v 100 120

o Direct + Indirect V VR

140

+ v + + v v v ++ + + + vvvv v vv + + vvv + v v v v vv+v v+ + +v v v v vv+ v v + + + + + + + + + +


Fitted trend

100

120

+ +

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

150

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

50

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 104 79 54 38 Female 89 67 46 31 Both sexes 97 73 50 34 Child mortality (probability of dying at ages 1-4, per 1,000) Male 60 37 17 10 Female 66 39 18 10 Both sexes 63 38 17 10 Under-five mortality (deaths under age 5 per 1,000 live births) Male 158 113 70 47 Female 149 103 63 41 Both sexes 153 108 67 44 Ratio of male to female mortality (per 100)

Infant 116 117 119 121

Child 92 95 96 102

Under-five 106 109 113 116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

133

Guinea
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

120

140

+ + +

+ ++ + + ++ + + ++ + + + + + +
Fitted trend

80
o Direct + Indirect V VR

100

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

300

Deaths per 1000 live births Deaths per 1,000

Male Female Both 5q0 1q0 4q1

100

150

200

250

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 179 158 137 113 Female 162 140 119 95 Both sexes 170 149 128 104 Child mortality (probability of dying at ages 1-4, per 1,000) Male 156 123 93 62 Female 162 126 93 62 Both sexes 159 125 93 62 Under-five mortality (deaths under age 5 per 1,000 live births) Male 307 262 217 168 Female 298 248 201 152 Both sexes 302 255 209 160 Ratio of male to female mortality (per 100)

Infant 111 113 116 118

Child 96 98 99 100

Under-five 103 106 108 111

134

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Guinea-Bissau
Average (Under-five m ortality only)

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Under-five mortality by sex (decade average) Deaths per female 1q0 (per Ratio of male to 1000 live births 100) 300 50 100 200

140

160

+ + + + ++ + + ++ + +
o Direct + Indirect V VR

120

100

+ +

80

1970

1980

1990 Date

2000

2010

Weighted av erage

5q0

Male Female Both

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. .. .. .. Female .. .. .. .. Both sexes .. .. .. .. Child mortality (probability of dying at ages 1-4, per 1,000) Male .. .. .. .. Female .. .. .. .. Both sexes .. .. .. .. Under-five mortality (deaths under age 5 per 1,000 live births) Male 310 275 254 224 Female 261 231 214 189 Both sexes 282 249 231 203 Ratio of male to female mortality (per 100)

Infant .. .. .. ..

Child .. .. .. ..

Under-five 119 119 119 119

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

135

Haiti
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

140

+ + + + + + v + + +

120

+ + + + + + + + ++ + + ++ + + + +
Fitted trend

v 100 80

80
o Direct + Indirect V VR

100

60

1970

1980

1990 Date

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

200

Deaths per 1000 live births Deaths per 1,000

Male Female Both

50

100

150

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 146 125 91 72 Female 119 103 75 60 Both sexes 133 114 83 66 Child mortality (probability of dying at ages 1-4, per 1,000) Male 75 56 37 24 Female 76 58 39 26 Both sexes 75 57 38 25 Under-five mortality (deaths under age 5 per 1,000 live births) Male 210 174 124 95 Female 186 155 110 84 Both sexes 198 165 117 90 Ratio of male to female mortality (per 100)

Infant 122 122 122 121

Child 98 96 95 93

Under-five 112 112 112 112

136

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Honduras
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+ + + + + v vvv + v vv v v
o Direct + Indirect V VR

140

100

100

+ v v v +v

+ + + +

v 120 vv v v v v vv

v vv v

120

v vv vv v

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

150

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

50

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 104 66 44 33 Female 80 52 35 27 Both sexes 92 59 39 30 Child mortality (probability of dying at ages 1-4, per 1,000) Male 63 32 16 12 Female 58 31 16 12 Both sexes 60 32 16 12 Under-five mortality (deaths under age 5 per 1,000 live births) Male 160 96 59 45 Female 134 81 50 39 Both sexes 147 89 55 42 Ratio of male to female mortality (per 100)

Infant 129 127 126 125

Child 107 102 97 96

Under-five 119 118 117 116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

137

Hungary
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v v v vv vv v v v v vvv vvv vv v v vvvvv v v v v v vv v v v v v v v v

140 100 80 120

v v v vv vv v v v vv vvv v vvv v v v v v vv v v vv v vv v v v v v v v v
o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 34 21 12 7.0 Female 27 16 10 5.8 Both sexes 31 19 11 6.4 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.1 2.4 2.0 1.4 Female 2.6 1.9 1.6 1.1 Both sexes 2.9 2.1 1.8 1.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 37 23 14 8.3 Female 30 18 11 6.9 Both sexes 34 21 13 7.6 Ratio of male to female mortality (per 100)

Infant 126 126 123 120

Child 119 126 129 128

Under-five 125 126 124 121

138

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

India
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 120 110

100 110 120

+ ++ + + + + v+ + + + ++ + + + ++ ++ v+ + v v ++ + + + v v v v v v v v vvvvvvvv v + vv v + vv v + vv v
o Direct + Indirect V VR

+ +

vv

v 100

60

70

vv vvvvvvv vv v v v v vv v vvvv v v v v v v v v v v v vv vvv v v vv vv v v v v vv v v v v v v


Fitted trend

80

90

Fitted trend

1970

1980

1990 Date

2000

2010

80 1970

90

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140


5q0 1q0 4q1

Deaths per 1000 live births Deaths per 1,000

150

100

50

1970

1980

1990 Decade

2000

2010

40 1970

60

80

100

120

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 113 93 74 57 Female 115 93 74 59 Both sexes 114 93 74 58 Child mortality (probability of dying at ages 1-4, per 1,000) Male 56 34 27 21 Female 74 50 42 38 Both sexes 64 42 34 29 Under-five mortality (deaths under age 5 per 1,000 live births) Male 162 124 99 77 Female 180 138 113 95 Both sexes 171 131 106 86 Ratio of male to female mortality (per 100)

Infant 98 100 100 97

Child 75 69 63 56

Under-five 90 89 87 81

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

139

Indonesia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

+ 140

+ +

+ +

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

+ + + + + + + + ++ + + + + + ++ + + + + + ++ + + + + + + + +

100

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 131 88 56 33 Female 101 70 46 28 Both sexes 116 79 52 30 Child mortality (probability of dying at ages 1-4, per 1,000) Male 62 35 18 7.0 Female 60 34 17 6.3 Both sexes 61 35 17 6.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 184 120 73 40 Female 155 102 62 34 Both sexes 170 111 68 37 Ratio of male to female mortality (per 100)

Infant 130 126 121 117

Child 102 104 106 113

Under-five 119 118 117 116

140

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Iran (Islamic Republic of)


Average

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v 140 v 120 v vv

140

160

v 120 vv

100

80

60

Weighted av erage

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 150


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

50

100

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 110 81 51 33 Female 104 76 48 31 Both sexes 107 79 49 32 Child mortality (probability of dying at ages 1-4, per 1,000) Male 46 29 13 6.7 Female 33 20 8.3 4.0 Both sexes 40 25 11 5.4 Under-five mortality (deaths under age 5 per 1,000 live births) Male 151 107 63 40 Female 134 95 56 35 Both sexes 143 101 59 37 Ratio of male to female mortality (per 100)

Infant 106 106 106 106

Child 139 143 157 171

Under-five 113 113 113 113

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

141

Iraq
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

+ v vv + + + + ++

vvv 120 100

120

+ +

+ + + ++ + + + + + 1990 Date

100

80

Fitted trend

1970

1980

2000

2010

80

o Direct + Indirect V VR

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

100

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 72 55 51 39 Female 63 46 41 30 Both sexes 68 50 46 35 Child mortality (probability of dying at ages 1-4, per 1,000) Male 28 17 15 9.0 Female 26 15 13 7.7 Both sexes 27 16 14 8.4 Under-five mortality (deaths under age 5 per 1,000 live births) Male 98 71 65 48 Female 87 61 53 38 Both sexes 93 66 59 43 Ratio of male to female mortality (per 100)

Infant 115 119 124 128

Child 109 112 115 117

Under-five 113 117 121 126

142

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Ireland
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v v v v v v v v vvv v v v v

140

v v v v v vvv vv v v v v vv v v v v v v vv vv v v v v v v vv v
o Direct + Indirect V VR

140 100 120

v vv v v v v v v v v v vv v vv v vv vv vv v

100

120

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

v Fitted trend 1970 1980 1990 Date 2000 2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 18 10 6.7 4.7 Female 15 7.9 5.4 3.9 Both sexes 16 8.9 6.1 4.3 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.5 2.1 1.3 .9 Female 2.8 1.7 1.1 .7 Both sexes 3.2 1.9 1.2 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 22 12 8.0 5.6 Female 17 10 6.5 4.6 Both sexes 20 11 7.3 5.1 Ratio of male to female mortality (per 100)

Infant 125 125 123 121

Child 124 127 123 119

Under-five 125 125 123 121

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

143

Israel
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

v v vv v vv v v v vvv v v v v v v v v vv v v v v v v v
o Direct + Indirect V VR

120

120

vv

v v vv vv

v v vv v v

100

80

Fitted trend

80

100

vv v v

v vv v v v v v v v vv v v v v v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 23 13 7.7 4.7 Female 19 11 6.7 4.1 Both sexes 21 12 7.2 4.4 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.9 2.3 1.7 1.4 Female 3.5 2.2 1.5 1.0 Both sexes 3.7 2.2 1.6 1.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 27 15 9.4 6.1 Female 23 13 8.2 5.1 Both sexes 25 14 8.8 5.6 Ratio of male to female mortality (per 100)

Infant 119 115 114 116

Child 112 106 116 130

Under-five 118 113 114 119

144

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Italy
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 v v v v v v vvvvv vvv vv vv vv v vv v v vv v

140 v v vvvvvvvvv vv vv vvv v v v v v v vvv v v v v v v vv v v

v v v vv v v v v

120

100

80

Fitted trend

80

o Direct + Indirect V VR

100

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 22 12 6.8 3.8 Female 18 9.3 5.7 3.3 Both sexes 20 11 6.3 3.6 Child mortality (probability of dying at ages 1-4, per 1,000) Male 2.6 1.5 1.3 .6 Female 2.3 1.3 1.1 .6 Both sexes 2.4 1.4 1.2 .6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 25 13 8.1 4.5 Female 20 11 6.9 3.9 Both sexes 23 12 7.5 4.2 Ratio of male to female mortality (per 100)

Infant 125 124 120 115

Child 115 114 111 103

Under-five 124 123 118 113

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

145

Japan
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 v vvvv v vvvvv v v vv vv v v vv vvv vv vv v v v v v v vv v v v 120

140 v vv v v v vvvvv v v vv vv v v v v v vv vv v v v v v v vv v vv v v
o Direct + Indirect V VR

80

100

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

12

14

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 11 6.0 4.4 3.0 Female 8.6 5.0 3.8 2.6 Both sexes 10 5.5 4.1 2.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.9 2.3 1.7 1.0 Female 3.0 1.7 1.3 .8 Both sexes 3.4 2.0 1.5 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 15 8.3 6.1 4.0 Female 12 6.7 5.1 3.4 Both sexes 13 7.5 5.6 3.7 Ratio of male to female mortality (per 100)

Infant 128 121 117 114

Child 129 129 125 120

Under-five 128 123 119 115

146

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Jordan
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 140

+ +

140

+ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + ++ + + + + ++
o Direct + Indirect V VR +

+ +

80

100

120

+ + + 1990 Date

60

Fitted trend

1970

1980

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 73 49 33 24 Female 74 45 28 19 Both sexes 74 47 30 21 Child mortality (probability of dying at ages 1-4, per 1,000) Male 15 8.5 4.8 2.8 Female 16 8.7 4.8 2.8 Both sexes 16 8.6 4.8 2.8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 87 57 38 27 Female 89 53 33 21 Both sexes 88 55 35 24 Ratio of male to female mortality (per 100)

Infant 99 109 118 128

Child 95 97 99 98

Under-five 98 107 115 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

147

Kazakhstan
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

160

+ + +

140

100

+ 80

60

80

o Direct + Indirect Fitted trend V VR

100

++

120

+ vv v vvv + vvvvv vv vvv v v v v v vvvv + vvv + +

v v vvvv vvv v vvv v vv v v v vvv v vv vv v

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex differentials (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 62 54 33 Female .. 50 40 25 Both sexes .. 56 47 29 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 12 11 6.2 Female .. 11 10 5.0 Both sexes .. 11 10 5.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 73 64 39 Female .. 60 50 30 Both sexes .. 67 57 34 Ratio of male to female mortality (per 100)

Infant .. 126 133 131

Child .. 107 119 125

Under-five .. 122 130 130

148

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Kenya
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

140

+ +

+ + + ++ + + + +++ + + + + + + + ++ + + + + + + + + + + + + +

80
o Direct + Indirect V VR

100

120

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

140

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

60

80

100

120

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 91 73 73 74 Female 81 63 61 60 Both sexes 86 68 67 67 Child mortality (probability of dying at ages 1-4, per 1,000) Male 58 46 46 46 Female 53 42 42 43 Both sexes 56 44 44 45 Under-five mortality (deaths under age 5 per 1,000 live births) Male 144 116 115 117 Female 130 103 101 100 Both sexes 137 109 108 109 Ratio of male to female mortality (per 100)

Infant 112 116 120 124

Child 110 109 108 107

Under-five 111 113 114 116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

149

Kuwait
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 v v v v v v v vv v vv vv v v vv v vv v v vv vvv vv v v v v vv v 80 100 120

+ 140 + + + + 120 v v v vv vv vvvvv v v + ++ + v + + + v v v v+ v vv v v v v v v v v vvv v v vv


o Direct + Indirect V VR

80

100

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 38 22 13 10 Female 35 19 11 8.8 Both sexes 37 20 12 9.4 Child mortality (probability of dying at ages 1-4, per 1,000) Male 4.6 2.7 1.6 1.2 Female 4.9 2.3 1.2 1.0 Both sexes 4.7 2.5 1.4 1.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 43 24 15 11 Female 39 21 12 10 Both sexes 41 23 14 11 Ratio of male to female mortality (per 100)

Infant 110 116 117 115

Child 94 123 137 122

Under-five 108 117 119 116

150

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Kyrgyzstan
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

160

+ +

140

80

60

Fitted trend

80

o Direct + Indirect V VR

100

v v vvv+ v v v v v v vvvv v v v vv v v v + + vvvv + + + +

100

120

v vvv v v v v vvv v v v vv v v v vvvvv v vv

120

140

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

120

Deaths per 1000 live births Deaths per 1,000

40

60

80

100

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

20

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 83 61 44 Female .. 66 46 34 Both sexes .. 75 54 39 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 15 12 8.9 Female .. 18 12 8.2 Both sexes .. 16 12 8.5 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 97 73 52 Female .. 83 58 42 Both sexes .. 90 65 47 Ratio of male to female mortality (per 100)

Infant .. 126 133 129

Child .. 88 100 109

Under-five .. 118 126 125

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

151

Lao People's Democratic Republic


Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

120

140

+ +
o Direct + Indirect V VR

100

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Male Female Both

Deaths per 1000 live births Deaths per 1,000

50

100

150

200

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 149 125 87 60 Female 124 104 73 50 Both sexes 136 115 80 55 Child mortality (probability of dying at ages 1-4, per 1,000) Male 78 61 35 19 Female 77 60 36 20 Both sexes 77 60 35 19 Under-five mortality (deaths under age 5 per 1,000 live births) Male 215 178 119 77 Female 191 158 106 69 Both sexes 203 168 113 73 Ratio of male to female mortality (per 100)

Infant 120 120 120 120

Child 102 101 98 94

Under-five 113 113 113 113

152

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Latvia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v v v v vv v v v v v v v vv v v v v vv v v v v v v v v v v v v v vv v v v 80 v

v v v v v vv v v v vv v

140

100

80

o Direct + Indirect V VR

v
Fitted trend

100

vv v v vv v v v v vv v vv v v vv v v v v vv v

120

120

140

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 160 80 100 120 140

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 23 15 17 9.0 Female 17 11 14 7.9 Both sexes 20 13 16 8.5 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.8 5.1 4.0 2.4 Female 2.9 3.8 2.9 1.6 Both sexes 3.4 4.5 3.5 2.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male 27 20 21 11 Female 20 15 17 10 Both sexes 24 17 19 11 Ratio of male to female mortality (per 100)

Infant 136 133 123 114

Child 130 132 135 148

Under-five 135 132 125 119

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

153

Lesotho
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 140

+ 140 + + + ++ + + + + ++ + + + + + + ++ + + + +
o Direct + Indirect V VR

120

+ +

80

100

+
Weighted av erage

60

1970

1980

1990 Date

2000

2010

60

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 123 94 74 79 Female 110 84 66 70 Both sexes 116 89 70 74 Child mortality (probability of dying at ages 1-4, per 1,000) Male 69 48 39 43 Female 53 38 31 34 Both sexes 61 43 35 38 Under-five mortality (deaths under age 5 per 1,000 live births) Male 183 138 111 118 Female 157 118 95 101 Both sexes 170 128 103 110 Ratio of male to female mortality (per 100)

Infant 112 112 112 112

Child 129 129 128 128

Under-five 117 117 117 117

154

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Liberia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

++

140

+ + +
o Direct + Indirect V VR

+ + + + + + + ++ + + + ++ + + + + + + + +
Fitted trend

120 100

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

100

150

200

250

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 163 156 135 106 Female 132 129 114 92 Both sexes 148 143 125 99 Child mortality (probability of dying at ages 1-4, per 1,000) Male 125 117 92 57 Female 113 107 86 55 Both sexes 119 112 89 56 Under-five mortality (deaths under age 5 per 1,000 live births) Male 267 254 215 157 Female 230 222 191 142 Both sexes 249 239 203 150 Ratio of male to female mortality (per 100)

Infant 123 120 118 115

Child 111 109 107 104

Under-five 116 114 113 111

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

155

Libyan Arab Jamahiriya


Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 100 v v v v v 140

o Direct + Indirect V VR

120 vv vv v 100

140

v v

v v
Weighted av erage Adjusted weighted av erage

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80 1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 100


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

20

40

60

80

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 92 47 29 21 Female 81 41 25 18 Both sexes 87 44 27 19 Child mortality (probability of dying at ages 1-4, per 1,000) Male 16 6.8 2.9 1.4 Female 20 8.7 4.2 2.4 Both sexes 18 7.7 3.6 1.9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 107 53 32 22 Female 99 49 30 20 Both sexes 103 51 31 21 Ratio of male to female mortality (per 100)

Infant 114 114 114 114

Child 82 78 69 60

Under-five 108 108 108 108

156

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Lithuania
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality 160 Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) v v 140 v vv v vv v v v vv v v v v vv v v v v v v v
Fitted trend

v v v v v vv v v v v v vv v vvvv v vv vv vv vvvv v v v v v v v v v v v
o Direct + Indirect V VR

140

120

100

80

Fitted trend

1970

1980

1990 Date

2000

2010

80 1970

100

120

vv v v v v v vv v vvv v v

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

25

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 22 14 13 7.3 Female 17 11 11 6.2 Both sexes 20 13 12 6.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.4 4.5 3.3 2.0 Female 2.9 3.6 2.5 1.4 Both sexes 3.2 4.1 2.9 1.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 26 19 17 9.3 Female 20 15 13 7.6 Both sexes 23 17 15 8.5 Ratio of male to female mortality (per 100)

Infant 132 130 124 117

Child 116 126 134 143

Under-five 130 129 126 122

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

157

Madagascar
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ 120 + +

+ + +

+ +

++ + + + + ++ + ++

80
o Direct + Indirect V VR

100

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

5q0 1q0 4q1

50

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 131 119 100 81 Female 123 102 80 59 Both sexes 127 110 90 70 Child mortality (probability of dying at ages 1-4, per 1,000) Male 97 82 62 43 Female 98 79 58 40 Both sexes 98 81 60 42 Under-five mortality (deaths under age 5 per 1,000 live births) Male 216 191 156 120 Female 210 173 133 97 Both sexes 213 182 145 109 Ratio of male to female mortality (per 100)

Infant 107 116 126 136

Child 99 103 107 109

Under-five 103 110 117 125

158

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Malawi
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ + + + + ++ + + + + + + + + + +
o Direct + Indirect V VR

100

+ + + + ++ + + + ++ + + + + + +

80

120

60

Fitted trend +

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

300

Deaths per 1000 live births Deaths per 1,000

100

150

200

250

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

50

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 185 154 125 94 Female 165 138 113 86 Both sexes 175 146 119 90 Child mortality (probability of dying at ages 1-4, per 1,000) Male 147 121 86 50 Female 141 114 78 44 Both sexes 144 118 82 47 Under-five mortality (deaths under age 5 per 1,000 live births) Male 305 257 201 140 Female 283 236 182 126 Both sexes 294 247 192 133 Ratio of male to female mortality (per 100)

Infant 112 112 111 110

Child 104 107 110 115

Under-five 108 109 110 111

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

159

Malaysia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v vv vv v v v v v v v v v v v vv v vv v v v v v v vv vvvv v vv

140 v vv vvvvv v v vvv

vv v v v v vv v vv v vv v vv v v

100 80
o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 43 25 15 10 Female 33 20 12 8.6 Both sexes 38 23 13 9.5 Child mortality (probability of dying at ages 1-4, per 1,000) Male 14 7.6 4.4 3.0 Female 14 7.3 3.9 2.4 Both sexes 14 7.4 4.1 2.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 56 32 19 13 Female 46 27 16 11 Both sexes 51 30 17 12 Ratio of male to female mortality (per 100)

Infant 129 126 123 121

Child 101 105 112 126

Under-five 121 121 120 122

160

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Mali
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

o Direct + Indirect V VR

140

+ +

120

+ + ++ + + + + +++ + + + ++ + + + + + + + + + +
Fitted trend

100

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both 5q0 1q0 4q1

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

150

200

250

300

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 167 150 133 117 Female 142 129 116 103 Both sexes 155 140 125 110 Child mortality (probability of dying at ages 1-4, per 1,000) Male 192 154 130 106 Female 194 152 125 97 Both sexes 193 153 127 102 Under-five mortality (deaths under age 5 per 1,000 live births) Male 327 281 246 210 Female 309 262 226 190 Both sexes 318 271 236 200 Ratio of male to female mortality (per 100)

Infant 117 116 115 114

Child 99 101 105 108

Under-five 106 107 109 111

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

161

Mauritania
Average

Sex ratio of under-five mortality 120


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

90
o Direct + Indirect V VR

100

110

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 200


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 140 89 81 81 Female 126 77 67 64 Both sexes 133 83 74 73 Child mortality (probability of dying at ages 1-4, per 1,000) Male 73 65 55 54 Female 80 65 53 49 Both sexes 76 65 54 52 Under-five mortality (deaths under age 5 per 1,000 live births) Male 203 148 132 131 Female 196 136 116 110 Both sexes 199 142 124 121 Ratio of male to female mortality (per 100)

Infant 112 116 121 126

Child 91 100 105 111

Under-five 104 109 114 119

162

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Mauritius
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v vv v v v v v vv v v v vv v v v v v v v vv v vv v vv v v v v v v v v vv

v v v v v

140

100

80

Fitted trend

80

o Direct + Indirect V VR

100

v v v v v vv v v v v vv vv v v v vv vv v vv v v vv vv v v v v v

120

120

140

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

60

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 52 29 21 17 Female 41 22 16 13 Both sexes 47 26 19 15 Child mortality (probability of dying at ages 1-4, per 1,000) Male 15 9.2 5.0 3.2 Female 16 8.0 4.3 2.8 Both sexes 16 8.6 4.7 3.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male 67 38 26 20 Female 57 30 20 16 Both sexes 62 34 23 18 Ratio of male to female mortality (per 100)

Infant 126 131 133 131

Child 98 114 116 115

Under-five 118 127 129 128

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

163

Mexico
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 vvvvvvvvvv vvvvvv vv v v vvvvvvvv v vvvvvv vvv 80 100 120

140

160

+ + v vv vvvv vvvvvvv vvvvvvvvvv vv v v + vvvv vvvvvv + + +

80
o Direct + Indirect V VR

100

120

+
Fitted trend

60

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 69 47 34 21 Female 57 39 27 16 Both sexes 63 43 30 19 Child mortality (probability of dying at ages 1-4, per 1,000) Male 26 10 6.5 4.2 Female 26 10 6.0 3.6 Both sexes 26 10 6.2 3.9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 93 57 40 25 Female 81 49 33 20 Both sexes 87 53 36 22 Ratio of male to female mortality (per 100)

Infant 120 122 124 126

Child 100 101 108 119

Under-five 114 117 121 125

164

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Mongolia
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+ + + + +

140

v v v v +v v v+ v v + + v

v+ v

v v v

120

120

v v v v vv v v v v v v

v v

100

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

20

40

60

80

100

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 91 70 44 Female .. 68 52 33 Both sexes .. 80 61 39 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 38 25 11 Female .. 31 21 9.2 Both sexes .. 35 23 10 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 126 93 54 Female .. 97 71 42 Both sexes .. 112 82 48 Ratio of male to female mortality (per 100)

Infant .. 135 135 135

Child .. 123 120 115

Under-five .. 130 130 130

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

165

Morocco
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

160

+ + vv+

120

+ + + + + + vvv vv + ++ + + + +
o Direct + Indirect V VR

v v v vvv v

100

80

+ +
Fitted trend

100

120

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births

Deaths per 1,000

50

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 122 86 57 38 Female 109 74 48 30 Both sexes 116 80 52 34 Child mortality (probability of dying at ages 1-4, per 1,000) Male 54 37 16 7.1 Female 62 40 17 7.3 Both sexes 58 39 17 7.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 169 120 73 44 Female 165 111 64 37 Both sexes 167 116 68 41 Ratio of male to female mortality (per 100)

Infant 112 116 120 125

Child 88 95 96 98

Under-five 103 109 114 119

166

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Mozambique
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ + + + + + + + + ++ + + ++++ + + + + ++ + + + +
o Direct + Indirect V VR

80

100

120

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

250

Deaths per 1000 live births Deaths per 1,000

Male Female Both 5q0 1q0 4q1

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 164 152 131 100 Female 140 133 118 93 Both sexes 152 143 125 97 Child mortality (probability of dying at ages 1-4, per 1,000) Male 118 124 108 80 Female 121 121 102 72 Both sexes 120 122 105 76 Under-five mortality (deaths under age 5 per 1,000 live births) Male 263 257 225 172 Female 244 238 208 158 Both sexes 254 248 217 165 Ratio of male to female mortality (per 100)

Infant 117 114 111 108

Child 98 102 106 110

Under-five 108 108 108 108

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

167

Myanmar
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

100
o Direct + Indirect V VR

120

140

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

40 1970

60

80 100

140

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 114 97 93 87 Female 86 73 70 66 Both sexes 100 86 82 77 Child mortality (probability of dying at ages 1-4, per 1,000) Male 66 50 47 42 Female 59 46 43 38 Both sexes 63 48 45 40 Under-five mortality (deaths under age 5 per 1,000 live births) Male 172 143 136 126 Female 139 116 110 102 Both sexes 156 130 123 114 Ratio of male to female mortality (per 100)

Infant 133 133 133 133

Child 112 110 109 109

Under-five 124 124 124 124

168

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Namibia
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ + + + + + +

120

+ + + + + + +

100

80

+
o Direct + Indirect V VR

+
Fitted trend

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

100 120 140

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

40

60

80

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 99 76 62 48 Female 89 64 49 36 Both sexes 94 70 55 42 Child mortality (probability of dying at ages 1-4, per 1,000) Male 47 32 25 22 Female 43 29 22 19 Both sexes 45 31 24 21 Under-five mortality (deaths under age 5 per 1,000 live births) Male 141 106 85 70 Female 128 91 70 55 Both sexes 134 99 78 62 Ratio of male to female mortality (per 100)

Infant 110 118 126 134

Child 110 111 113 117

Under-five 110 116 122 128

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

169

Nepal
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 140

140

120

+ + + ++ + ++ + + + + + + + + + + + + ++ + + + + + + + +
o Direct + Indirect V VR

80

100

60

Fitted trend

1970

1980

1990 Date

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 155 120 86 51 Female 141 109 78 46 Both sexes 148 115 82 48 Child mortality (probability of dying at ages 1-4, per 1,000) Male 78 55 33 14 Female 95 66 40 17 Both sexes 86 61 37 16 Under-five mortality (deaths under age 5 per 1,000 live births) Male 220 169 116 64 Female 222 168 115 62 Both sexes 221 168 116 63 Ratio of male to female mortality (per 100)

Infant 110 110 111 111

Child 82 83 83 80

Under-five 99 100 101 103

170

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Netherlands
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v v v vv vv v v v v v vv v v v vvv v v v vv vv v vv v vv v v v v v v v 80 100 120 140

140

v v

100

120

v v v vv v v vv v vv v vv v vv vvv v v vv v vv

v v v vv v vv v v

80

o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

12

14

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 12 8.9 6.4 5.0 Female 9.0 6.8 5.0 4.0 Both sexes 10 7.9 5.7 4.5 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.0 2.0 1.3 1.0 Female 2.3 1.6 1.1 .8 Both sexes 2.6 1.8 1.2 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 15 11 7.7 6.0 Female 11 8.4 6.1 4.8 Both sexes 13 10 6.9 5.4 Ratio of male to female mortality (per 100)

Infant 131 130 128 124

Child 131 127 125 124

Under-five 131 130 127 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

171

New Zealand
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

140

140

v vv v vv vv

v vv v

v v v v vv

v v v vv v v v v v v

v v

v vv vv v

120

v v vv v

vv v v

100

80

Fitted trend

80

o Direct + Indirect V VR

100

120

v v v v

v vvv v v vvv v v v v v v v vv v v v v v v vv v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

20

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 17 13 7.8 5.8 Female 13 10 6.2 4.7 Both sexes 15 12 7.0 5.3 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.7 2.8 1.8 1.2 Female 2.9 2.1 1.4 1.0 Both sexes 3.3 2.4 1.6 1.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 21 16 10 7.0 Female 16 12 7.6 5.8 Both sexes 18 14 8.6 6.4 Ratio of male to female mortality (per 100)

Infant 132 129 126 124

Child 127 132 124 111

Under-five 131 130 126 121

172

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Nicaragua
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+ 140 + +

100

vv

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

+ v + + + vv v + v v v v v + +v v v v v v + v ++ v v v v v v + + + v + v + +

v vv v v v vv

v v v vv v v v vvv v v v v v v v v

120

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

150

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

50

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 103 80 45 27 Female 85 65 36 21 Both sexes 94 72 41 24 Child mortality (probability of dying at ages 1-4, per 1,000) Male 61 36 13 5.3 Female 53 31 12 4.8 Both sexes 57 34 13 5.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 157 113 58 32 Female 133 94 47 26 Both sexes 146 104 53 29 Ratio of male to female mortality (per 100)

Infant 121 124 127 130

Child 115 115 113 110

Under-five 118 120 123 126

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

173

Niger
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

o Direct + Indirect V VR

140

+ 120 + + + +

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

+ + + + + + + + + ++ + + + + + + ++ + + +

100

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both 5q0 1q0 4q1

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

150

200

250

300

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 172 169 147 103 Female 151 149 131 93 Both sexes 161 159 139 98 Child mortality (probability of dying at ages 1-4, per 1,000) Male 182 166 146 103 Female 197 176 151 103 Both sexes 189 171 149 103 Under-five mortality (deaths under age 5 per 1,000 live births) Male 322 307 272 195 Female 318 300 262 186 Both sexes 320 303 267 191 Ratio of male to female mortality (per 100)

Infant 114 113 112 111

Child 92 94 97 99

Under-five 101 102 103 105

174

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Nigeria
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

+ 140

120

+ + +

+ + + ++ + + ++ + + ++ + + + + + + + +

80
o Direct + Indirect V VR

100

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

200

250

5q0 1q0 4q1 Male Female Both

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

100

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 153 141 140 120 Female 132 122 121 103 Both sexes 143 132 130 112 Child mortality (probability of dying at ages 1-4, per 1,000) Male 122 113 109 91 Female 118 111 110 93 Both sexes 120 112 109 92 Under-five mortality (deaths under age 5 per 1,000 live births) Male 256 238 234 200 Female 235 220 217 187 Both sexes 246 229 226 193 Ratio of male to female mortality (per 100)

Infant 116 116 116 116

Child 103 101 100 98

Under-five 109 108 108 107

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

175

Norway
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v 140

v v v v vv v v v v v v v vv v v v v v vv v v v v v v v v v v v v v v v v v v
o Direct + Indirect V VR Fitted trend

100

100

vv vv v v v v vv v v v v v v v vv vv v v v v vv v v v vv v v v v v v

120

140

80

80

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 160 80 100 120 140

14

Deaths per 1000 live births Deaths per 1,000

10

12

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 12 9.2 5.1 3.6 Female 8.9 7.1 4.0 2.8 Both sexes 10 8.2 4.6 3.2 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.0 2.1 1.3 .9 Female 2.1 1.5 1.1 .7 Both sexes 2.5 1.8 1.2 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 15 11 6.5 4.4 Female 11 8.7 5.1 3.5 Both sexes 13 10 5.8 4.0 Ratio of male to female mortality (per 100)

Infant 130 129 127 126

Child 144 135 127 121

Under-five 133 130 127 125

176

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Occupied Palestinian Territory


Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

Weighted av erage Adjusted weighted av erage

140

120

100

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80 1970

o Direct + Indirect V VR

100

120

140

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 100


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

20

40

60

80

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 78 46 28 20 Female 69 40 25 18 Both sexes 74 43 26 19 Child mortality (probability of dying at ages 1-4, per 1,000) Male 22 11 5.8 3.7 Female 17 8.4 4.3 2.7 Both sexes 20 10 5.1 3.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 99 56 33 24 Female 85 48 29 21 Both sexes 92 52 31 22 Ratio of male to female mortality (per 100)

Infant 113 113 113 113

Child 130 132 134 137

Under-five 116 116 116 116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

177

Pakistan
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

o Direct + Indirect V VR

Fitted trend Adjusted trend

140

140

v 120 v v v vv v v v 80

120

80

+ + + v +++ + + + ++ + + + v + + + v v + + v v + ++ + ++ + v v + + v + ++ + + + + v

100

100

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

140

5q0 1q0 4q1

60

80 100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

40

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 113 100 87 73 Female 103 89 75 61 Both sexes 108 95 81 67 Child mortality (probability of dying at ages 1-4, per 1,000) Male 60 50 40 30 Female 71 55 42 30 Both sexes 66 52 41 30 Under-five mortality (deaths under age 5 per 1,000 live births) Male 167 145 124 100 Female 167 139 114 89 Both sexes 167 142 119 95 Ratio of male to female mortality (per 100)

Infant 110 113 116 120

Child 85 90 95 100

Under-five 100 104 109 113

178

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Panama
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 100 120 v vv v v vv v vvv vv v vv v v vvv v vv vv v v vvv vvv v v v vv v

+ 140

100

vv vv v v + v v vv v v v v v v v v v v v v vvvv v v+ v v v v v vv v v v v
o Direct + Indirect V VR

120

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

60

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 44 33 28 21 Female 36 28 23 17 Both sexes 40 31 25 19 Child mortality (probability of dying at ages 1-4, per 1,000) Male 22 10 7.2 6.5 Female 21 10 6.7 5.6 Both sexes 21 10 6.9 6.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 64 43 35 28 Female 56 37 29 23 Both sexes 60 40 32 25 Ratio of male to female mortality (per 100)

Infant 121 121 121 122

Child 102 103 108 115

Under-five 114 116 118 120

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

179

Papua New Guinea


Average

Sex ratio of under-five mortality 120


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

vv 110 v

v v vv vv v v

100

v v v vv vvv v vv v

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

90

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 112 82 71 57 Female 100 73 63 50 Both sexes 106 78 67 54 Child mortality (probability of dying at ages 1-4, per 1,000) Male 60 38 32 23 Female 50 32 27 19 Both sexes 55 35 29 21 Under-five mortality (deaths under age 5 per 1,000 live births) Male 165 117 101 78 Female 145 103 89 69 Both sexes 156 110 95 74 Ratio of male to female mortality (per 100)

Infant 112 112 112 112

Child 118 118 118 118

Under-five 114 114 114 114

180

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Paraguay
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

o Direct + Indirect V VR

+ v + + vvv v + vv v v + v v vv v v v vvvv v

140

v v v v v v v v

vv vvv v v v vv vv

120

100

100

120

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

40

50

60

70

5q0 1q0 4q1

20

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 54 51 45 38 Female 49 44 36 29 Both sexes 52 48 41 34 Child mortality (probability of dying at ages 1-4, per 1,000) Male 20 17 12 7.1 Female 19 15 11 6.6 Both sexes 20 16 11 6.9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 74 67 56 45 Female 67 58 47 36 Both sexes 71 63 52 40 Ratio of male to female mortality (per 100)

Infant 110 117 124 132

Child 108 110 110 107

Under-five 110 115 121 127

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

181

Peru
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 80 100 140 vvvvvv vv vv vvvvv v v vvvvvvvvv v vv vv

140

+ + + + + + ++ + ++++ vv + + + ++ + + vvvvvvvvv vv+ ++ vv vv + vv+vvvv + v v vv vvvv ++ + + + + +


o Direct + Indirect V VR +

80

100

120

60

+ 1990 Date

Fitted trend

1970

1980

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 112 81 47 29 Female 97 68 39 23 Both sexes 105 75 43 26 Child mortality (probability of dying at ages 1-4, per 1,000) Male 58 32 26 11 Female 57 33 25 11 Both sexes 58 33 26 11 Under-five mortality (deaths under age 5 per 1,000 live births) Male 164 111 72 39 Female 148 99 63 33 Both sexes 156 105 68 36 Ratio of male to female mortality (per 100)

Infant 117 120 123 126

Child 100 98 103 98

Under-five 110 113 115 117

182

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Philippines
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

160

+ + + + + + + + v v + vvvv v+ +vvvv vvv v vvvv + v vvv + +v + + + + + + + ++ + +


o Direct + Indirect V VR

140

100

80

+
Fitted trend

100

120

vvvv v vvvv v v v v v v vvvv v v vv v

120

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 83 64 44 29 Female 67 49 33 21 Both sexes 75 57 38 25 Child mortality (probability of dying at ages 1-4, per 1,000) Male 31 20 10 5.1 Female 33 20 10 4.8 Both sexes 32 20 10 5.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male 111 82 53 34 Female 97 69 42 26 Both sexes 104 76 48 30 Ratio of male to female mortality (per 100)

Infant 124 129 133 138

Child 95 100 102 106

Under-five 115 120 126 132

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

183

Poland
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v vvvv vvvv vvvv vv v vvv v v v v v vv v v v vv v v vv v v vv v

140

100

120

v vvvv v vvvv vv v vvvvvvvvvv v vv

v vv vvv vv vv vv v v

80

o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 28 20 13 6.9 Female 22 16 11 5.8 Both sexes 25 18 12 6.4 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.9 2.8 1.9 1.2 Female 3.1 2.2 1.5 1.0 Both sexes 3.5 2.5 1.7 1.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 32 23 15 8.2 Female 25 18 12 6.8 Both sexes 28 20 14 7.5 Ratio of male to female mortality (per 100)

Infant 131 130 124 119

Child 125 127 126 125

Under-five 130 129 125 120

184

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Portugal
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

v v v v vv v v v v v vv v v v v v vv vv vv v v vv v v v v vvv v v v v v v
o Direct + Indirect V VR

v v v v v v vv v vv v v v v v vv vv v v v v v v vv v v v v v v v v v

120

120

100

100

v v

80

Fitted trend

80

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 40 18 8.3 4.0 Female 32 15 6.8 3.4 Both sexes 36 17 7.6 3.7 Child mortality (probability of dying at ages 1-4, per 1,000) Male 8.7 4.4 2.7 1.1 Female 7.5 3.5 2.1 .9 Both sexes 8.1 4.0 2.4 1.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male 48 23 11 5.1 Female 39 18 8.9 4.2 Both sexes 44 20 10 4.7 Ratio of male to female mortality (per 100)

Infant 124 126 122 118

Child 116 127 129 131

Under-five 122 126 124 121

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

185

Puerto Rico
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

100

80

Fitted trend

80

o Direct + Indirect V VR

100

v v v vv v v vv v v v v vv v v v vv v v vv v v v v

v vv vv v vv v v vv v v v v vv vv v v v v v

v v v

120

120

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

30

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 25 17 12 8.1 Female 19 14 10 7.3 Both sexes 23 16 11 7.7 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.6 2.9 2.2 1.7 Female 3.3 2.3 1.7 1.3 Both sexes 3.4 2.6 2.0 1.5 Under-five mortality (deaths under age 5 per 1,000 live births) Male 29 20 14 10 Female 23 16 12 8.6 Both sexes 26 18 13 9.2 Ratio of male to female mortality (per 100)

Infant 131 127 119 111

Child 111 126 128 128

Under-five 128 127 120 114

186

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Republic of Korea
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

100

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

++ +

v v v v vvvv v v vv vvv v v vvv v v v vv v

v v v v v v v v v v vv v v vv vv v vv vvv v v
Fitted trend Adjusted trend

120

120 1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

60

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 48 23 8.4 5.0 Female 44 21 7.7 4.6 Both sexes 46 22 8.1 4.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male 16 6.6 3.1 1.7 Female 15 5.8 2.6 1.3 Both sexes 15 6.2 2.8 1.5 Under-five mortality (deaths under age 5 per 1,000 live births) Male 63 29 11 6.6 Female 58 27 10 5.8 Both sexes 61 28 11 6.3 Ratio of male to female mortality (per 100)

Infant 108 109 109 110

Child 107 114 120 129

Under-five 108 110 112 114

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

187

Republic of Moldova
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

+ vv v v

v v v vvv vv v v v +v v vv v v vvv +

v v v v v vv v vv v vv v v v v v v v v v v v

140

120

100

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

60

o Direct + Indirect V VR

80

100

120

140

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

60

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 37 30 21 Female .. 29 23 16 Both sexes .. 33 27 18 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 8.5 7.3 5.5 Female .. 6.8 5.8 4.4 Both sexes .. 7.7 6.6 4.9 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 46 37 26 Female .. 35 29 20 Both sexes .. 41 33 23 Ratio of male to female mortality (per 100)

Infant .. 130 130 129

Child .. 126 126 125

Under-five .. 129 129 128

188

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Romania
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 vv v vvv v v vv v v vvvv v v vv v v v vv v v v vvvv vv v vvvv 80 100 120

140 v v v v v vvv vvvvv v v vvv v v v vv v v v v v v vvvvvvvv v v 100 80


o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 38 28 24 16 Female 32 22 19 13 Both sexes 35 25 22 15 Child mortality (probability of dying at ages 1-4, per 1,000) Male 8.7 7.8 5.4 2.9 Female 7.7 6.7 4.5 2.3 Both sexes 8.2 7.3 5.0 2.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 46 35 29 19 Female 39 29 24 15 Both sexes 43 32 27 17 Ratio of male to female mortality (per 100)

Infant 120 124 125 126

Child 113 116 120 126

Under-five 118 122 124 126

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

189

Russian Federation
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v vvvvvvv vvvvvvvvvv vvvvv vvvvv vv vv v v v vv vv v v

140 100 80 120

vvvvvv v v v v vvvvvvvvvvvvvvvvvv v v vvvv vvv vv v v

o Direct + Indirect V VR

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

40

Deaths per 1000 live births Deaths per 1,000

Male Female Both

20

30

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 34 29 26 17 Female 26 21 19 13 Both sexes 30 25 23 15 Child mortality (probability of dying at ages 1-4, per 1,000) Male 7.2 5.4 4.7 2.4 Female 5.9 4.3 3.7 1.9 Both sexes 6.5 4.9 4.2 2.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 41 34 31 19 Female 31 25 23 15 Both sexes 36 30 27 17 Ratio of male to female mortality (per 100)

Infant 133 135 134 131

Child 122 125 126 128

Under-five 131 133 132 131

190

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Rwanda
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

120

140

+ +

++ + + + + + + + + + ++ + + ++ + + + + +
Fitted trend

80
o Direct + Indirect V VR

100

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

200

100

150

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 142 128 132 110 Female 124 113 118 99 Both sexes 133 120 125 104 Child mortality (probability of dying at ages 1-4, per 1,000) Male 101 85 100 67 Female 90 78 92 64 Both sexes 96 81 96 65 Under-five mortality (deaths under age 5 per 1,000 live births) Male 229 202 218 169 Female 204 182 199 156 Both sexes 216 192 209 163 Ratio of male to female mortality (per 100)

Infant 114 113 112 111

Child 112 110 108 105

Under-five 112 111 110 109

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

191

Senegal
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ + + + + ++ + + + + + ++ + ++ + + + + + + + + ++ + + + ++ + + + + ++ + +
o Direct + Indirect V VR

80

100

120

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

250

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

100

150

200

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 111 90 75 65 Female 95 77 64 55 Both sexes 103 83 69 60 Child mortality (probability of dying at ages 1-4, per 1,000) Male 160 107 83 72 Female 165 106 78 64 Both sexes 162 107 80 68 Under-five mortality (deaths under age 5 per 1,000 live births) Male 253 188 152 133 Female 244 175 136 116 Both sexes 249 181 144 124 Ratio of male to female mortality (per 100)

Infant 117 117 118 119

Child 97 101 106 113

Under-five 104 107 111 115

192

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Serbia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v 140 v v v v v v v vv v

140

v vv v v v v v v

120

100

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex differentials (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 38 19 9.0 Female .. 29 14 6.7 Both sexes .. 34 17 7.9 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 6.6 2.5 1.3 Female .. 6.4 2.4 1.1 Both sexes .. 6.5 2.4 1.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 45 21 10 Female .. 35 17 7.8 Both sexes .. 40 19 9.1 Ratio of male to female mortality (per 100)

Infant .. 132 133 135

Child .. 104 104 112

Under-five .. 127 129 131

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

193

Sierra Leone
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

100

+ + + + + ++ + + + + + + + ++ + + ++

80
o Direct + Indirect V VR

120

+
Fitted trend

60

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex differentials (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

100

150

200

250

300

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 162 165 113 Female .. 140 145 101 Both sexes .. 151 155 107 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 129 134 64 Female .. 113 117 56 Both sexes .. 121 125 60 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 270 277 170 Female .. 237 245 151 Both sexes .. 254 261 161 Ratio of male to female mortality (per 100)

Infant .. 116 114 112

Child .. 115 115 115

Under-five .. 114 113 112

194

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Singapore
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v vv v v v vv 120 v v v vvvv

v v vv vv vv v v v

140

140

v v

v vv v v

v v v v

v vv v v vv vvv v vv v v v v v v v v
Fitted trend

120

100

100

vvvv v vv v v v

v v v v v

v v

80

80

o Direct + Indirect V VR

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 17 10 4.5 2.6 Female 13 8.1 3.7 2.0 Both sexes 15 9.1 4.1 2.3 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.5 2.2 1.3 .8 Female 3.4 2.0 1.1 .6 Both sexes 3.5 2.1 1.2 .7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 20 12 5.8 3.3 Female 16 10 4.8 2.7 Both sexes 18 11 5.3 3.0 Ratio of male to female mortality (per 100)

Infant 130 124 122 126

Child 105 113 117 116

Under-five 125 121 120 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

195

Slovakia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

140

140

v v v vvv vvv v v v vv vv v v v v vv v vv v v v v v vv v

vv

v v

v v vv v v v v vvv v v v v v v v v vv v v vv v v v v vvv v v v

v v v

120

100

80

Fitted trend

80

o Direct + Indirect V VR

100

120

v
Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

25

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 27 18 11 7.6 Female 20 13 8.9 6.2 Both sexes 24 16 10 6.9 Child mortality (probability of dying at ages 1-4, per 1,000) Male 4.9 2.7 2.0 1.7 Female 3.9 2.2 1.6 1.4 Both sexes 4.4 2.4 1.8 1.5 Under-five mortality (deaths under age 5 per 1,000 live births) Male 32 20 13 9.2 Female 24 16 10 7.5 Both sexes 28 18 12 8.4 Ratio of male to female mortality (per 100)

Infant 132 132 127 122

Child 125 121 122 122

Under-five 130 130 126 122

196

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Slovenia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v v v 140 v v v v vv v 80 v v v v v
Fitted trend

v v

v v v

v v

140

vv v vv v vv v v v

120

120

v v v v vv v

vv v

v v

100

80

o Direct + Indirect V VR

Fitted trend

1970

1980

1990 Date

2000

2010

100 1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex differentials (decade average) 160 80 100 120 140

Deaths per 1000 live births Deaths per 1,000

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 14 6.9 3.7 Female .. 11 5.1 3.3 Both sexes .. 12 6.0 3.5 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 2.4 1.4 1.1 Female .. 1.8 1.1 .7 Both sexes .. 2.1 1.2 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 16 8.2 4.8 Female .. 13 6.1 4.0 Both sexes .. 14 7.2 4.4 Ratio of male to female mortality (per 100)

Infant .. 127 136 112

Child .. 130 128 154

Under-five .. 128 134 119

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

197

Somalia
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

120

140

+ + +

+ + + + +

100
o Direct + Indirect V VR

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Male Female Both

Deaths per 1000 live births Deaths per 1,000

200

250

5q0 1q0 4q1

100 1970

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 163 142 142 118 Female 140 123 122 102 Both sexes 152 132 132 110 Child mortality (probability of dying at ages 1-4, per 1,000) Male 124 106 106 83 Female 114 98 98 77 Both sexes 119 102 102 80 Under-five mortality (deaths under age 5 per 1,000 live births) Male 267 233 232 191 Female 239 209 208 171 Both sexes 253 221 220 181 Ratio of male to female mortality (per 100)

Infant 116 116 116 116

Child 108 108 108 107

Under-five 112 112 112 112

198

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

South Africa
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

140

+ 120 +

+ +

100

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

vvv v +v v v+ vvvv v +vvvvvvvvvv

v v v vvv vvvv vv vvvvvvvvvv

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

40

60

80

100

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 82 62 59 59 Female 65 50 48 49 Both sexes 74 57 54 54 Child mortality (probability of dying at ages 1-4, per 1,000) Male 32 24 22 29 Female 31 22 18 23 Both sexes 32 23 20 26 Under-five mortality (deaths under age 5 per 1,000 live births) Male 112 85 79 86 Female 94 71 66 71 Both sexes 103 78 73 79 Ratio of male to female mortality (per 100)

Infant 126 124 122 119

Child 105 112 120 129

Under-five 119 120 121 122

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

199

Spain
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 v v v vv v vv v v vv v v v vvv v vvv v v v vvvv v v v v vv vv v v vv 80 100 120

140 v vv vv v v vv v v v v v vv vv v v vvv v vv v v v v v v v v v vv v vv v 100 80


o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 18 10 6.0 4.2 Female 14 8.1 4.9 3.4 Both sexes 16 9.2 5.5 3.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.6 2.2 1.5 1.0 Female 2.9 1.8 1.3 .8 Both sexes 3.3 2.0 1.4 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 22 12 7.6 5.1 Female 17 10 6.2 4.3 Both sexes 20 11 6.9 4.7 Ratio of male to female mortality (per 100)

Infant 127 125 123 121

Child 122 123 120 116

Under-five 126 125 122 120

200

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Sri Lanka
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

160

+ + + + + + + + v vvvvv vvvvvvv vv v v vv v vv v vvv

140

120

+ v

100

v v vvv vvvvvv v v

vv vv v v

120

v vv v v v v

80

60

Fitted trend

80

o Direct + Indirect V VR

100

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

70

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

60

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 53 33 24 18 Female 44 27 19 15 Both sexes 49 30 22 17 Child mortality (probability of dying at ages 1-4, per 1,000) Male 19 8.8 4.9 4.5 Female 22 9.2 4.9 4.0 Both sexes 20 9.0 4.9 4.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 71 42 28 23 Female 65 36 24 19 Both sexes 68 39 26 21 Ratio of male to female mortality (per 100)

Infant 119 121 123 125

Child 90 96 100 111

Under-five 110 115 118 122

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

201

Sudan
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

160

+ 140

120

+ + + + + + ++ + + +
o Direct + Indirect V VR

80

100

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

200

Deaths per 1000 live births Deaths per 1,000

Male Female Both

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

50

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 127 111 92 76 Female 106 94 80 67 Both sexes 117 103 86 71 Child mortality (probability of dying at ages 1-4, per 1,000) Male 88 77 64 48 Female 87 76 63 47 Both sexes 87 76 63 48 Under-five mortality (deaths under age 5 per 1,000 live births) Male 204 179 150 120 Female 184 163 137 111 Both sexes 194 171 144 116 Ratio of male to female mortality (per 100)

Infant 120 118 115 113

Child 101 101 102 102

Under-five 111 110 109 108

202

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Swaziland
Average

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ +

+ + +

100

120

+
o Direct + Indirect V VR

+ +

80

60

Weighted av erage

+ 1970 1980 1990 Date 2000 2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 129 91 80 83 Female 102 72 64 65 Both sexes 116 81 72 74 Child mortality (probability of dying at ages 1-4, per 1,000) Male 59 38 33 43 Female 62 41 35 44 Both sexes 61 39 34 43 Under-five mortality (deaths under age 5 per 1,000 live births) Male 181 125 110 122 Female 158 109 96 106 Both sexes 169 117 104 114 Ratio of male to female mortality (per 100)

Infant 127 127 127 127

Child 95 94 93 97

Under-five 115 115 115 115

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

203

Sweden
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v 140

140

v v v v vv v v vv v v v v v v v v v v vv v v v v v v v v

100

80

Fitted trend

80

o Direct + Indirect V VR

100

v vvv vv v v v v v v vv vv v v v v v v vv v v v vv v v v v v vv v v v

120

120

v vv v vv v v v v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

12

Deaths per 1000 live births Deaths per 1,000

10

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 10 7.2 4.6 3.1 Female 7.7 5.7 3.7 2.5 Both sexes 8.8 6.5 4.2 2.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male 1.9 1.2 .8 .9 Female 1.5 1.0 .6 .7 Both sexes 1.7 1.1 .7 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 12 8.4 5.4 3.9 Female 9.2 6.7 4.4 3.3 Both sexes 11 7.6 4.9 3.6 Ratio of male to female mortality (per 100)

Infant 128 126 124 122

Child 128 123 118 115

Under-five 128 126 123 120

204

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Switzerland
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

140

120

v 100 v
o Direct + Indirect V VR

v v

80

Fitted trend

80

100

120

vv vv vv v v vv v v v v v vv v v v v v vv vvv v vv v v v v

140

v v v v vv vv vv v v v vv v vv v v vvv v v v v v vv vv v v v v v v v v v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 13 8.1 5.8 4.7 Female 10 6.3 4.6 3.9 Both sexes 11 7.2 5.2 4.3 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.0 2.2 1.5 .9 Female 2.3 1.7 1.1 .7 Both sexes 2.6 1.9 1.3 .8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 16 10 7.2 5.6 Female 12 7.9 5.7 4.6 Both sexes 14 9.1 6.5 5.1 Ratio of male to female mortality (per 100)

Infant 132 130 125 120

Child 132 130 127 126

Under-five 132 130 126 121

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

205

Syrian Arab Republic


Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 120 140

140

+ + + ++
o Direct + Indirect + V VR

+ + + + + ++ v v + +

120

100

100

v + +

vv

80

80

60

Weighted av erage

1970

1980

1990 Date

2000

2010

60

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

20

40

60

80

100

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 81 50 30 19 Female 67 41 25 16 Both sexes 74 45 27 17 Child mortality (probability of dying at ages 1-4, per 1,000) Male 32 13 5.4 2.5 Female 31 13 5.8 2.9 Both sexes 31 13 5.6 2.7 Under-five mortality (deaths under age 5 per 1,000 live births) Male 110 62 35 21 Female 95 54 30 18 Both sexes 103 58 33 20 Ratio of male to female mortality (per 100)

Infant 122 122 122 122

Child 104 99 92 86

Under-five 116 116 116 116

206

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Tajikistan
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

160

100

+ v + + +v v v vvvvvvvvvv v v v + vv v + + + + v+ +

v vv vv vvvvv vvvvv v v v v v v

120

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex differentials (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 113 93 69 Female .. 91 74 54 Both sexes .. 102 84 62 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 36 27 20 Female .. 39 28 20 Both sexes .. 37 27 20 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 145 117 87 Female .. 127 101 73 Both sexes .. 136 109 80 Ratio of male to female mortality (per 100)

Infant .. 124 125 127

Child .. 93 94 97

Under-five .. 114 117 119

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

207

Thailand
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 v vvv v v v vv v v v vvv vvvv vv v vvvvv v vv vv v vvvv v v v 80 100 120 140

+ v v v + + v vvv + vv vv vv v v v vv v v v vv v vv vvvvvv + + ++ v vv v v
o ++

80

100

120

140

60

Fitted trend

1970

1980

1990 Date

2000

2010

60

Direct + Indirect + V VR

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

80

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

20

40

60

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 58 34 18 9.0 Female 46 27 15 7.5 Both sexes 52 31 16 8.2 Child mortality (probability of dying at ages 1-4, per 1,000) Male 26 11 6.4 4.3 Female 25 11 5.5 3.4 Both sexes 26 11 6.0 3.9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 83 45 24 13 Female 70 38 20 11 Both sexes 77 41 22 12 Ratio of male to female mortality (per 100)

Infant 125 123 122 120

Child 106 109 118 125

Under-five 118 119 120 121

208

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

TFYR Macedonia
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

v vv vv v v v vvvvv v
o Direct + Indirect V VR

vv v v v vvv v v v v v v v vv v

120

v v vv v v v v

100

v
Fitted trend

80

80

100

v v v v

120

v v vv v v v v v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

50

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

20

30

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 44 25 14 Female .. 41 22 11 Both sexes .. 43 23 13 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 7.3 2.8 1.0 Female .. 7.2 2.6 1.0 Both sexes .. 7.3 2.7 1.0 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 51 28 15 Female .. 48 24 12 Both sexes .. 50 26 14 Ratio of male to female mortality (per 100)

Infant .. 107 115 120

Child .. 101 107 106

Under-five .. 106 114 119

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

209

Timor-Leste
Average

Sex ratio of under-five mortality 120


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 120 90 100 110

110

+ + +

90
o Direct + Indirect V VR

100

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

200

300

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 237 190 125 79 Female 198 159 104 66 Both sexes 218 175 115 73 Child mortality (probability of dying at ages 1-4, per 1,000) Male 138 102 59 29 Female 139 105 62 32 Both sexes 138 104 60 31 Under-five mortality (deaths under age 5 per 1,000 live births) Male 341 273 176 106 Female 309 247 159 96 Both sexes 326 260 168 101 Ratio of male to female mortality (per 100)

Infant 120 120 120 120

Child 99 98 95 91

Under-five 110 110 110 110

210

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Togo
Average

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ + + + + + ++ + + + ++ + ++ +

100

120

80

+
o Direct + Indirect V VR

60

Weighted av erage

1970

1980

1990 Date

2000

2010

80

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

50 1970

100

150

200

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 137 117 105 85 Female 109 93 84 68 Both sexes 123 105 95 76 Child mortality (probability of dying at ages 1-4, per 1,000) Male 88 63 48 32 Female 83 61 48 32 Both sexes 86 62 48 32 Under-five mortality (deaths under age 5 per 1,000 live births) Male 213 173 148 114 Female 183 148 127 98 Both sexes 198 161 138 106 Ratio of male to female mortality (per 100)

Infant 125 125 125 125

Child 107 104 102 98

Under-five 116 116 116 116

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

211

Trinidad and Tobago


Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v v v v v v v v

100

+ 80
o Direct + Indirect V VR

80

++

100

v v v v v v v v v v v v v vv v vv v v vv v + + v + v v

v v v v v v v v vv v v vv v v v v v vv vv v v v v v v v v v

140

120

120

140

vv

60

Fitted trend

1970

1980

1990 Date

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 42 33 32 31 Female 34 27 25 24 Both sexes 38 30 28 27 Child mortality (probability of dying at ages 1-4, per 1,000) Male 12 8.5 7.1 7.8 Female 10 7.6 6.3 6.7 Both sexes 11 8.0 6.7 7.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 53 42 39 38 Female 44 34 31 31 Both sexes 49 38 35 35 Ratio of male to female mortality (per 100)

Infant 121 123 125 127

Child 111 112 113 116

Under-five 119 121 123 125

212

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Tunisia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+
o Direct + Indirect V VR

140

v v v v v + vvv v v vv ++ v v v v + v +
Fitted trend

120

120

v 100

100

v v

v vv v

vv vv v vv v

80

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

40

60

80

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 108 61 34 24 Female 99 52 27 18 Both sexes 103 57 30 21 Child mortality (probability of dying at ages 1-4, per 1,000) Male 29 13 5.1 3.2 Female 37 14 4.6 2.3 Both sexes 33 14 4.9 2.8 Under-five mortality (deaths under age 5 per 1,000 live births) Male 133 73 39 27 Female 132 65 31 20 Both sexes 133 69 35 24 Ratio of male to female mortality (per 100)

Infant 109 119 128 137

Child 78 94 112 141

Under-five 101 113 125 137

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

213

Turkey
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

140

160

+ + + + + + + + + ++ + + + + + + + + + + + + + +

100

120

80

+
o Direct + Indirect V VR

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

50

100

150

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 136 87 50 31 Female 116 76 44 28 Both sexes 127 82 47 29 Child mortality (probability of dying at ages 1-4, per 1,000) Male 35 21 10 4.6 Female 39 23 10 4.6 Both sexes 37 22 10 4.6 Under-five mortality (deaths under age 5 per 1,000 live births) Male 166 107 59 36 Female 151 97 53 32 Both sexes 159 102 56 34 Ratio of male to female mortality (per 100)

Infant 117 116 114 113

Child 89 93 95 100

Under-five 110 110 111 111

214

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Turkmenistan
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

+ vv v vv v vv vvv v v + v v v 120

v vv v vvvvvv v vv v v v

100

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex differentials (decade average) 140 80 100 120

140

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

40

60

80

100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

20

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male .. 94 76 58 Female .. 78 60 44 Both sexes .. 86 68 51 Child mortality (probability of dying at ages 1-4, per 1,000) Male .. 28 21 15 Female .. 26 19 14 Both sexes .. 27 20 15 Under-five mortality (deaths under age 5 per 1,000 live births) Male .. 119 95 73 Female .. 101 78 57 Both sexes .. 110 87 65 Ratio of male to female mortality (per 100)

Infant .. 121 127 133

Child .. 107 109 111

Under-five .. 117 122 127

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

215

Uganda
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

o Direct + Indirect V VR

140

+ 120 + ++ + + ++ + + + + 80 +

+ + + + + + + + + + + + +
Fitted trend

100

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

140

180

Male Female Both

80 100

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

60

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 107 112 101 87 Female 101 100 85 69 Both sexes 104 106 93 78 Child mortality (probability of dying at ages 1-4, per 1,000) Male 82 87 77 61 Female 72 76 66 52 Both sexes 77 82 71 56 Under-five mortality (deaths under age 5 per 1,000 live births) Male 180 189 170 142 Female 166 168 145 117 Both sexes 173 179 158 130 Ratio of male to female mortality (per 100)

Infant 106 112 119 126

Child 114 115 116 117

Under-five 108 113 117 122

216

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Ukraine
Loess

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 v v v v vv v v vv v vv vvvvvvv v v vv v v v v v v v v v v v v vv v v v 140

160 + v + v v vv v v v v v vvvvvvvvvvv vvv v v v v v + vvvvv v v vv v v v + + 80 60


o Direct + Indirect V VR

100

120

140

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

35

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

10

15

20

25

30

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 29 23 20 17 Female 21 17 15 12 Both sexes 25 20 18 15 Child mortality (probability of dying at ages 1-4, per 1,000) Male 5.2 3.8 3.0 2.3 Female 4.6 3.3 2.6 1.9 Both sexes 4.9 3.5 2.8 2.1 Under-five mortality (deaths under age 5 per 1,000 live births) Male 34 27 23 19 Female 26 20 18 14 Both sexes 30 24 21 17 Ratio of male to female mortality (per 100)

Infant 135 136 136 135

Child 115 116 117 119

Under-five 132 133 133 133

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

217

United Arab Emirates


Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

+ 140 + + + + v

120

100

80

Weighted av erage

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

120

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average) 60


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

10

20

30

40

50

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 53 30 15 11 Female 42 24 12 8.8 Both sexes 48 27 14 10 Child mortality (probability of dying at ages 1-4, per 1,000) Male 11 5.4 1.9 1.2 Female 9.5 4.9 1.8 1.2 Both sexes 10 5.1 1.8 1.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 63 36 17 12 Female 51 29 14 10 Both sexes 57 32 15 11 Ratio of male to female mortality (per 100)

Infant 125 125 125 125

Child 112 110 105 103

Under-five 123 123 123 123

218

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

United Kingdom
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 v v vvvv vv v vv vvvvv v vvv vvv v vvv vv v v v v v vv v v

140 v vvvv vv v vv vvvvvv v v v v vvvv v v v vvv vvv v v v v v 100 80


o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 17 11 6.8 5.6 Female 13 8.4 5.4 4.5 Both sexes 16 10 6.1 5.1 Child mortality (probability of dying at ages 1-4, per 1,000) Male 2.8 1.9 1.2 1.0 Female 2.3 1.5 1.0 .8 Both sexes 2.5 1.7 1.1 .9 Under-five mortality (deaths under age 5 per 1,000 live births) Male 20 13 8.0 6.6 Female 16 10 6.4 5.3 Both sexes 18 11 7.2 6.0 Ratio of male to female mortality (per 100)

Infant 129 129 127 124

Child 121 122 122 123

Under-five 128 128 126 124

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

219

United Republic of Tanzania


Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

160

Fitted trend Adjusted trend

140

+ + +

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

80 1970

o Direct + Indirect V VR

100

++ + + + + ++ + + + + ++ + + + + + + + + ++ + + + + + + + + + + +

120

100

120

140

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

200

Deaths per 1000 live births Deaths per 1,000

Male Female Both

150

5q0 1q0 4q1

100

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 120 107 100 73 Female 107 96 90 66 Both sexes 113 102 95 69 Child mortality (probability of dying at ages 1-4, per 1,000) Male 93 81 72 49 Female 85 77 70 50 Both sexes 89 79 71 49 Under-five mortality (deaths under age 5 per 1,000 live births) Male 201 180 164 118 Female 182 165 153 112 Both sexes 192 173 159 115 Ratio of male to female mortality (per 100)

Infant 112 112 111 111

Child 109 106 103 99

Under-five 110 109 107 106

220

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

United States of America


Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 80 100 120 vvvvvvv vvvvvv vv vvvv vvvv v v v vvvv vvvvvvvv v

140 100 80
o Direct + Indirect V VR

120

vvvvvvv v v vv vvvvvvv vvvvvvvv v vv v vvv vvvv v v

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

15

20

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 18 12 8.6 7.5 Female 14 9.4 7.0 6.1 Both sexes 16 11 7.8 6.8 Child mortality (probability of dying at ages 1-4, per 1,000) Male 3.1 2.4 1.8 1.3 Female 2.5 1.9 1.4 1.1 Both sexes 2.8 2.1 1.6 1.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 21 14 10 8.8 Female 17 11 8.4 7.2 Both sexes 19 13 9.4 8.0 Ratio of male to female mortality (per 100)

Infant 127 125 123 122

Child 125 126 125 124

Under-five 127 125 124 122

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

221

Uruguay
Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160

v v v vvvv vv v v vv v v v v vv v v v vv v v v
o Direct + Indirect V VR

140

140

v v v v vv v v v v v v v v v vvv v v v v v v v v v v vv vvv v v

120

100

80

Fitted trend

80

100

120

v vv v vv v

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

10

20

30

40

50

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 49 31 20 15 Female 39 25 16 12 Both sexes 44 28 18 14 Child mortality (probability of dying at ages 1-4, per 1,000) Male 6.0 3.8 3.1 3.6 Female 5.5 3.4 2.5 2.7 Both sexes 5.8 3.6 2.8 3.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 55 35 23 19 Female 45 28 18 15 Both sexes 50 32 21 17 Ratio of male to female mortality (per 100)

Infant 126 126 128 129

Child 110 111 121 131

Under-five 124 124 127 130

222

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Uzbekistan
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

160

+ + +

100

80

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

100

120

++ + + ++ + + + vv + vvvvvv vv vv + vvvvvv + vv v v vvv +

140

v vvvv vvvv vv v vvvvvvvvv v v v v

120

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

60

80

100

5q0 1q0 4q1

40

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

20

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 92 78 65 56 Female 69 58 48 41 Both sexes 81 68 57 49 Child mortality (probability of dying at ages 1-4, per 1,000) Male 20 16 13 11 Female 17 14 12 10 Both sexes 18 15 12 10 Under-five mortality (deaths under age 5 per 1,000 live births) Male 110 93 77 66 Female 85 72 59 51 Both sexes 98 82 69 59 Ratio of male to female mortality (per 100)

Infant 133 134 135 136

Child 113 113 112 112

Under-five 129 130 130 131

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

223

Venezuela (Bolivarian Republic of)


Loess

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140 v v vvv vvvvvv vvvvv v vvv v v vv vvvv vvv vvvv vvvv v 80 100 120

140 v v v vv vvv vvvvv v vv vv v v v v v vv v v v vvvvv v vv vvv 100 80


o Direct + Indirect V VR

120

Fitted trend

Fitted trend

1970

1980

1990 Date

2000

2010

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

20

30

40

50

60

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

10

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 48 34 24 20 Female 39 27 19 16 Both sexes 44 30 22 18 Child mortality (probability of dying at ages 1-4, per 1,000) Male 16 8.0 6.5 5.6 Female 16 7.7 5.8 4.7 Both sexes 16 7.8 6.1 5.2 Under-five mortality (deaths under age 5 per 1,000 live births) Male 63 41 31 26 Female 55 34 25 20 Both sexes 59 38 28 23 Ratio of male to female mortality (per 100)

Infant 123 126 127 129

Child 98 105 113 119

Under-five 116 121 124 126

224

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Viet Nam
Average

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 80 100 120 140

+ + + + + + + + + + + + + + + + + + + +

++

100

120

140

+ 80
o Direct + Indirect V VR

+
Weighted av erage

60

1970

1980

1990 Date

2000

2010

60

Weighted av erage Adjusted weighted av erage

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


5q0 1q0 4q1 Male Female Both

Deaths per 1000 live births Deaths per 1,000

0 1970

50

100

150

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 105 70 37 23 Female 83 55 29 18 Both sexes 95 62 33 21 Child mortality (probability of dying at ages 1-4, per 1,000) Male 71 39 13 4.7 Female 57 31 11 4.0 Both sexes 64 35 12 4.4 Under-five mortality (deaths under age 5 per 1,000 live births) Male 169 106 50 28 Female 135 84 40 22 Both sexes 152 95 45 25 Ratio of male to female mortality (per 100)

Infant 127 127 127 127

Child 125 124 121 118

Under-five 125 125 125 125

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

225

Yemen
Linear

Sex ratio of under-five mortality


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

120

140

160

+ + + ++

80

100

60

Fitted trend

1970

1980

1990 Date

2000

2010

80

o Direct + Indirect V VR

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

250

Deaths per 1000 live births Deaths per 1,000

5q0 1q0 4q1

Male Female Both

100

150

200

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

50

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 182 124 92 69 Female 157 107 79 58 Both sexes 170 116 86 64 Child mortality (probability of dying at ages 1-4, per 1,000) Male 99 59 37 23 Female 105 63 41 26 Both sexes 102 61 39 25 Under-five mortality (deaths under age 5 per 1,000 live births) Male 263 176 126 91 Female 245 163 116 83 Both sexes 254 170 121 87 Ratio of male to female mortality (per 100)

Infant 116 117 117 118

Child 95 93 91 88

Under-five 107 108 108 109

226

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

Zambia
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 100 120 140

o Direct + Indirect V VR

140

+ + +

120

+ + + + + + + + + ++ + + + + ++ + + + + + + + + + + + + + + + +

100

80

Fitted trend

1970

1980

1990 Date

2000

2010

80

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

100 120 140 160 180

5q0 1q0 4q1

Male Female Both

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

80

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 109 105 114 108 Female 98 92 98 91 Both sexes 104 98 106 99 Child mortality (probability of dying at ages 1-4, per 1,000) Male 70 74 85 83 Female 76 74 79 71 Both sexes 73 74 82 77 Under-five mortality (deaths under age 5 per 1,000 live births) Male 171 171 190 181 Female 166 159 169 156 Both sexes 169 165 180 169 Ratio of male to female mortality (per 100)

Infant 112 114 116 118

Child 91 100 108 117

Under-five 103 108 112 117

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality

227

Zimbabwe
Linear

Sex ratio of under-five mortality 160


Ratio of male to to female 5q0 100) Ratio of to female 5q0 (per Ratio of malemalefemale 5q0(per 100)

Sex ratio of infant mortality Ratio of male to female 1q0 Ratio of male to female 1q0 (per 100) 160 140

140

++ + + + + v + + + + + v + v ++ + + + + ++ ++ v + + + + + v + + +vvv + + + + + + + +
o Direct + Indirect V VR

120

120

v v v vvvv v

100

80

+
Fitted trend

80

100

60

1970

1980

1990 Date

2000

2010

60

Fitted trend Adjusted trend

1970

1980

1990 Date

2000

2010

Infant, child, and under-five mortality by sex (decade average)


Ratio ofRatio to femaleto female (per 100) male of male mortality
5q0 1q0 4q1 Male Female Both

Trends in sex ratios (decade average) 140 80 100 120

Deaths per 1000 live births Deaths per 1,000

60

80

100

120

1970

1980

1990 Decade

2000

2010

60

5q0 1q0 4q1

40

1970

1980

1990 Decade

2000

2010

Estimates of infant, child and under-five mortality by sex, by decade


Infant mortality (deaths under age 1 per 1,000 live births) Decade 1970s 1980s 1990s 2000s Male 90 66 62 65 Female 67 53 54 62 Both sexes 78 60 58 63 Child mortality (probability of dying at ages 1-4, per 1,000) Male 50 38 40 48 Female 54 37 35 37 Both sexes 52 37 37 42 Under-five mortality (deaths under age 5 per 1,000 live births) Male 136 101 99 109 Female 117 88 87 97 Both sexes 126 95 93 103 Ratio of male to female mortality (per 100)

Infant 134 124 115 105

Child 94 102 114 129

Under-five 116 115 114 113

228

United Nations Department of Economic and Social Affairs/Population Division Sex Differentials in Childhood Mortality