Abstract
INTRODUCTION: The under-five mortality rate (U5MR) refers to the probability that a newborn will die before reaching exactly five years of age. The U5MR is expressed per 1,000 live births. Saudi Arabia has made efforts to achieve the sustainable development goals (SDGs), for child mortality by 2030. Although Saudi Arabia has put in place initiatives to achieve the SDGs for child mortality by 2030, data on the success of these initiatives are lacking. The aim of this study was to investigate and compare U5MR trends and patterns in Saudi Arabia by decade and sex over a 50-year period (1973-2022). METHODS: Data on the U5MR in Saudi Arabia during 1973-2022 were extracted from the UNICEF database. The mean mortality rates every 10 years were calculated and then compared over decades between males and females using a chi-square test. A two-sided P-value of < 0.05 was considered statistically significant. RESULTS: The U5MR was highest in 1973 (149.1 per 1,000 live births; 150.7 males vs. 147.3 females) and lowest in 2022 (6.4 per 1,000 live births; 6.6 males vs. 6.3 females). The statistical analysis revealed a significant decline in the mean U5MR during 1973-2022 (P < 0.01), with no difference between male and female U5MR in any of the five decades. CONCLUSIONS: The analysis of U5MR trends over five decades in Saudi Arabia (1973-2022) revealed a remarkable decline in the rate among both males and females, with a U5MR of 149.1 per 1,000 live births in 1973 and 6.4 per 1,000 live births in 2022. Saudi Arabia has achieved the SDG target 3.2 (ending preventable deaths of newborns and children under five years of age by 2030). Based on an analysis of the UNICEF data and a literature review, recommendations are proposed to achieve even greater reductions in the U5MR, especially in the neonatal and infant stages.