A new study says that a global campaign to save new mothers and children under five in developing nations has made strong gains but is set to fall well shy of UN goals.
Only nine out of 137 countries are on track to meet the twin Millennium Development Goals (MDG), set in 2000, of slashing child mortality by two-thirds between 1990 and 2015, and maternal deaths by three-quarters over the same period.
Based on current trends, 31 developing nations will reach the first target, and 13 will achieve the second, said the study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
The nine countries set to achieve both UN targets for 2015 are: China, Egypt, Iran, Libya, Maldives, Mongolia, Peru, Syria and Tunisia.
The glass-half-empty glass-half-full report, published in The Lancet, nonetheless underscored major progress in reducing child mortality.
Overall, the number of deaths of children under five in the African, Asian and Latin American countries examined dropped from 11.6 million in 1990 to an estimated 7.2 million in 2011, an average decline of 2.2 percent per year.
Some nations -- including Cambodia, Ecuador, Rwanda, Malaysia and Vietnam -- saw at least a five percent rate of decline over the last decade, more than twice the global average.
But such advances must not obscure the fact that millions of infants and small children succumb to preventable deaths every year, a fact highlighted by the huge gap between rich and poor nations, the authors said.
In 2011 the childhood mortality in Sweden, Italy and Greece is about 0.5 deaths per 1,000 live births, whereas in Niger and Equatorial Guinea it is about 87, a 173-fold difference.
Also worrying, said the researchers, was the mortality rate among infants during the first week of life, which declined only 1.7 percent over the two-decade period.
"The difference between neonatal and overall mortality in children under five might seem small ... but it can be a sign of other problems in the health system," co-author Haidong Wang, a professor at IHME, said in a statement.
For maternal deaths related to pregnancy and childbirth, the number fell from just under 410,000 in 1990 to 273,500 in 2011.
Kenya, Morocco, Zambia and Zimbabwe led the way over the last decade with annual declines in mortality of more than eight percent. Even war-torn Afghanistan -- which continues to have one of the worst maternal death rates in the world -- has shown a nearly five percent annual decline since 2000.
Part of this improvement, especially in sub-Saharan Africa, is due to better prevention and treatment for HIV/AIDS, the authors said.
Global health programmes and more insecticide-treated bednets to combat malaria have also played a role.
For child mortality, improved education among women of reproductive age alone accounted for more than half of the decline, according to an earlier study by the same team.
But the ambitious 2015 goals will still remain beyond reach at current rates of progress, the researchers warned.
"If the world is going to achieve these (MDG) goals, we need to see immediate, concerted action on the part of governments, donors and bilateral agencies," said Rafal Loranzo, a professor at IHME and lead author of the study.