MILLENNIUM DEVELOPMENT GOALS to reduce child mortality for the under fives by as much as two-thirds look likely to be missed in most countries, researchers have said.

The warning comes as a new report, published in The Lancet, found that the leading causes of death in this age group are preterm birth complications and pneumonia.

A US-led study of 6.3 million deaths found these two causes each accounted for 15%.

Infectious causes,  including pneumonia, diarrhoea, and malaria, made up 51.8% of deaths. These rates were particular high in India, Nigeria, Pakistan, Democratic Republic of Congo, and China.

However, the authors note that the rate of deaths worldwide has been reduced “dramatically”, from 77.4 to 45.6 per 1000 births over the course of 13 years.

“Despite remarkable progress at the level of global averages, at national level, [this Millennium Development Goal (MDG)] will not be achieved in most countries in 2015,” the author said.

“As we enter the final 500 days of the MDG era, our analysis underlines a major transition for child survival symbolised by the fact that preterm birth complications are now the leading cause of under-5 deaths globally, not just of deaths in the neonatal period.

Although great progress has been made in child survival in the past two decades, with most of this progress in the past decade, it has not been enough.

They have warned that if trends continue, by 2030 4.4 million children under the age of five will still die – as much as 60% of these in sub-Saharan Africa.

The study was carried out by researchers from Johns Hopkins Bloomberg School of Public Health, USA, the London School of Hygiene and Tropical Medicine, UK, the World Health Organization, Switzerland, and the University of Edinburgh, UK.

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