By Michael Gwarisa
More than 32,000 children in Zimbabwe die before their fifth birthday every year. The figure, drawn from the latest UN child mortality estimates, places the country among those making the slowest progress in reducing under-five deaths in sub-Saharan Africa.
That number is easier to grasp when placed in context. It is roughly the population of Kariba town, wiped out annually.
Zimbabwe’s under-five mortality rate stands at 64.7 deaths per 1,000 live births. In practical terms, nearly 65 out of every 1,000 children born will not live to see their fifth birthday. Behind the statistics are thousands of families, repeated loss, and a public health challenge that has stubbornly refused to ease.
What stands out is not just the scale of the deaths, but the pace of change, or lack of it.
Since 1990, Zimbabwe’s under-five mortality rate has been declining at an average of just 0.8 percent per year. Given the margin of error in the data, progress over the past three decades could be close to negligible. This is far below the global trend, where under-five deaths have dropped by about 60 percent over the same period.
There was even a period of regression. Between 1990 and 2000, Zimbabwe’s mortality rate worsened, rising from 84 to 99 deaths per 1,000 live births before beginning a slow decline. That lost decade continues to cast a long shadow.
Across the region, Zimbabwe’s position is complicated. Countries like Nigeria still record significantly higher mortality rates, over 115 deaths per 1,000 live births, and far greater absolute numbers of child deaths. Yet even here, the comparison offers little reassurance. Progress across much of sub-Saharan Africa remains too slow, and the region now accounts for the majority of global under-five deaths.
In 2024 alone, 2.8 million children died before their fifth birthday across sub-Saharan Africa.
The causes are well known, and, crucially, largely preventable.
Prematurity, pneumonia, malaria, diarrhoea, and complications during birth continue to drive child mortality. For newborns, the risks are even more concentrated, with prematurity, birth asphyxia, and infections leading the list. These are not conditions that require cutting-edge solutions. In many cases, they can be addressed through basic, well-established interventions, timely care during pregnancy and delivery, access to antibiotics, vaccinations, and strengthened primary healthcare systems.
What is changing, however, is the global response.
Progress in reducing child deaths has slowed significantly in recent years. Between 2000 and 2015, under-five mortality declined rapidly worldwide. Since then, the pace has dropped sharply. If current trends continue, millions more children will die before 2030, many of them in sub-Saharan Africa.
For Zimbabwe, the implications are stark.
If the country were to reach mortality levels seen in high-income nations, tens of thousands of children’s lives could be saved each year. The gap between what is happening and what is possible remains wide.
There are examples of faster progress elsewhere. Countries such as Bangladesh have dramatically reduced child mortality over a relatively short period, showing that improvement is achievable with sustained investment and targeted interventions.
Zimbabwe is not short of knowledge or solutions. The challenge lies in consistent implementation — strengthening health systems, expanding access to care, and focusing on the conditions that continue to claim the most lives.
For now, the reality remains unchanged: each year, the country loses a population the size of Kariba. And without faster progress, that number will continue to repeat itself.
