Child and adolescent mortality in the WHO European Region: Concerning trends requiring urgent action

The WHO European Region is experiencing concerning setbacks in child and adolescent mortality, highlighting the need for urgent, coordinated action. Using estimates from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), we analyzed mortality trends from 2000 to 2022 across neonatal, under-five, 5-to-14-year-old, and 15-to-19 age groups. Our findings reveal stagnation or increases in mortality rates across multiple countries over the last five years of this period, with the highest burden in Central Asia and Eastern Europe. Several high-income countries also show worrisome plateaus or increases. Alarmingly, adolescent mortality rates are rising in 22 countries, causing the regional median to increase for the first time in decades. These trends reflect widening inequities, disproportionately affecting migrant children and socioeconomically disadvantaged groups. Contributing factors likely encompass health challenges faced by migrant populations, worsening adolescent mental health exacerbated by COVID-19, negative social media influences, economic decline, and armed conflict. Urgent action is needed to strengthen maternal, neonatal, and child health services and tackle preventable causes of mortality, including inadequate perinatal care, infectious diseases, and injuries. Equity-focused policies, improved health systems, a comprehensive approach to strengthening health systems, and cross-border collaboration are critical. The upcoming WHO/UNICEF 2026-2030 regional child and adolescent health and well-being strategy presents a vital opportunity to address these concerning trends.