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Potential reduction in the number of deaths that would have occurred if all second administrative-level units in the 20 countries with the greatest number of deaths of children under 5 in 2017 realized a homogenous U5MR that was equal to that of the lowest observed mortality rate in that country. In total, 66% of under-5 deaths could have been averted if all countries maintained mortality rates equal to the second administrative-level unit with the lowest mortality. If this reference rate is set to the lowest observed rate across all of the 99 countries that were included in this study, 95% of under-5 deaths could have been averted. The size of each bar represents the total number of under-5 deaths in each country. The red portion of each bar indicates the number of deaths ‘attributed’ to geographical inequality in mortality rates, whereas the blue portion represents the number of deaths that would remain in the scenario in which all second administrative-level units within countries had the same mortality rate as the best-performing unit. b, Locations of under-5 deaths ‘attributable’ to geographical inequality, across all second administrative-level units in each country. Each country has one unit highlighted with a green diamond, which is the reference unit, or the location with the lowest mortality rate in the country in 2017.

The relative uncertainty in second administrative-level estimates compared with mean estimated U5MRs in each second administrative-level unit for 2017. Mean rates and relative uncertainty are split into population-weighted quartiles. These cut-off points indicate the relative uncertainty minimum, 25th, 50th, and 75th percentiles, and maximum, which are 0.29, 0.51, 0.63 and 0.86, and 3.12, respectively. The under-5 mortality minimum, 25th, 50th, and 75th percentiles, and maximum are 1.4, 13.0, 22.9, and 44.8, and 190.6 deaths per 1,000 live births. Areas in which our estimates are more uncertain are colored with a scale of increasing blue hue, whereas areas in which the mean estimates of U5MR are high are colored with a scale of increasing red hue. Purple areas have high, but uncertain, estimates of U5MRs. White areas have low relative mortality, with fairly certain estimates. Relative uncertainty is defined as the ratio of the width of the 95% uncertainty interval to the mean estimate. (Source: www.nature.com)

 

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