Prematurity, birth asphyxia, and pneumonia remain the leading causes of death among children under the age of five in Kenya, according to the latest Kenya Vital Statistics Report 2024 (KVSR) released by the Kenya National Bureau of Statistics (KNBS).

The report released on Wednesday, July 9, 2025, paints a grim picture of child health in the country, revealing that prematurity and birth asphyxia alone were responsible for 4,112 deaths out of the 20,156 under-five deaths recorded in health facilities last year. Pneumonia followed closely, accounting for 2,816 fatalities.

Prematurity refers to the birth of a baby before 37 weeks of gestation, while birth asphyxia is the failure to initiate or sustain breathing at birth. Both conditions are largely preventable and closely tied to the quality of maternal healthcare, access to skilled birth attendants, and the availability of neonatal intensive care units (NICUs).

Mortality rates

KNBS notes that the deaths affect both male and female children almost equally, with minimal variation between sexes.

 “Prematurity and asphyxia have persistently been the top child killers over the last five years,” the report states, underscoring the urgent need for targeted interventions in maternal and newborn care.

Pneumonia, a preventable and treatable respiratory infection, remains the second most lethal condition for children under five. Its impact is widespread across both urban and rural areas, cutting across gender and socio-economic lines.

Taken together, prematurity, birth asphyxia, and pneumonia account for over one-third of all child deaths reported in health facilities, a statistic that health experts say is both alarming and avoidable.

Other notable causes of death include neonatal infections, sepsis, gastroenteritis, anaemia, and malaria. However, none rival the scale of the top three.

According to UNICEF, Kenya’s under-five mortality rate currently stands at 41 deaths per 1,000 live births, well above the Sustainable Development Goal (SDG) target of 25 per 1,000 by 2030.

Health stakeholders are being urged to scale up investments in maternal and child health, strengthen health systems, and improve access to essential newborn care.

“This report is a wake-up call. We must invest more in primary healthcare and ensure no child dies from preventable causes,” KNBS said.