'The State of the World's Children', UNICEF's annual flagship report, paints a stark picture of what is in store for the world's poorest children if governments, donors, businesses and international organisations do not accelerate efforts to address their needs.
"Denying hundreds of millions of children a fair chance in life does more than threaten their futures -- by fueling intergenerational cycles of disadvantage, it imperils the future of their societies," said UNICEF Executive Director Anthony Lake.
The report said that the pace of progress on child and maternal health and survival can increase or decrease as a result of policy choices made by governments and the international community in the coming years.
However, if current trends continue, there will be 3.6 million deaths of children under age 5 in 2030 alone.
A total of 69 million such deaths will have occurred between 2016 and 2030, with sub-Saharan Africa accounting for around half of these and South Asia for another third.
The global maternal mortality rate will be around 161 deaths per 100,000 live births -- still five times the level for high-income countries in 1990.
It said pneumonia will remain the second biggest killer of children under the age of five and preterm birth complications will remain the first.
The report noted that significant progress has been made in saving children's lives, getting children into school and lifting people out of poverty.
But this progress has been neither even nor fair, the report said.
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Across much of South Asia and sub-Saharan Africa, children born to mothers with no education are almost three times more likely to die before they are five than those born to mothers with a secondary education.
And girls from the poorest households are twice as likely to marry as children than girls from the wealthiest households.
The report said that while child mortality generally declines as average income increases, many poorer countries are outpacing richer neighbours in reducing their under-five mortality rates.
However, some countries in the fast lane for global economic growth -- including India and Nigeria -- have been in the slower lane for child mortality reduction.
The report points to evidence that investing in the most vulnerable children can yield immediate and long-term benefits.
"Inequity is neither inevitable, nor insurmountable," the report said, adding that better data on the most vulnerable children, integrated solutions to the challenges children face, innovative ways to address old problems, more equitable investment and increased involvement by communities can help level the playing field for children.
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