The Lottery of Birth

Giving all children an equal chance to survive

February 2015


The Lottery of Birth shines a spotlight on the children left behind by global and national progress in child mortality reduction.

The report is based on inaugural analysis of disaggregated data from 87 low- and middle-income countries around the world.

Examining inequality in children’s chances of survival – between subnational regions, urban and rural areas, ethnic groups, and economic groups – this report explores a series of fundamental questions:

  • What is the magnitude of the problem? How many countries are leaving children behind?
  • Is inequitable progress in reducing child mortality inevitable?
  • Does focusing on disadvantaged groups mean overall progress will necessarily be slower?
  • What can be done to allow countries to shift onto more equitable pathways, ensuring that disadvantaged groups catch up with those with lower child mortality rates?

The new evidence presented in this report reveals that equitable progress is not only possible, but faster. It contradicts the widespread belief that reaching the poorest and most disadvantaged groups is harder and therefore likely to slow progress.

This report makes a powerful case for putting action to tackle inequalities in child survival at the heart of the global fight against poverty – including in the post-2015 framework and in national development strategies.



The Lottery of Birth – full report

La Lotería del Nacimiento

La Lotería del Nacimiento – resumen ejecutivo

La Loterie de la Naissance

La Loterie de la Naissance – résumé

Country spotlights on inequality and child mortality







Human interest case studies

Ma Than Shi and Ma Yee Mon Htwe from Myanmar

Jalil and Amina from Nigeria

Iffat and Ahmad from Pakistan

Modeste from Rwanda

Rakhal and Mala from Bangladesh

Edna and Heloise from Brazil

Lozimary from Malawi


Related reading

Born Equal: How reducing inequality could give our children a better future 

Leaving No One Behind: Embedding equity in the post-2015 framework through stepping stone targets