Missing in the middle: measuring a million deaths annually in children aged 5–14 years

Premature death remains pivotal in health measurement. Mortality measures attract political attention as indicators of social and economic progress and they figured prominently in the Millennium Development Goals (MDGs).1 Despite its importance, we measure mortality poorly in most places: global coverage by civil registration and vital statistics (CRVS) systems is only 38%, and around a third of these deaths are captured on poor-quality systems.2 Progress in CRVS systems has been glacial: the global coverage of deaths that were registered in 2015 increased by only 2% from those in 2000.