Afghan babies have been dying in huge numbers for decades. Now, something is changing.

For decades, Afghanistan has ranked with the very poorest African countries as one of the hardest places for infants and small children to survive. Conflict, poverty, poor health services and low levels of female education and rights combined to produce extremely high mortality rates for Afghan newborns, older infants and very young children. But finally, after 15 years of Western-backed civilian rule, their chances of survival are improving dramatically.

In 2000, after four years under an extremist Taliban regime that kept women secluded at home, nearly 100 of every 1,000 Afghan babies died before their first birthday, according to the annual United Nations World Population survey. That rate was topped only by a handful of African nations, led by Sierra Leone with 149 infant deaths and followed by Angola with 138 and Liberia with 129. In the United States, the rate was six.

But today, with health services for Afghan women more widely available, the death rate for their babies has fallen sharply, even though most mothers still have very little or no education and many still give birth at home. In a few isolated provinces the mortality rate is still high, but a recent Afghan government survey found that between 2001 and 2015, the nationwide mortality rate for all infants had fallen from 66 to 45 deaths per 1,000 live births, and from 87 to 55 deaths per 1,000 for all children under 5 years old.

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