Nearly 9.7 million children die each year before their fifth birthday from diseases from pneumonia to malaria, the UN Children's Fund (Unicef) said.

But simple, affordable measures could save more lives, it said.

While the annual toll is below 10 million for the first time, it still means that more than 26,000 young children die each day, most from preventable causes.

Unicef warned that despite recent advances, Africa, South Asia and the Middle East are not on track to meet a United Nations goal of reducing child mortality by two-thirds between 1990 and 2015, to fewer than 5 million deaths per year.

'The enormity of the challenge should not be under-estimated,' the agency said in its annual report, “The State of the World's Children.”

The toughest climb lies ahead - attempting to boost children's life expectancy in countries ravaged by the HIV/AIDS epidemic and plagued by weak governance and poor health systems, Unicef said.

Sub-Saharan Africa has fared worst since 1990, and now accounts for 49 per cent of under-five deaths worldwide but only 22 per cent of births. A child born in the poverty-stricken region has a one-in-six chance of dying before turning five.

Nearly half of the 46 countries in sub-Saharan Africa have had either stable or worsening child mortality rates since 1990, the report said.

Only three - Cape Verde, Eritrea and the Seychelles - are on track to meet the 2015 child survival goal.  'There is no room for complacency,' said Unicef executive director Ann Veneman.

'More needs to be done to increase access to treatment and means of prevention, to address the devastating impact of pneumonia, diarrhoea, malaria, severe acute malnutrition and HIV,' the former US agriculture secretary said.

Children in the developing world frequently succumb to respiratory or diarrhoeal infections that no longer threaten lives in rich countries. Many also die from measles and other diseases that can be prevented through vaccines.

Unsafe water and poor sanitation also cause extensive disease and death, especially among malnourished children. Yet simple, affordable measures such as breast-feeding, vaccinations and insecticide-treated bed nets can dramatically reduce child deaths, according to Unicef.

Ensuring a 'continuum of health care' for mothers, newborns and young children, extending from the household to the local clinic and beyond, is key to survival, it said.

Unicef praised East Timor and Nepal as well as Haiti and Ethiopia for putting in place clear strategies to improve the livelihood of children, despite their extensive poverty.

The under-five mortality rate in China has also declined markedly to 24 for every 1,000 live births, from 45 in 1990, it said.-Reuters