Objective To investigate the death trend

cause of death

and healthcare service status of children under 5 years in Beibei district of Chongqing municipality from 2012 to 2019 to provide suggestions for the formulation of children’s health-care strategies. Methods From 2012 to 2019

the death cases of permanent resident children under 5 years in Beibei were derived from the System of Cause of Death Registration and Reporting Information system of the Chinese Center for Disease Control and Prevention. The infant mortality rate（IMR）

the under-5 mortality rate（U5MR）

cause of death constituent ratio

seasonal distri-bution of death

and utilization of premortem health care services were analyzed. Results From 2012 to 2019

IMR and U5MR were 2.70‰ and 3.87‰

respectively

and the trend of U5MR was not statistically significant（APC=-10.77%

P>0.05）. During the past 8 years

the top 6 causes of death in children under 5 were congenital heart disease

neonatal respiratory distress

drowning

perinatal pulmonary hemorrhage

pneumonia

and malignant tumors. The proportion of deaths from congenital heart disease decreased from 30.00% in 2012 to 5.56% in 2019. There was no significant difference in U5MR between sea-sons（P>0.05）. The proportion of children under 5 who had received inpatient and outpatient treatment before death was 93.71%. Conclusion Compared with the past

the U5MR and the proportion of congenital heart disease death in the Beibei district decreased markedly. Neonatal respiratory distress and drowning were harmful to children’s health

and the utiliza-tion rate of healthcare services before death remains high

which indicates the need to further strengthen perinatal healthcare and injury prevention.