Abstract / Summary
Abstract Background China has made remarkable progress in reducing child mortality, yet substantial regional disparities persist, particularly in western and rural areas. This study aimed to analyse the long-term trends in neonatal mortality rate (NMR), infant mortality rate (IMR) and under-five mortality rate (U5MR) in rural Guangxi from 2000 to 2024 and to forecast these indicators up to 2030. Methods This ecological study used official NMR, IMR and U5MR data for rural Guangxi from 2000 to 2024. Joinpoint regression was applied to calculate annual percent change (APC) and average annual percent change (AAPC) and to identify trend joinpoints. Autoregressive integrated moving average (ARIMA) models were constructed to project mortality rates for 2025–2030. Results From 2000 to 2024, NMR, IMR and U5MR in rural Guangxi declined continuously, with AAPCs of − 10.97% (95% CI: −11.47% to − 10.33%, P < 0.001), − 10.03% (95% CI: −10.65% to − 9.61%, P < 0.001) and − 9.04% (95% CI: −9.61% to − 8.64%, P < 0.001), respectively. The ARIMA models projected that by 2030, NMR, IMR and U5MR will reach 0.90‰, 1.13‰ and 1.80‰, respectively. Conclusions Rural Guangxi achieved substantial reductions in child mortality between 2000 and 2024, but the decline has slowed markedly in recent years, suggesting a possible plateau. Future efforts should prioritise strengthening neonatal critical care networks and primary maternal and child health services in rural areas.