Kabul, Afghanistan ? Six years after the Taliban’s ouster, medical care in Afghanistan has improved such that nearly 90,000 children who would have died before age 5 in 2001 will survive this year, Afghan President Hamid Karzai said Sunday.

Saddled for years with one of the world’s worst records on child health, Afghanistan has seen access to health care rise dramatically since the U.S.-led invasion.

Thousands of health clinics have been built across the country, and the Afghan government and aid agencies have trained tens of thousands of doctors, vaccinators and health volunteers who now reach into some of the country’s most remote areas.

Access to health care for Afghans has jumped from 8 percent of the population in the 1990s to close to 85 percent today, thanks in large part to efforts by USAID, the World Bank and the European Commission.

The under-5 child mortality rate in Afghanistan has declined from an estimated 257 deaths per 1,000 live births in 2001 to about 191 per 1,000 in 2006, a 25 percent drop, the Ministry of Public Health said, relying on a new study from Johns Hopkins University.

“This is certainly very positive news,” said the U.N. spokesman in Afghanistan, Adrian Edwards. “To come from such low life expectancy to see this improvement does appear to be an indication that the work on the health sector here is beginning to pay off.”

Karzai, surrounded by smiling Afghan children at a news conference in Kabul, thanked aid organizations and health workers for their work. He said 89,000 children will be saved each year because of the improved health care.

Still, Afghanistan faces severe problems. Even with the improvements, almost one in five Afghan children will die before age 5, translating into 250,000 childhood deaths a year, mostly from malnutrition, diarrhea, tuberculosis and malaria, said Health Minister Mohammad Amin Fatimi.

Childhood immunizations have risen dramatically, but Afghan infants make up the bulk of the country’s high child mortality rate, said Tariq Ihsan of Save the Children.

“Many newborns are dying because they don’t have access to immediate health care. I think that’s a real challenge for Afghanistan. They need to ask, ‘Are we saving enough newborns?”‘ Ihsan said.

Still, deaths of Afghan children who don’t reach their first birthday have dropped from 165 per 1,000 in 2001 to 129 per 1,000 today, a drop of some 22 percent, Edwards said.

Afghanistan’s child mortality rate, from birth to age 5, has been among the world’s worst. Before recent improvements, only Sierra Leone, with 283 child deaths per 1,000 live births, Angola with 260 and Niger at 259 ranked below Afghanistan’s 257, UNICEF said in a 2006 report.

By comparison, the United States has eight under-5 child deaths per 1,000 births. Singapore and Iceland, with three childhood deaths per 1,000, topped the rankings.