This study uses annual time series data on under five mortality rate for Madagascar from 1960 to 2020 to predict future trends of U5MR over the period 2021 to 2030. Residuals and forecast evaluation criteria indicate that the applied model is stable in forecasting U5MR in Madagascar. The ANN (12, 12, 1) projections indicate that U5MR will remain high throughout the out of sample period. Hence, we implore health authorities in Madagascar to allocate more resources to the maternal and child health (MNCH) program to ensure availability of medical supplies and medical staff at all levels of healthcare especially in the rural areas.