Neonatal mortality

Neonatal mortality, covering deaths in the first month after birth, is of significance because the health interventions needed to address the major causes of neonatal deaths generally differ from those needed to address other under-five deaths. Neonatal mortality is increasingly important because the proportion of under-five deaths that occur during the neonatal period is increasing as under-five mortality declines.

Over the last two decades almost all regions have seen slower declines in neonatal mortality than in under-five mortality. Globally, neonatal mortality has declined 28 per cent from 32 deaths per 1,000 live births in 1990 to 23 in 2010 - an average of 1.7 per cent a year, much slower than for under-five mortality (2.2 per cent per year) and for maternal mortality (2.3 per cent per year). The fastest reduction was in Latin America and the Caribbean (52 per cent), followed by East Asia and the Pacific and Central and Eastern Europe / Commonwealth of Independent (48 per cent); the slowest reduction was in sub-Saharan Africa (19 per cent).

Over the same period the share of neonatal deaths among under-five deaths has increased from about 37 per cent to slightly above 40 per cent worldwide and is expected to further increase as under-five mortality declines. While the relative increase is modest (10 per cent) at the global level, there are differences across regions. The largest increases have been in Eastern and Southern Africa (18 per cent) and East Asia and the Pacific (18 per cent), the smallest in Latin America and the Caribbean (9 per cent; see table 3). In East Asia and the Pacific, which had one of the largest declines in under-five mortality, neonatal deaths accounted for 52 per cent of under-five deaths in 2010. East Asia and the Pacific South Asia will have to pay more attention to health interventions that address neonatal mortality in order to continue their success in reducing under-five mortality.

In South Asia neonatal deaths account for about 50 per cent of under-five deaths. Almost 30 per cent of all neonatal deaths globally occurred in India. Sub-Saharan Africa, which accounts for nearly a third of neonatal deaths, has the highest neonatal mortality rate (35 deaths per 1,000 live births in 2010) and has shown the least progress in reducing that rate over the last two decades.

With the proportion of under-five deaths during the neonatal period increasing in every region and almost all countries, systematic action is required by governments and partners to reach women and babies with effective care. Highly cost-effective interventions are feasible even at the community level, and most can be linked with preventive and curative interventions for mothers and for babies. For example, early post-natal home visits are effective in promoting healthy behaviours such as breastfeeding and clean cord care as well as in reaching new mothers. Case management of neonatal infections can be provided alongside treatment of childhood pneumonia, diarrhoea and malaria. Care at birth brings a triple return on investment, preventing stillbirths and saving mothers and newborns.

                                                        Neonatal mortality declined in all regions
                                                 Decline in neonatal mortality rate (percent), by UNICEF region, 1990 and 2010
                  

                    The share of neonatal deaths among under-five deaths has increased in all regions
                             Proportion of under-five deaths occur in neonatal period (%), by UNICEF region, 1990 and 2010
                 

Neonatal mortality rate, number of neonatal deaths and neonatal deaths as a share of under-five deaths, by UNICEF region, 1990 and 2010