Special emphasis must be placed on prenatal and post-natal care, essential obstetric care, and care for newborns, particularly for those living in areas without access to services

The challenge

Each year, about 4 million children die within the first 28 days of life – the newborn (neonatal) period. Given that these deaths of newborns account for 37 per cent of all under-five deaths, improving neonatal survival is essential if MDG 4 – reduce child mortality – is to be reached.

More than one third of neonatal deaths are caused by infections
Global distribution of neonatal deaths by direct cause (2000)


Source: Lawn, J. E., S. Cousens and J. Zupans, ‘4 million neonatal deaths: When? where? why?’ The Lancet, vol. 365, no. 9462, 2005, pp. 891-900.

Newborns in developing countries are 10 times more likely to die than newborns in industrialized countries. Sub-Saharan Africa and South Asia have the highest neonatal mortality rates at 41 deaths per 1,000 live births, compared to 3 deaths per 1,000 live births in industrialized countries.

Newborns in developing countries are 10 times more likely to die than newborns in industrialized countries
Neonatal mortality rate (per 1,000 live births), by region (2004)

Source: SOWC 2009.

Interventions are simple, inexpensive – and effective

A large proportion of the babies who die could be saved with low-tech, low-cost interventions, which would also help save the lives of mothers and prevent stillbirths. Reducing neonatal deaths requires improving women's health during pregnancy, providing appropriate care for both mother and newborn during and immediately after birth, and caring for the baby during the first weeks of life.

Key interventions for reducing neonatal mortality and morbidity

Source: Darmstadt, G. L. et al., ‘Evidence-based, cost-effective interventions: How many newborns can we save?’, The Lancet, vol. 365, no. 9463, 2005, pp. 977-988.

Cost-effective, feasible interventions include initiating breastfeeding within one hour of birth, ensuring proper umbilical cord care, keeping the baby warm and dry, recognizing danger signs and seeking care, and giving special attention to infants with low birthweight.

The best way to ensure a continuum of care from pregnancy through early childhood is by integrating interventions in community-based programmes and linking them to other services within health systems.

Efforts to develop a core set of indicators to monitor these interventions for the care of newborns are under way. But more work is needed to finalize these indicators for inclusion in household surveys.

 UNICEF addresses newborn health within existing programme areas, such as immunization, nutrition, maternal health, prevention of mother-to-child transmission of HIV/AIDS (PMTCT), and prevention and control of malaria.

Coverage of key neonatal survival interventions in the developing world

Source: UNICEF global databases 2007.    

References

The Lancet Neonatal Survival Series, March 2005.

The Partnership for Maternal, Newborn and Child Health.