The world has made huge progress in reducing child mortality – but the great remaining challenge is to save the lives of newborn babies.
Child mortality rates have plummeted to less than half of what they were in 1990, according to a new report – “Levels and Trends on Child Mortality Report 2015”—released today by UNICEF, WHO, the World Bank Group and the Population Division of UNDESA . Under-five deaths have dropped from 12.7 million per year in 1990 to 5.9 million in 2015 – a 53 percent drop since 1990. While this is remarkable and demonstrates strong political commitment can bring about real change in the lives of children, most progress is benefitting children older than 1 month.
The report also reveals that too many children -16,000 under the age of 5- are still dying from preventable causes. The first 28 days of life – the neonatal period – are the most vulnerable time for a child’s survival. Newborn deaths now make up 45% of all deaths of children under 5-years old and the rate of progress for reducing newborn morality has been slower thano for children after the neonatal period. To demonstrate this point, 63 countries need to accelerate progress to reach the SDG target for newborn mortality, more than the 47 countries for the under-five mortality target.
The new report reveals that three of the five leading causes of under-five death occur during the neonatal period: preterm birth complications, birth complications and neonatal sepsis. Other main causes of child death include pneumonia and diarrhea. The first day is the most dangerous day of life. Each year more than 1 million babies die on the day they are born. An additional 2.6 million babies (stillbirths) and 300,000 women die due to complications of pregnancy and childbirth.
Today the world is positioned as never before to save newborn babies and their mothers. “We know how to prevent unnecessary newborn mortality. Quality care around the time of childbirth including simple affordable steps like ensuring early skin-to-skin contact, exclusive breastfeeding and extra care for small and sick babies can save thousands of lives every year,” noted Dr Flavia Bustreo, Assistant Director General at WHO. “The Global Strategy for Women’s, Children’s and Adolescents’ Health, to be launched at the UN General Assembly this month, will be a major catalyst for giving all newborns the best chance at a healthy start in life.”
Quality care during childbirth results in a triple return on investment, saving mothers, newborns and preventing stillbirths. Closure of the quality gap through the provision of effective care for all women and babies at the time of birth in facilities could prevent an estimated 113 000 maternal deaths, 531 000 stillbirths, and 1·325 million neonatal deaths annually by 2020 at an estimated running cost of US$4·5 billion per year (US$0·9 per person).Newborn survival and health and stillbirth prevention starts with the survival and health of women before conception and during pregnancies and childbirth. Pregnancy and childbirth are the second leading causes of death among adolescent girls aged 15-19 worldwide. Without access to emergency obstetric services, many women and their babies die in pregnancy or during childbirth while many more suffer long-term health consequences that otherwise are preventable.
With the new Global Strategy for Women’s, Children’s and Adolescents’ Health and the Every Newborn Action Plan, ending preventable deaths for mothers and newborns is within reach. The Global Strategy for Women’s, Children’s and Adolescents’ Health, to be launched at the UN General Assembly this month, will be a major catalyst for giving all newborns the best chance at a healthy start in life. Every Newborn action plan, endorsed at the World Health Assembly in 2014, sets a clear vision for how to improve maternal and newborn health by 2035 and is supported by mortality and coverage targets, strategic actions, innovations and opportunities, evidence on costs and impact of interventions, milestones and clear roles for all actors.
- In 2015, 2.7 million newborns died globally, down from 5.1 million in 1990
- Newborn mortality rate fell from 36 deaths per 1,000 live births in 1990 to 19 in 2015.
- Newborn deaths now make up 45% of all deaths of children under 5-years old.
- The decline in neonatal mortality over 1990–2015 has been slower than that of post-neonatal under-five mortality (1-59 months): 47 percent, compared with 58 percent globally.
- 63 countries need to accelerate progress to reach the Sustainable Development Goal for newborn mortality, more than the 47 countries for the under-five mortality target.