Addressing Critical Knowledge Gaps in Newborn Health

A Decade of Change for Newborn Survival

This supplement, published in Health Policy and Planning, presents a comprehensive multi-country analysis of the changes in newborn care and survival from 2000-2010 and 5 detailed country case studies in order to better understand the process of taking solutions to scale and how to accelerate progress for reduction of mortality and morbidity.

It was authored by over 60 health experts with contributions from an additional 90 experts and coordinated by Save the Children's Saving Newborn Lives program. These analyses took over 3 years, using multiple data streams and new approaches to standardizing qualitative data regarding policy and program change.

The five detailed country case studies demonstrate that changing the trajectory for newborn survival is possible even in challenging settings when focus is placed on reaching the poorest families with the most effective interventions. Low-income countries, such as Bangladesh, Malawi and Nepal, that are on track to meet the 2015 target of Millennium Development Goal 4 have reduced newborn deaths at about double the rate that their neighbors have.

The HPP series includes comprehensive analyses of how Bangladesh, Nepal and Malawi are leaders in reducing newborn deaths; how Uganda has made strides in policy change for newborns; and how in Pakistan national partnerships and champions have kept newborn health on the agenda despite challenges including earthquakes and floods.

Free Access to the Full Papers:

Key Highlights:

  • In 2010, 3.1 million newborns died in the first month of life (17% fewer than in 2000).

  • Maternal mortality is declining faster than before, but newborn mortality is declining at half that rate—showing that improved maternity services are not enough to combat threats to newborn survival.  Declines in newborn mortality rates are also 30 percent slower than those of children under 5 who survive the newborn period.

  • From 2003 to 2008, official development assistance doubled for maternal, newborn and child health in the 68 countries with the most newborn deaths, but only 6 percent of this funding mentioned the word “newborn” and only 0.1 percent included specific newborn care interventions.

  • Family planning—i.e., increased access to voluntary contraception—has led to reductions in newborn deaths, which often relate to too short a time between births or the youth of a mother.  Prime examples are Nepal and Bangladesh, where the average number of babies per woman has been reduced by 50 percent.

  • 10 countries—including India and Ethiopia—account for two-thirds of neonatal deaths.

  • While economic growth is often linked to improved newborn survival, some of the world’s poorest countries have achieved tremendous progress in both newborn and child survival.  These include Malawi in Africa and Nepal in South Asia, both on track to meet MDG4, and Sri Lanka, which, despite conflict there, provides a dramatic example of halving deaths due to preterm birth.

  • The new report includes comprehensive analyses of how Bangladesh, Nepal and Malawi are leaders in reducing newborn deaths, how Uganda has made strides in policy change for newborns, and how in Pakistan national partnerships and champions have kept newborn health on the agenda despite challenges including earthquakes and floods.

  • More than 75 percent of newborn deaths could be prevented in 2015 with universal coverage of high-impact interventions like Kangaroo Mother Care (wrapping a newborns in skin-to-skin contact with their mothers for warmth and improved breastfeeding), antibiotics for babies with infections, exclusive breastfeeding, and other basic care.

The analyses show that changing the trajectory for newborn survival is possible even in challenging settings. With the Millennium Development Goals deadline rapidly approaching and neonatal mortality contributing an increasing proportion of under-five mortality, the supplement brings optimism that change is possible. There is an urgent need to scale up care that reduces newborn deaths within the continuum of care, more investment, improving frontline worker capacity and changing social norms so that it is no longer acceptable for babies around the world to die of preventable causes.

 Additional Resources Related to "A Decade of Newborn Survival"