Addressing Critical Knowledge Gaps in Newborn Health

Newborn Numbers

Globally, 2.8 million babies die during their first month of life (the newborn period) and 2.6 million babies are stillborn. Why? When? Where? What can we do?

This page provides the latest global, country and regional estimates related to neonatal survival. The following information is aimed to support governments, program managers, policymakers and stakeholders in national planning for newborn health policy and implementation. For questions or information not found on this resource page, please email us at info@healthynewbornnetwork.org

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Three main causes of death —prematurity, complications during childbirth, and neonatal infections — account for four out of five newborn deaths (more than 80% of the total burden). Globally, complications from preterm birth and complications during childbirth are among the top three killers of children under-five (after pneumonia), accounting for 17% and 11% of the total number respectively. 

The latest estimates of global newborn deaths each year are:

  •  Complications from prematurity: 965,100
  •  Complications during childbirth including birth asphyxia: 661,700
  •  Neonatal infections (pneumonia, sepsis, meningitis, tetanus, diarrhea): 629,700

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The day a baby is born is the most dangerous day of a child’s life in countries rich and poor. An estimated 1,049,300 children die each year on the day they are born, representing 15 percent of all deaths among children under-5 each year. Data and evidence shows that if nations are truly committed to accelerate progress in reducing child mortality, they must concentrate more attention and resources around delivering quality care at the time of birth and during the critical day and weeks after birth. Care at birth brings a triple return on investment, saving mothers, newborns and preventing stillbirths. Nearly half of births in low-income countries occur without a skilled attendant, and even fewer mothers and babies have postnatal contact with providers who can deliver interventions that save lives.


In 2013, more than three-quarters of the world's newborn deaths occur in South Asia (1,070,000 deaths) and sub-Saharan Africa (1,066,000 deaths), which have both the highest neonatal mortality rates among regions and the largest number of annual births. With 1,760,000 newborn deaths in 2013, ten countries alone make up for two-thirds of the total annual number of neonatal deaths, with India accounting for more than a quarter and Nigeria for a tenth. These same 10 countries also account for nearly 56% of maternal deaths worldwide.  


The pace of progress toward Millennium Development Goal (MDG) 4 for child survival is accelerating as the 2015 target draws nearer. Newborn mortality is on the decline globally, falling from 33 deaths per 1,000 live births in 1990 to 20 in 2013. This means that across the world, more newborns are alive and healthy today than 20 years ago, but a lack of political attention and resources continue to contribute to the slow progress in saving newborn lives. While newborn deaths have decreased from 4.7 million in 1990 to 2.8 million in 2013, this decline is a third slower than for under-five deaths after the first month of life. As a result, the proportion of under-five deaths happening in the first four weeks of life has increased – today newborns account for 44% of deaths among all children under-five – up from 36% in 1990. Complications during childbirth and from preterm birth together accounted for one fourth of all under-five deaths. With the share of under-five deaths during the neonatal period rising in every region and almost all countries, newborn health must be addressed more effectively if progress on overall mortality is to continue at a rapid rate.

Some countries have achieved remarkable progress in reducing neonatal mortality. Five countries have reduced their neonatal mortality rates by more than 75% between 1990 and 20132 (Estonia, Luxembourg, Maldives, the Czech Republic and Serbia). Countries that have achieved increases in contraceptive use and concurrent reductions in fertility have made more progress for newborn survival. 

Sub-Saharan Africa has seen a fast decline in its under-five mortality rate, with the annual rate of reduction doubling between 1990–2000 and 2000–2013. However, progress in reducing the neonatal mortality rate remains virtually stagnant in this region. The number of neonatal deaths has in fact increased in sub-Saharan Africa, from 944,000 in 1990 to 1,029,000 in 2013.  In contrast, Latin America and the Caribbean has made the most progress in the past two decades than any other region in the world, reducing its newborn mortality rate by 58% from 255,000 deaths in 1990 to 101,000 in 2013. Though starting at lower preterm birth rates, some high-income countries, such as Canada, Switzerland and the United States have also made little progress since 2000, due in part to increasing preterm birth prevalence.


Since 2000, major advances in the evidence base for newborn survival have enabled countries to pave the way for impact at large scale, showing that rapid change is possible. Thanks to joint efforts by multiple national and global stakeholders, we have begun to bend the curve for newborn survival. Trends showing progress, lessons learned, and success stories are proof that efforts to save newborn lives have been effective.  

Over two-thirds of newborn deaths could be prevented annually through the high coverage of cost-effective, low-tech maternal and newborn health interventions. Evidence-based strategies to save the lives of women and babies include a menu of interventions, which are usually provided through integrated service delivery packages at different levels along the continuum of care, from pre-pregnancy, through pregnancy and birth, as well as postnatal care. National coverage data is available for some service delivery packages (e.g. antenatal care, skilled attendance) and for a few specific interventions that have been a focus for a longer time, such as tetanus toxoid immunization. Other high impact neonatal interventions with recent attention, such as Kangaroo Mother Care and neonatal resuscitation, have no national data available. 

Learn about measuring coverage of key interventions: visit HNN’s Newborn Indicators page.  

Countdown to 2015. Accountability for Maternal, Newborn and Child Survival: 2013 Update. Note: median for 75 Countdown priority countries with available data; bars refer to ranges between countries.

The following resources are recommended sources for global and country data. Take a look at the trends and progress towards improving newborn health around the world.   

Each year, The State of the World's Children, UNICEF's flagship publication, closely examines a key issue affecting children. The report includes supporting data and statistics that can be downloaded in MS Excel format and is available in French and Spanish language versions.Childinfo contains UNICEF’s statistical information, including data used in UNICEF’s publications, The State of the World’s Children and Progress for Children. In addition, Childinfo holds technical resources for conducting UNICEF-supported Multiple Indicator Cluster Surveys (MICS), a major source of global development data. 
Multiple Indicator Cluster Survey: UNICEF assists countries in collecting and analyzing data in order to fill data gaps for monitoring the situation of children and women through its international household survey initiative the Multiple Indicator Cluster Surveys (MICS).

WHO Neonatal Mortality Statistics. Raw data inputs for country neonatal mortality estimates can be downloaded here, including latest estimates and methodology for neonatal mortality. World Health Statistics is the WHO's annual report that presents the most recent health statistics for 193 member states. All reports are available for download in Adobe PDF and MS Excel and include country-level data on mortality rates, cause of death, human resources and coverage indicators. In addition, the Global Health Observatory is WHO's portal providing access to data and analyses for monitoring the global health situation.

Child Mortality Estimates (CME Info) is a database containing the latest child mortality estimates based on the research of the UN Inter-agency Group for Child Mortality Estimation.
 

 The Countdown to 2015 Initiative tracks coverage levels for health interventions proven to reduce maternal, newborn and child mortality. Download the latest report and access country-specific profiles for 75 countries. 

 

The DHS program, funded by USAID, provides technical assistance to countries to conduct surveys on population, health, HIV and nutrition, advancing global understanding of health and population trends in developing countries. Reports, survey questionnaires, and related materials are available for downloading. The DHS website also includes STATcompiler, which provides quick facts and country comparisons, allowing users to build customized tables from hundreds of DHS surveys and indicators. 

The Institute for Health Metrics and Evaluation (IHME) is an academic institution in The University of Washington, Seattle, USA. IHME works to advance modelling methods for global health issues including mortality, health financing, among others. It also coordinates work for the Global Burden of Disease studies.

 

The Guttmacher International Data Center allows users to create tables and maps with the most current data available from 75 countries and 22 world regions. The Data Center is an easy to use tool for finding information on abortion, pregnancy, services and financing, adolescents, and contraception.

 Key newborn health publications:

 

A new series of papers, published May 20th, 2014 in The Lancet, presents the clearest picture to date of progress and challenges in improving newborn survival around the world, and sets targets that must be achieved by 2030 in order to ensure every newborn has a healthy start. 

 

  

Each year, Save the Children releases its annual report: State of the World's Mothers. This year's 14th annual report highlights newborn health - which countries are doing the best – and which are doing the worst – at preventing newborn deaths.The report includes the Birth Day Risk Index and the renowned Mothers Index. You can download the full report in English andExecutive Summaries are available in multiple languages.

The supplement, "A decade of change for newborn survival (2000-2010): a multi country analysis of progress towards scale", 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 coordinated by Save the Children’s Saving Newborn Live program, and funded by the Bill & Melinda Gates Foundation in collaboration with over 150 contributors (mainly in-country partners). 

The first-ever national, regional and global estimates preterm birth  were published in Born Too Soon: The Global Action Report on Preterm Birth in 2012.

 

 

The first ever global and national estimates of stillbirths were presented in The Lancet Series on Stillbirth, which also provided the most comprehensive assessment to date of global numbers and causes of stillbirths, perceptions and beliefs around the world, and the solutions to prevent stillbirths—well-known interventions as well as innovations. 

The December 2010 issue of Seminars in Perinatology higlights Global Perinatal Health. The papers provide insight on accelerating progress through innovations, interactions, and interconnections. Read the article that reviews progress for newborn health globally, with a focus on the countries in which most deaths occur.