Newborn deaths drop but account for higher share of global child deaths

Fewer newborns are dying worldwide, but progress is too slow and Africa is being left further and further behind. These are the findings of a new study published in the medical journal PLoS Medicine today. The study covering 20 years and all 193 WHO Member States was led by researchers from the World Health Organization, Save the Children and the London School of Hygiene and Tropical Medicine. The estimates are based on more data than ever, show detailed trends over time, forecast future progress and were consulted extensively with countries.

Newborn deaths dropped from 4.6 million in 1990 to 3.3 million in 2009, but fell only slightly during the last decade. More investment into health care for women and children since 2000 when the Millennium Development Goals (MDGs) were set resulted in more rapid progress for the survival of mothers (2.3% per year) and under-five children (2.1% per year) than for newborns (1.7% per year).

According to the new figures, newborn deaths, that is deaths in the first four weeks of life (neonatal period), today account for 41% of all child deaths before the age of five. That share grew from 37% over the last decade, and is likely to increase further. The first week of life is the riskiest week for newborns, and yet countries are only just starting postnatal care programmes to reach mothers and babies at this critical time.

“Newborn survival is being left behind despite well-documented, cost-effective solutions to prevent these deaths.” says Dr. Flavia Bustreo, Assistant Director-General of WHO. “With four years to achieve the Millennium Development Goals, more attention and action for newborns is critical.”

Almost 99% of newborn deaths occur in the developing world. The new study found that more than half of these deaths now happen in just five large countries – India, Nigeria, Pakistan, China and Democratic Republic of the Congo. India alone has over 900,000 newborn deaths per year, nearly 28% of the global total. Nigeria, the world’s seventh most populous country, now ranks second in newborn deaths up from fifth in 1990. This is due to an increase in the total number of births while the risk of newborn death has decreased only slightly. China, in contrast, moved from second place to fourth by simultaneously halving the risk of newborn death (23 to 11 per 1000) and reducing the overall numbers of births.

With 1% per year, Africa has seen the slowest progress of any region in the world. Among the 15 countries with more than 39 neonatal deaths per 1000 live births, 12 were from the WHO African Region (Angola, Burundi, Chad, Central African Republic, Democratic Republic of the Congo, Equatorial Guinea, Guinea, Guinea-Bissau, Mali, Mauritania, Mozambique, and Sierra Leone) plus Afghanistan, Pakistan and Somalia., At the current rate of progress it would take the continent over 150 years to reach U.S. or U.K. newborn survival levels..

Of the ten countries with a newborn mortality reduction of more than two-thirds in these two decades, eight were high income countries (Cyprus, Czech Republic, Estonia, Greece, Luxembourg, Oman, San Marino, and Singapore), and two were middle income countries (Maldives and Serbia).

“This study shows in stark terms that where babies are born dramatically influences their chances of survival, and that especially in Africa too many mothers experience the heartbreak of losing their baby.” said one of the co-authors, Dr. Joy Lawn of Save the Children’s Saving Newborn Lives programme. “These losses are avoidable with highly cost-effective, and feasible interventions addressing leading causes of newborn death – preterm birth, childbirth complications, and newborn infections.”

While the United Nations reports annually on child mortality under the ages of five and one years, estimates for newborn deaths are released only sporadically.

Learn more:

1.  Download the full paper (PDF)
2.  View the excel spreadsheet with neonatal data for 193 countries regarding numbers and rates and progress.

Photo © The ONE Campaign and Living Proof