Written by Mikkel Oestergaard and Colin Mathers from the World Health Organization
Where you are born matters tremendously for your risk of dying within the first four weeks of life – for example, if your mother gave birth to you today in Mali, you would be more than 30 times more likely to die within the first four weeks of life compared to someone being born today in Sweden. And compared to a generation ago – in 1990 – your chances of dying within this period of life has reduced by only 13% in Mali, but by 54% in Sweden.
These are some of the sad realities in global newborn health coming to light by new estimates of newborn mortality produced by the World Health Organization (WHO) in collaboration with other United Nations agencies, academic researchers from the Child Health Epidemiology Reference Group and Save the Children. The work is part of an ongoing international collaboration led by the WHO and UNICEF to understand levels and causes of child mortality in the world – both in newborn and in children under the age of five.
Estimates build on the largest publicly available database of newborn mortality, and on novel analytical methods for predicting trends and levels of newborn mortality risk, including the development of a statistical model to predict for the 155 countries (92% of global live births in 2009) without reliable civil registration systems to capture the birth and death of newborn.
The new evidence includes annual time series for the period 1990-2009 of newborn mortality risk and deaths for 193 countries – the first ever United Nations estimates of levels and trends of global newborn mortality – and provides new key data for national and international efforts in setting priorities for improving newborn health.
With this work, it is becoming clear that progress in reducing newborn mortality is trailing further and further behind advancements being made in reducing mortality in older children and in maternal mortality, which calls for increased explicit focus on newborn health to meet the increasing relative burden of newborn mortality in the world.
A total of 79 million babies died in the first month of life over the 20 years from 1990 to 2009, with a reduction in annual number of deaths from 4.6 million in 1990 to 3.3 million newborn deaths in 2009.
Between the years 1990 and 2009, the average annual rate of reduction in the risk of newborn mortality was 1.7% per year globally, but almost 25% faster for child mortality (at 2.1% per year) and more than 35% faster for maternal mortality (at 2.3% per year). In the same time period, the proportion of annual child deaths that occur in newborn has increased by 8% globally, from 37% to 41%.
The global numbers hide large regional and country differences in reducing newborn mortality risk. Africa is clearly falling further and further behind the rest of the world in improving care for newborn and is today the region with the highest mortality risk for newborn – for every 1000 live births in Africa today, close to 36 babies will die in the first month of life. If current rates of progress continues in Africa, it will take the region more than 150 years to catch up to newborn survival rates experienced today in high-income countries such as Sweden where less than 4 babies die per 1000 live births.
We all want to see our babies having the best possible chances of survival no matter where the mother is giving birth. We hope that everyone will make use of this new evidence base to help set priorities in newborn health to help develop conditions and care that allow all babies the same high chances of survival.
- Download the paper (PDF)
Photo: Laurent Duvillier/Save the Children