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| Special emphasis must be placed on prenatal and postnatal care, essential obstetric care, and care for newborns, particularly for those living in areas without access to services |
The challenge
Each year, about 4 million children die within the first 28 days of life - the newborn (neonatal) period. Given that these newborn deaths account for 37 per cent of all under-five deaths, improving neonatal survival is essential if MDG 4 - reduce child mortality - is to be reached.
EACH YEAR, AROUND 4 MILLION NEWBORNS PERISH IN THE FIRST 28 DAYS OF LIFE
Global distribution of neonatal deaths by cause (2000)
Source: Lawn JE, S. Cousens and J. Zupans. 2005. "4 million neonatal deaths: When? where? why?" The Lancet, 365(9462): 891-900.
Newborns in developing countries are eight times more likely to die than newborns in industrialized countries. Sub-Saharan Africa and South Asia have the highest neonatal mortality rates at 44 deaths per 1,000 live births, compared to four deaths per 1,000 live births in industrialized countries.
NEWBORNS IN DEVELOPING COUNTRIES ARE EIGHT TIMES MORE LIKELY TO DIE THAN NEWBORNS IN INDUSTRIALIZED COUNTRIES
Neonatal mortality rate (per 1,000 live births), by region (2000)
Sources: UNICEF global databases, 2007
Interventions are simple, inexpensive -- and effective
A large proportion of the babies who die could be saved with low-tech, low-cost interventions, which would also help save the lives of mothers and prevent stillbirths. Reducing neonatal deaths requires improving women's health during pregnancy, providing appropriate care for both mother and newborn during and immediately after birth, and caring for the baby during the first weeks of life.
KEY INTERVENTIONS FOR REDUCING NEONATAL MORTALITY AND MORBIDITY
Source: Darmstadt, GL et al. 2005. "Evidence-based, cost effective interventions: How many newborns can we save?"The Lancet 365 (9463): 977-988.
Cost-effective, feasible interventions include initiating breastfeeding within one hour of birth, ensuring proper cord care, keeping the baby warm, recognizing danger signs and seeking care, and giving special care to infants with low birthweight.
The best way to ensure a continuum of care from pregnancy through early childhood is by integrating interventions in community-based programmes and linking them to other services within health systems.
Efforts to develop a core set of indicators to monitor these newborn care interventions are under way. But more work is needed to finalize these indicators for inclusion in household surveys.
UNICEF addresses newborn health within existing programme areas, such as immunization, nutrition, maternal health, prevention of mother-to-child transmission of HIV/AIDS (PMTCT), and prevention and control of malaria.
COVERAGE OF KEY NEONATAL SURVIVAL INTERVENTIONS IN THE DEVELOPING WORLD
References
The Lancet Neonatal Survival Series, March 2005.The Partnership for Maternal, Newborn and Child Health