Newborn health epidemiology
Key facts
- Maternal, perinatal and newborn health and mortality are closely linked and the risk of dying from neonatal conditions can be lessened by improved access to skilled care at birth and by key interventions provided during pregnancy and birth for the mothers and immediate post partum/postnatal period (within 48 hours).
- Every day, about 8 000 newborn babies die from preventable causes.
- Nearly 99% of all neonatal deaths occur in low- and middle-income countries.
- 70% of global deaths among newborn babies happen in just two WHO regions: Africa and South-east Asia.
- Essential maternal and newborn care and access to care for complications can save the lives of mothers and newborn babies.
- Strengthening the health system and integrating the interventions into packages of care that can be delivered at all levels - from home to facility - during pregnancy, childbirth, neonatal period, and childhood will be key to increasing the coverage of survival interventions.
Neonatal mortality
Deaths that occur among babies less than 28 days of life (neonatal period) account for about 40% of all under-five deaths1. The risk of dying during the neonatal period is highest closest to birth and decreases over the subsequent days and weeks: up to 50% of neonatal deaths occur within the first 24 hours of life and about 75% during the first week of life. In 2010, an estimated 3.1 million babies died during their first month of life. Apart from the 3.1 million newborn deaths that took place in 2010 an additional 2.6 million babies were estimated to be stillborn2.
Trends
Neonatal mortality has been declining worldwide. The number of deaths among babies 0-28 days of life decreased from 4.4 million in 1990 to 3.1 million in 2010. There was also a 28% reduction in neonatal mortality rates (NMRs) over the same period of time, from an estimated 32 deaths per 1000 live births to 23 deaths per 1000 live births - a slow progress. While some advancement have been in place and NMRs have declined in all WHO regions of the world, progress is unequally distributed.
While NMRs were halved in the European and Western Pacific regions, the reduction observed in the African region was only of 19%. Progress has been generally slow, and slowest in the region with highest NMR.
Although both, numbers and rates, have been lessening over the last 20 years, neonatal mortality account for an increasingly proportion of under-five deaths. Globally, this proportion augmented from an estimated 37% in 1990 to 40% in 20101.
Trends in neonatal mortality rates at global and regional levels. 1990-2010
Chart data from: UN-IGME. Levels & trends in child mortality. Report 2011
Distribution
70% of all neonatal deaths were concentrated in just two regions of the world: the African Region and South-east Asia. More than half (53%) of all these deaths were clustered in only five countries: India, Nigeria, Pakistan, China and Democratic Republic of the Congo. The vast majority (nearly 99%) of deaths among babies less than 28 days of life occurred in low- and middle-income countries. The risk of a newborn baby dying in a low-income group is about 8 times higher than that of a newborn from a high-income setting1.
Causes of neonatal mortality
Among the 3.1 million deaths that occurred among babies 0-28 days of life, about one third were due to infections (including pneumonia, sepsis, neonatal tetanus and diarrhea). Preterm birth complications caused another one million deaths among newborn babies. Birth asphyxia was the third major cause of death in this early period of life3. Newborn and maternal mortality are closely linked. Therefore, the risk of dying from neonatal conditions can be mitigated with quality care during pregnancy, safe and clean delivery by a skilled attendant, and immediate postnatal care, including resuscitation, extra care of low birth weight babies, attention to baby warmth, treatment of neonatal sepsis and early initiation of breastfeeding.
What we do
Improving maternal, newborn and under-five health and survival is one of WHO’s priorities. MCA is working to reduce maternal, newborn and under-five mortality by providing evidence-based clinical and programmatic guidance, setting global standards, and providing technical support to Member States. In addition, WHO advocates for more affordable and effective treatments, designs training materials and guidelines for health workers, and supports countries to implement policies and programmes and monitor progress.
1 UN-IGME. Levels & trends in child mortality. Report 2011
2 Cousens S et al. Regional and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis. Lancet 2011; 377:1319-30
3 WHO. World Health Statistics 2011.