Every Newborn: Progress, Priorities, and Potential Beyond Survival

Despite unprecedented progress in halving global maternal and child deaths over the past two decades, slower progress has been made in saving the lives of newborn babies in the first month of life. Every year, 2.9 million newborn babies die from mainly preventable causes, and 2.6 million more are stillbirths.In order to inform future actions to address this slow progress, this article reviews the status and progress of newborn health since the 2005 Lancet Neonatal Survival Series was published.  It is the second article of five published in the Lancet’s Every Newborn Series.Status of newborn health:

• From 1990 to 2012 the neonatal mortality rate (NMR) has decreased by 37%, from 33 to 21 deaths per 1,000 live births. This progress is slower than the 50% reductions in mortality rates for children aged 1 to 59 months.
• Regional variations in NMR reductions are substantial. Rates in neonatal mortality reduced by 65% between 1990 and 2012 in eastern Asia, compared with only 28% in sub-Saharan Africa and 17% in Oceania. 
• Country NMR variations are significant.  For example Sierra Leone has the highest NMR in the world at 49.5 deaths per 1,000 live births (2012). Japan has an NMR of 1 death per 1,000 live births (2012). 

2035 targets:Using findings of multi-country analyses and stakeholder consultations, the authors propose national targets for the post-2015 agenda: no more than 10 stillbirths per 1000 total births, and no more than 10 neonatal deaths per 1,000 live births by 2035.Priorities to accelerate progress in reaching targets:Where? Those countries with the highest burden of newborn deaths. Top three include India (777,000), Nigeria (267,000), and Pakistan (202 400). Also, those countries with the highest risk of stillbirth and neonatal mortality. These are in Africa.When? Around the time of birth.What? Three leading causes of neonatal deaths include severe infections, complications during delivery and preterm.Who? Babies born preterm or are small. These factors are the biggest risks for more than 80% of neonatal deaths.Counting deaths: An estimated third of babies are not given a birth certificate by their first birthday and most of neonatal deaths and almost all stillbirths are unaccounted for, receiving no death certificate. The authors conclude by putting emphasis on the fact that improvements in child survival, development and human capital in the post-2015 era will only be reached if every newborn baby is given a healthy start to life.Progress in neonatal  health for MamaYe countries include:Ethiopia: is sixth in the world for the highest burden of neonatal deaths in 2012 (87, 800).Malawi: is making rapid progress, with an average reduction rate (ARR) of 3.2% (1990-2012).Nigeria: is second only to India for the highest burden of newborn deaths in the world in 2012 (267,000)Sierra Leone: is making slow progress with an ARR of 0.8% between 1990 and 2012. To read the article, click here. Free registration is required.To read other articles in the series, click here.Lawn, J.E., Blencowe, H., Oza, S., You, D., Lee, A.C., Waiswa, P., Lalli, M., Bhutta, Z., Barros, A.J.D., Christian, P., Mathers, C., & Cousens, S.N. (2014). Progress, Priorities, and Potential Beyond Survival. The Lancet, 384(9938), 189 – 205.