Health of newborn babies key to reducing child mortality, report finds

Nearly three million babies die within the first month of life – more than one million on the same day they are born – largely from preventable causes, according to a new report published today. 

Newborn deaths today account for 43 percent of all child deaths, up from 36 percent in 1990, the report said. The highest newborn mortality rates were in sub-Saharan Africa, where the number of newborns who died each year slightly increased in that time period. 

The report, produced by the nonprofit Save the Children and titled “Surviving the First Day: State of the World’s Mothers 2013,” noted that reducing newborn deaths will be critical to moving towards the United Nation’s Millennium Development Goal (MDG) that aims to cut child deaths by two-thirds by 2015. Most of the 75 countries where child deaths are greatest are not on track to do so, according to the Countdown to 2015, a collaborative organization that monitors progress to the MDGs related to child and maternal health.

Save the Children’s focus on newborn health highlights that while significantly fewer children under the age of five die each year than 20 years ago, progress has been slower for the youngest and most vulnerable of children – newborns.

Sixty-five percent of all newborn deaths occur in just 10 countries in sub-Saharan Africa and South Asia, according to the report. Somalia had the highest mortality rate, and India had the greatest number of deaths, among babies who die the day they are born. 

State of the World's Mothers 2013 (Courtesy/Save the Children)

And yet, according to Save the Children, effective and low-cost interventions exist that, combined with trained health workers and increased access to quality healthcare, could reduce newborn mortality by up to 75 percent. The report said that such efforts have helped resource-poor countries like Bangladesh, Nepal, and Malawi each dramatically reduce its newborn death rate by more than 40 percent since 1990.

The leading causes of newborn death are preterm birth, birth complications, and infections, the report noted. In an example of the impact that one low-cost intervention could have, the report found that to reduce the number of babies that die because of prematurity, an event that causes 35 percent of all newborn deaths, a steroid injection for mothers that costs only US$0.51 could save 340,000 newborns each year. 

But in order for such solutions to make their way to the world’s poorest mothers, investments are needed at the country and global level, the report concluded.

“Ending preventable deaths within a generation will require an increased focus on the steps needed to reduce newborn mortality. What is lacking is the political will and funding to deliver these solutions to all the mothers and babies who need them,” the report said.

“The immediate thing we need is more workers who are able to be skilled and confident in what they can do for newborns,” Joy Lawn told GlobalPost. Lawn is a principal adviser on the report and newly appointed director of the Maternal and Reproductive & Child Health Centre at the London School of Hygiene and Tropical Medicine.

Funding, too, is a challenge to overcome. While the report documents that donor funding for maternal, newborn, and child health has increased significantly between 2003 and 2008, the amount allocated for newborn-specific programs “still lags far behind the need.”

Lawn called current funding levels “inappropriate” given the magnitude of the problem. Newborn deaths far outnumber children who die from HIV/AIDS, she pointed out, and yet that disease has been the cornerstone of US global health policy under PEPFAR, the President’s Emergency Plan for AIDS Relief.

Still, Lawn said that more than funding, greater attention and leadership around newborn health is needed.

“Overall, if you’re going to rank what the problems are, the first one is still that the attention and noise given to this issue is still small compared to the size of the problem,” she said. “The funding is an issue, but the funding will follow.”

Lawn said that progress is being made. Earlier this month, representatives from 50 countries convened in Johannesburg, South Africa, for the first global conference on newborns. Discussions from that meeting will inform a Global Newborn Action Plan, which is due out later this year, Lawn said.

Save the Children’s report comes out just days shy of Mother’s Day. In addition to rankings of birth-day mortality rates in 186 countries, it also includes an index of the best and worst places to be a mother, based on factors including a country’s maternal mortality rate, under-five child mortality rate, and formal education. Finland, Sweden, and Norway are the top three countries in a list of 176. Sierra Leone, Somalia, and the Democratic Republic of the Congo are at the bottom of the list. 

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