27. Newborn Survival
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Editors/Authors: Joy E. Lawn, Jelka Zupan, Geneviève Begkoyian, and Rudolf Knippenberg
Disease / Condition
Adolescent & Childhood Diseases
Maternal & Neonatal Conditions
Ten thousand newborns die each day?an unconscionable level of mortality given that most could be saved at relatively low cost. In the past, neonatal survival has not received enough attention, because these deaths are virtually invisible, occurring at home and often going unregistered. Of the 4 million known neonatal deaths each year, the majority occur in Sub–Saharan Africa and South Asia, where they are most often caused by infections, preterm birth, and asphyxia. Because neonate deaths account for more than one–third of the world's deaths of children under five, reduction in the under–five mortality rate cannot be achieved without substantial reduction in neonatal deaths.
Addressing newborn mortality requires links within the continuum of care from maternal health through pregnancy, childbirth, early neonatal care, and general child health. This creates a particular challenge in poor countries struggling with inadequate levels of skilled care and unstable health care systems. Nevertheless, community–level interventions form a first step. These encompass essential newborn care at time of birth, which can be carried out at home by a cadre of alternative health workers; basic newborn resuscitation using a self–inflating bag and air; and extra care for small babies, especially feeding and warming.
Not only are high–impact, low–cost, feasible interventions available, but they could avert close to 70 percent of the world's neonatal deaths. An interim, phased–in strategy may be most effective in developing countries. For example, community services could be used now, as professional care is being strengthened. While countries continue to seek funding for more comprehensive health systems, simpler approaches at the family–community level and through outreach services can save many lives.
- 27.1 The Continuum of Care for Mothers, Newborns, and Children, Showing Epidemiological Terms around the Time of Birth and Packages of Care Relevant to Newborn Health, According to Service Delivery Level
- 27.2 Trends in Early and Late Neonatal and Postneonatal Mortality, by Country Income Levels
- 27.1 Institutionalizing a Neonatal Resuscitation Program in a Chinese Province
- 27.2 Steps to Increase Coverage of Key MNCH Interventions in Ethiopia
- 27.3 Adding Newborns to IMCI in India
- 27.4 South Africa and the Perinatal Problem Identification Programme: Locally Owned Data for Decision Making
- 27.5 Reducing Newborn Deaths Is Possible in Low-Income Countries
- 27.1 NMRs and Neonatal Deaths by Region for 2000, and Variation in NMR by Income Quintile and by Region
- 27.2 Interventions to Reduce Fetal and Neonatal Mortality by Timing of Intervention and by Scalability of Intervention
- 27.3 Packages for Universal Scale-up of Newborn Care
- 27.4 Estimated Marginal Effect and Cost of Adding Neonatal Packages to Existing MCH Packages for Three Scenarios in Selected Indian States and Sub-Saharan African Countries