Key facts
- Although the global number of newborns deaths
declined from 5 million in 1990 to 2.4 million in 2019, children face the
greatest risk of death in their first 28 days.
- In 2019, 47% of all under-5 deaths occurred in the
newborn period with about one third dying on the day of birth and close to
three quarters dying within the first week of life.
- Children who die within the first 28 days of birth
suffer from conditions and diseases associated with lack of quality care
at birth or skilled care and treatment immediately after birth and in the
first days of life.
- Preterm birth, intrapartum-related complications
(birth asphyxia or lack of breathing at birth), infections and birth
defects cause most neonatal deaths.
- Women who receive midwife-led continuity of care
(MLCC) provided by professional midwives, educated and regulated to
internationals standards, are 16% less likely to lose their baby and 24%
less likely to experience pre-term birth.
Who is most at risk?
Globally
2.4 million children died in the first month of life in 2019. There are
approximately 7 000 newborn deaths every day, amounting to 47% of all child
deaths under the age of 5-years, up from 40% in 1990.
The world
has made substantial progress in child survival since 1990. Globally, the
number of neonatal deaths declined from 5.0 million in 1990 to 2.4 million in
2019. However, the decline in neonatal mortality from 1990 to 2019 has been
slower than that of post-neonatal under-5 mortality The share of neonatal
deaths among under-five deaths is still relatively low in sub-Saharan Africa
(36 per cent), which remains the region with the highest under-five mortality rates.
In Europe and Northern America, which has one of the lowest under-five
mortality rates among SDG regions, 54 per cent of all under-five deaths occur
during the neonatal period. An exception is Southern Asia, where the proportion
of neonatal deaths is among the highest (62 per cent) despite a relatively high
under-five mortality rate.
Sub-Saharan
Africa had the highest neonatal mortality rate in 2019 at 27 deaths per 1,000
live births, followed by Central and Southern Asia with 24 deaths per 1,000 live
births. A child born in sub-Saharan Africa or in Southern Asia is 10 times more
likely to die in the first month than a child born in a high-income country.
Causes
The
majority of all neonatal deaths (75%) occurs during the first week of life, and
about 1 million newborns die within the first 24 hours. Preterm birth,
intrapartum-related complications (birth asphyxia or lack of breathing at
birth), infections and birth defects cause most neonatal deaths in 2017. From
the end of the neonatal period and through the first 5 years of life, the main
causes of death are pneumonia, diarrhoea, birth defects and malaria.
Malnutrition is the underlying contributing factor, making children more
vulnerable to severe diseases.
Priority Strategies
The vast
majority of newborn deaths take place in low and middle-income countries. It is
possible to improve survival and health of newborns and end preventable
stillbirths by reaching high coverage of quality antenatal care, skilled care
at birth, postnatal care for mother and baby, and care of small and sick
newborns. In settings with well-functioning midwife programmes the provision of
midwife-led continuity of care (MLCC) can reduce preterm births by up to
24%. MLCC is a model of care in which a midwife or a team of midwives provide
care to the same woman throughout her pregnancy, childbirth and the postnatal
period, calling upon medical support if necessary. With the increase in
facility births (almost 80% globally), there is a great opportunity for
providing essential newborn care and identifying and managing high risk
newborns. However, few women and newborns stay in the facility for the
recommended 24 hours after birth, which is the most critical time when
complications can present. In addition, too many newborns die at home because
of early discharge from the hospital, barriers to access and delays in seeking
care. The four recommended postnatal care contacts delivered at health facility
or through home visits play a key role to reach these newborns and their
families.
Accelerated
progress for neonatal survival and promotion of health and wellbeing requires
strengthening quality of care as well as ensuring availability of quality
health services or the small and sick newborn.
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