NEWBORN SURVIVAL: A MULTI-COUNTRY ANALYSIS OF A DECADE OF CHANGE

Friday, 10th of August 2012

• NEWBORN SURVIVAL: A MULTI-COUNTRY ANALYSIS OF A DECADE OF CHANGE

Key messages below; full text is at http://heapol.oxfordjournals.org/content/27/suppl_3/iii6.full 

KEY MESSAGES

In 2010, 3.1 million newborns died in the first month of life, 17% fewer than in 2000. The annual rate of reduction of the neonatal mortality rate (NMR) globally (2.1%) has accelerated since 2000, but remains slower than the rate of reduction for maternal mortality (4.2%) and mortality amongst children aged 1–59 months (2.9%). Variation between regions and countries is considerable and not previously analysed.

There has been progress in reducing most causes of death since 2000, especially tetanus as well as neonatal infections addressable through child health programmes - pneumonia and diarrhoea. Deaths due to preterm birth complications are decreasing more slowly, and these are now the second leading cause of child deaths, requiring innovation for prevention solutions and urgent scale up of care solutions.

Our statistical analysis of inter-country NMR reduction suggests that in the last decade contextual factors, such as changes in income and fertility, are associated with more rapid NMR reduction, with measureable coverage change of newborn-related interventions contributing little. Lack of coverage data for some key interventions is a critical gap. In Africa, NMR change has been so limited that statistical modelling was not helpful in identifying predictors.

Official development assistance (ODA) for maternal, newborn and child health nearly doubled from 2003 to 2008, yet even by 2008 only 6.1% of this funding mentioned newborn-related activities. Per live birth in 2009, this equates to US$3.51 in ODA mentioning newborns or US$0.13 in ODA exclusively targeting newborns. Currently, government funding is not systematically tracked for reproductive, maternal, newborn and child health.

Over the last decade, and especially since 2005, there have been major advances in the evidence base for newborn survival—particularly more data and greater frequency of burden of disease estimation—and in consensus for implementation, as well as some increases in funding. In order to accelerate progress, greater emphasis is required on scaling up care, especially in the highest burden countries, and addressing context-specific implementation challenges regarding personnel, supplies and monitoring.