WHO, UNICEF call for improved prevention of newborn deaths

Interventions that include promoting breast-feeding, neonatal resuscitation, antenatal corticosteroids, and infection prevention and treatment could prevent 3 million maternal and newborn deaths each year, according to study findings published in The Lancet.

Worldwide, an estimated 3 million newborns die each year and an additional 2.6 million are stillborn. Newborn deaths accounted for 44% of deaths among children younger than 5 years in 2012, compared with 36% in 1990. In many regions, more than half of child deaths are newborns.

An estimated 5 million infants die without ever establishing a medical record. Stillborn infants, preterm infants and those who die shortly after birth are more likely to be unregistered, even in high-income countries. One in three newborns, more than 45 million infants, do not have a birth certificate by their first birthday.

South Asia and sub-Saharan Africa have the highest incidence of newborn deaths. In 2012, eight out of nine countries with neonatal death rates greater than 40 per 1,000 live births were in sub-Saharan Africa. India, Nigeria, and Pakistan have the next highest incidence of newborn deaths. While these countries have the most births, they have slow progress rates in decreasing deaths.

Joy Lawn, MPH, PhD, of the London School of Hygiene and Tropical Medicine, and colleagues, along with 55 global health experts, researchers, and policymakers from 27 institutions in 18 countries estimate that 116 million newborn deaths will occur by 2035 if greater investments in improving birth outcome are not made. Further, researchers also estimate that 31 million children will have disabilities and 68 million will have stunted growth by 2035 if improvement in care is not sought.

Lawn and colleagues said that investing in high-impact care prior to and immediately after birth is the most beneficial to prevention of newborn and maternal deaths.

“Our analysis shows that by increasing facility births and closing the quality gap at health care facilities by 2020, we could prevent an estimated 113,000 maternal deaths, 531,000 stillbirths, and 1.325 million newborn deaths each year,” study researcher Zulfiqar Bhutta, PhD, BBS, FRCPCH, FAAP, of the Centre for Global Child Health, the Hospital for Sick Children, in Toronto, said in a press release.

Analysis of eight high-burden countries indicated the most common barriers to improving newborn death rates were related to health workforce, financing and service delivery. These findings coincide with recent rapid reductions in newborn and maternal deaths by expanding their skilled workforce, reaching out to the poorest families, and focusing on improving care for small and ill newborns in Malawi, Nepal and Peru.

“We have made dramatic progress improving child survival in recent years, but it is clear that newborns have been left behind. To continue improving child survival, health, and development, we must now ensure every newborn has a healthy start. Investing in the health and wellbeing of newborns is a down payment on the future,” Mickey Chopra, PhD, chief of health at UNICEF, said in the release.

WHO and UNICEF will present this research at the Partners’ Forum hosted by the Partnership for Maternal, Newborn, and Child Health, in Johannesburg, South Africa, on June 30, in an effort to establish practical standards for care and improved measurements of births and deaths. — by Amanda Oldt