Abstract
The latest nationwide survey of Pakistan showed that considerable progress has been made toward reducing all child mortality indicators except neonatal mortality. The aim of this study is to compare Pakistan’s under-five mortality, neonatal mortality, and postnatal newborn care rates with those of other countries. Neonatal mortality rates and postnatal newborn care rates from the Demographic and Health Surveys (DHSs) of nine low- and middle-income countries (LMIC) from Asia and Africa were analyzed. Pakistan’s maternal, newborn, and child health (MNCH) policies and programs, which have been implemented in the country since 1990, were also analyzed. The results highlighted that postnatal newborn care in Pakistan was higher compared with the rest of countries, yet its neonatal mortality remained the worst. In Zimbabwe, both mortality rates have been increasing, whereas the neonatal mortality rates in Nepal and Afghanistan remained unchanged. An analysis of Pakistan’s MNCH programs showed that there is no nationwide policy on neonatal health. There were only a few programs concerning the health of newborns, and those were limited in scale. Pakistan’s example shows that increased coverage of neonatal care without ensuring quality is unlikely to improve neonatal survival rates. It is suggested that Pakistan needs a comprehensive policy on neonatal health similar to other countries, and its effective programs need to be scaled up, in order to obtain better neonatal health outcomes.
Highlights
The target of the fourth Millennium Development Goal (MDG4) was to reduce the global number of children dying under the age of five by two-thirds between 1990–2015 [1]
Data Source for Trend Analysis data were obtained from 27 Demographic and Health Surveys (DHS) from nine low- and middle-income countries (LMIC)
To the best of our knowledge, this is the first cross-national comparative study that focuses on the neonatal mortality and postnatal newborn care rates of LMICs
Summary
The target of the fourth Millennium Development Goal (MDG4) was to reduce the global number of children dying under the age of five by two-thirds between 1990–2015 [1]. The under-five deaths only halved to 43 deaths per 1000 live births, according to the MDG Report 2015. Observatory of the World Health Organization (WHO), children within the neonatal period (birth to the first 28 days) remain at the highest risk of dying, as this period comprised about 45% of all under-five deaths in 2013 [3]. Progress on reducing neonatal mortality is slower than that of under-five and infant mortality; the global neonatal mortality rate decreased from 33 per 1000 live births in 1990 to 21 in 2012 [2]. It is estimated that 99% of newborn deaths take place in low- and middle-income countries (LMICs) [4]
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