The Challenge of Reducing Neonatal Mortality in Low- and Middle-Income Countries

Abstract

* Abbreviations: MDG — : Millennium Development Goals NMR — : neonatal mortality rate UNICEF — : United Nations Children’s Fund Living beyond the first 28 days of life remains a major accomplishment, particularly in most of southern Asia and sub-Saharan Africa. Dr Cooper presents critical data bringing forward the facts that provide evidence that straightforward and simple medical interventions will help infants get off to a safe and healthy start. Unfortunately, the pace of improvement in the availability of these basic health care services is occurring extremely slowly. Countries that are chronically underresourced have multiple factors contributing to poor neonatal survival rates. Yet, greater progress in improving survival rates could occur with increased attention to providing basic perinatal care. The 2015 Millennium Development Goal for improved child survival will not be achieved in large part due to the inadequate focus given to this critical issue. —Jay E. Berkelhamer, MD, FAAP Section Editor The mortality rate for children under the age of 5 years has been declining for a number of decades in most parts of the world. Impetus for this decline was provided by Millennium Development Goal (MDG) 4, which was approved by the United Nations General Assembly at the turn of the millennium. As reviewed recently in this journal,1 MDG 4 had as its main target the reduction by two-thirds, between 1990 and 2015, in the mortality rate in children younger than 5 years of age. The number of deaths in children under 5 has fallen from an estimated 12 million in 1990 to ∼6.9 million in 2011, representing a 41% reduction in mortality.2 Although this reduction is not sufficient to achieve MDG 4, it is nevertheless impressive. Over the same period, the global neonatal mortality rate … Address correspondence to Peter A. Cooper, FC Paed (SA), PhD, Department of Paediatrics and Child Health, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, York Rd, Parktown, Johannesburg, South Africa. E-mail: peter.cooper{at}wits.ac.za