Why are 4 million newborn babies dying each year?

Abstract

In the summer of 2003 The Lancet published five articles on child survival written by the Bellagio Child Survival Group. These publications have had tangible effects. A Global Partnership for Child Survival secretariat is being established to assist the development and implementation of plans to reduce child deaths in 42 countries that account for 90% of deaths in those younger than 5 years of age. Two national meetings in Ethiopia and Cambodia have been held to discuss strategies for implementing the interventions outlined in the Bellagio child-survival series. Other countries are revising their child health and survival programmes. Although the Bellagio series has had an important effect in the child-survival arena a major gap in information and action remains about deaths in the first 4 weeks of life—the neonatal period. The second half of the 20th century witnessed a remarkable reduction in child mortality with a halving of the risk of death before the age of 5 years. Most of this reduction however has been because of lives saved after the first 4 weeks of life with little reduction in the risk of death in the neonatal period for most babies worldwide. Neonatal deaths estimated at nearly 4 million annually now account for 36% of deaths worldwide in children aged under 5 years. Millenium Development Goal 4 (MDG-4) regarding child survival stipulates a reduction of two-thirds in deaths in children aged under 5 years from 95 per 1000 in 1990 to 31 per 1000 in 2015. Given that the current global neonatal mortality rate is estimated to be 31 per 1000 live-births8 a substantial reduction in neonatal deaths will be required to meet MDG-4. Reduction of neonatal deaths should become a major public-health priority. (excerpt)