The first month of life is the most vulnerable period

Deaths in the first month of life, which are mostly preventable, represent 46 per cent of total deaths among children under five (2019 estimates). As mortality among children under five declines globally, deaths among these children are more and more concentrated in the first days of life. This makes focus on newborn care more critically than ever before. In 2019, an estimated 2.4 million children died in their first month of life, which is approximately 6,700 newborns every day, with about a third of all neonatal deaths occurring within the first day after birth, and close to three-quarters occurring within the first week of life. Despite ongoing challenges, major progress has been made in improving neonatal survival. Neonatal mortality is on the decline globally with the world’s neonatal mortality rate falling from 37 deaths per 1,000 live births in 1990 to 17 per 1,000 live births in 2019. The result is a drop in neonatal deaths worldwide from 5.0 million in 1990 to 2.4 million in 2019. However, this decline of 52 per cent is slower than the rate of decline among children under five year of age (70 per cent).

The large majority of newborn deaths (80 per cent) are due to complications related to preterm birth, intrapartum events such as birth asphyxia, or infections such as sepsis or pneumonia. Thus, targeting the time around birth with proven high impact interventions and quality care for small and sick newborns may prevent up to 80 per cent of newborn deaths. The “Every Newborn Action Plan” (ENAP) calls for an increased focus on the time around birth with targeted high impact interventions as a strategy for reducing not only newborn deaths but also maternal deaths and stillbirths, generating a triple return in investment.

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