The first month of life is the most vulnerable period

Deaths in the first month of life, which are mostly preventable, represent 47 per cent of total deaths among children under five. 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 critical than ever before. In 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7,000 newborns every day. Most of these newborns died in the first week of life with approximately one million dying in their first day and another one million dying in the following six days. 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 18 per 1,000 live births in 2018. The result is a drop in neonatal deaths worldwide from 5.1 million in 1990 to 2.5 million in 2018. However, this decline of 51 per cent is slower than the rate of decline among children aged 1-59 months (63 per cent).

The large majority of newborn deaths (79 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 79 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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