Why are so many newborns still dying?
Shafia Rashid is a senior program officer in FCI’s Global Advocacy program.
Estimates released earlier this month, based on research by WHO, Save the Children, and the London School of Hygiene and Tropical Medicine, indicate that 3.3 million newborn babies died in 2009. This reflects a substantial reduction over the past two decades: the authors estimate that 4.6 million newborns died in 1990, so newborn mortality has declined by 1.7% per year. While this is good news, the fact remains that maternal and child mortality have both been falling more rapidly, at 2.1% and 2.3%, respectively. (The child mortality figure includes newborns, meaning that mortality rates for children more than one month old can be assumed to have declined at an even higher rate.) As our colleague Flavia Bustreo, WHO’s Assistant Secretary-General for Family, Women’s and Children’s Health, has noted, “Newborn survival is being left behind despite well-documented, cost-effective solutions to prevent these deaths.”
At present, 41% of all children who don’t make it to their fifth birthday die during their first four weeks of life. This percentage has been rising, and will keep rising as long as child survival improves faster than newborn survival. Most newborn deaths, of course, occur in developing countries; Africa has shown the slowest progress, with newborn mortality falling by only 1% per year. Clearly, the world needs to more effectively address the continuing epidemic of newborn death — this is an essential key to meeting MDG 4’s goals for overall child survival.
Addressing these challenges requires concerted effort to improve both maternal and newborn health and survival. We know that the health of a woman and that of her newborn are closely linked: most maternal and newborn deaths are caused by the mother’s poor health before or during pregnancy or due to inadequate care in the critical hours, days, and weeks after birth. Improved, more accessible, and integrated services for both mother and baby can efficiently and effectively save both of their lives.
Last year, FCI collaborated with Dr. Zulfiqar Bhutta and a research team from Aga Khan University in Pakistan to review the research available on the impact of potential interventions on maternal and newborn outcomes, with a particular emphasis on linkages between the two. Initial results were presented at the Women Deliver conference and the Global Maternal Health Conference in 2010, and the final report will be published in BioMedCentral in January 2012.
The findings from this review highlight how health care for women and newborns is an interconnected continuum — many of the same clinical interventions benefit both mother and baby. It is therefore vital to interconnect care for women and for their newborn children — to promote greater efficiency and lower costs, and to reduce duplication of resources. Perhaps most importantly, integrating interventions can maximize impact on the health and survival of women and their newborns.
This research will be a helpful first step in better understanding why newborn survival is lagging, and — more importantly — in FCI’s efforts to promote investment in and implementation of health interventions that can save the lives of both women and their newborn babies.