Newborn Mortality

Every year worldwide about 3 million babies die within the first month of life. Of these, about one million die within 24 hours of birth and three of four die within the first week of life. As a proportion of child deaths, these neonatal deaths represent about 40% of all deaths of children under the age of 5 - a proportion that is increasing. If the Millennium Goal 4 of reducing early child mortality by two thirds is to be achieved, then action to reduce neonatal deaths – deaths within the first week of life – is urgently required. As Joy Lawn and colleagues appealed “Innovative approaches are required to….improve care in settings where far too many babies do not cry at birth”. To date, approaches to improve neonatal outcome have been, justifiably, focused on ensuring that women are attended by a trained health professional in labour and on simple measures to protect the baby from infection and cold. However, even in low resource countries that have increasing attendance rates in labor, birth asphyxia remains the major cause of death within the first 24 hours. For example, in India, where 60% of women are attended by a skilled care provider in labor, a third of all neonatal deaths occur within the first day - and of these a third are due to birth asphyxia. Overall, birth asphyxia ranks eighth as a global burden of disease, with estimated numbers of disability-adjusted life years (DALYs) due to birth asphyxia exceeding those due to all childhood conditions preventable by immunization. If we are to reduce neonatal death rates, and improve child health among survivors, then the consequences of birth asphyxia must be tackled. Using experiences from resource-limited settings, this session will illustrate how cheap cost-effective training of basic healthcare workers can be integrated with experimental research to improve care and introduce novel therapies, reducing asphyxia mortality and morbidity.