Saving Newborn Lives: The Global Perspective

Anne Tinker

DirectorSaving Newborn Lives Initiative

Save the Children FederationWashington, DC, USA

World Bank, October 29, 2003

40% of the world’s deaths of children under age 5 occur in the first month of life

4 million newborns die each year, and 4 million more are stillborn

Nearly 99% of the deaths occur in the developing world, most at home without skilled care

Poor newborn health can lead to learning disabilities, stunted growth, and early onset of chronic diseases

To meet the MDG on child mortality reduction, neonatal mortality must be reduced by at least one half

Why Focus on Newborns?

Relative Risk of Death per MonthD

eath

s p

er 1

000

live

bir

ths

Average number of deaths per month in each period of a child’s life

Newborn period 31 deaths per month

0

5

10

15

20

25

30

35

Post-neonatal period (1-11 months) 2 deaths per month Children (12-59 months)

1 death per month

The risk of dying is 15 times higher in the first month of life than in subsequent months of infancy

From: State of the Worlds Newborns 2001, State of the World’s Children 2001, WHO Publications

Causes of Newborn Deaths Pregnancy-related complications

(e.g., complications of prematurity, congenital anomalies)

34%

Delivery-related complications (e.g., asphyxia, birth injury) 29%

Infectious diseases (e.g., neonatal tetanus, pneumonia, sepsis, meningitis, diarrhea) 32%

WHO, 2001

Newborn Deaths are Preventable

70% of newborn deaths can be prevented by

simple, cost-effective interventions during

Pregnancy Delivery Newborn period

for as little as $1-3 per person per year.

Health Priorities for Newborns

Strong links with maternal health

Clean delivery and cord care Warming and drying Immediate, exclusive

breastfeeding Recognition and management

of the sick newborn: asphyxia, infection

Special care for the LBW infant

What is SNL?A global initiative, led by Save the Children and supported by the Gates Foundation, to improve newborn health and survival in the developing world

SNL’s strategy for improving newborn health and survival

Strengthen and expand proven, cost-effective interventions

Discover and diffuse new and better technologies and approaches

Increase understanding and commitment at global and country level

Build partnerships and mobilize resources to achieve scale and impact

Strengthen global and country level capacity to lead and support improved and sustained newborn health programming

Where we work

National programs fully operational in Pakistan, Bangladesh, Nepal, Malawi, Mali, and Bolivia

New programs being launched in India, Vietnam, Ethiopia, Myanmar, Indonesia, and Guatemala

Tools Development

Situation Analysis Newborn care training package Formative research guide List of core indicators

What can the World Bank do? Strengthen newborn health services in

health sector lending Include newborn mortality reduction as an

indicator of progress towards meeting the health MDGs

Establish partnerships, such as providing supplies and equipment while SNL or others provide technical assistance and community support

SNL Research Priorities

I. Improve household and community behaviors

II. Improve ENC delivery

III. Prevent and improve management of LBW

IV. Prevent and improve management of infection

V. Improve knowledge of causes of neonatal mortality

VI. Prevent and improve management of birth asphyxia

Research on key questions relating to newborn health and survival

How to improve newborn care practices and services in resource poor settings: community-based trials in India, Nepal and Malawi and Bangladesh

How to improve management of the sick newborn: research in prevention and management of birth asphyxia and infection

How to manage the low birth weight baby: lessons learned about kangaroo mother care and remaining research questions