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25 February 2014

Why are one million babies a year dying in their first day of life?

The first 24 hours in a baby's life are the most dangerous, but newborn deaths have been under-researched and neonatal care is under-funded.

By Sophie McBain

The first day of a baby’s life is the most dangerous. According to a report published by Save the Children today, one million newborns a year die in their first day of life. Another 2.9 million annually die within their first 28 days. And 1.2 million newborns die during labour. The charity believes that two million of these deaths are preventable, and if healthcare services were more equally distributed, this would reduce newborn mortality by 38 per cent.

These statistics make for depressing reading, but they are very significant. Traditionally, international aid agencies and charities have focussed on reducing infant mortality, which is usually defined as cutting down the number of deaths in children under five. Reducing infant mortality was one of the Millennium Development Goals pledged by the UN and signatory states in 2000, and since 1990 the number of children who do not make it to their fifth birthday has halved – although 18,000 children under five die each day from preventable illnesses.

Save the Children’s research however focuses specifically on the first month of life, and so highlights the important role that midwives can play in infant survival. Conventional statistics on infant mortality don’t count the 1.2 million babies that die during labour  – but these deaths are too numerous to ignore.

The best way of preventing the death of newborns is to ensure that women are looked after by skilled birth professionals – especially if they are trained in basic techniques like neonatal resuscitation and can advise on basic newborn care –  but each year 40 million women give birth without one, and two million of these will give birth completely alone. In Guinea, Nigeria, Somalia and Sierra Leone there are fewer than 2 doctors, nurses or other medical professionals per 10,000 people – but the critical threshold is considered to be 23. It’s no surprise then that together with Pakistan (which tops the list) these are the five countries where babies are most likely to die in childbirth or on their first day of life.

The positive from Save the Children’s report – if you can consider it that – is that the charity estimates that increasing health expenditure by $5 per person could prevent 32 million stillbirths, and save the lives of 147 million children and 5 million women by 2035. The biggest barrier isn’t financial: it’s finding the political will and commitment. 

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