Document Detail


Newborn survival: a multi-country analysis of a decade of change.
MedLine Citation:
PMID:  22692417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neonatal deaths account for 40% of global under-five mortality and are ever more important if we are to achieve the Millennium Development Goal 4 (MDG 4) on child survival. We applied a results framework to evaluate global and national changes for neonatal mortality rates (NMR), healthy behaviours, intervention coverage, health system change, and inputs including funding, while considering contextual changes. The average annual rate of reduction of NMR globally accelerated between 2000 and 2010 (2.1% per year) compared with the 1990s, but was slower than the reduction in mortality of children aged 1-59 months (2.9% per year) and maternal mortality (4.2% per year). Regional variation of NMR change ranged from 3.0% per year in developed countries to 1.5% per year in sub-Saharan Africa. Some countries have made remarkable progress despite major challenges. Our statistical analysis identifies inter-country predictors of NMR reduction including high baseline NMR, and changes in income or fertility. Changes in intervention or package coverage did not appear to be important predictors in any region, but coverage data are lacking for several neonatal-specific interventions. Mortality due to neonatal infection deaths, notably tetanus, decreased, and deaths from complications of preterm birth are increasingly important. Official development assistance for maternal, newborn and child health doubled from 2003 to 2008, yet by 2008 only 6% of this aid mentioned newborns, and a mere 0.1% (US$4.56m) exclusively targeted newborn care. The amount of newborn survival data and the evidence based increased, as did recognition in donor funding. Over this decade, NMR reduction seems more related to change in context, such as socio-economic factors, than to increasing intervention coverage. High impact cost-effective interventions hold great potential to save newborn lives especially in the highest burden countries. Accelerating progress requires data-driven investments and addressing context-specific implementation realities.
Authors:
Joy E Lawn; Mary V Kinney; Robert E Black; Catherine Pitt; Simon Cousens; Kate Kerber; Erica Corbett; Allisyn C Moran; Claudia S Morrissey; Mikkel Z Oestergaard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Health policy and planning     Volume:  27 Suppl 3     ISSN:  1460-2237     ISO Abbreviation:  Health Policy Plan     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-13     Completed Date:  2012-10-26     Revised Date:  2013-11-19    
Medline Journal Info:
Nlm Unique ID:  8610614     Medline TA:  Health Policy Plan     Country:  England    
Other Details:
Languages:  eng     Pagination:  iii6-28     Citation Subset:  H    
Affiliation:
Save the Children, Cape Town, South Africa. joylawn@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Africa South of the Sahara / epidemiology
Delivery of Health Care
Developing Countries / statistics & numerical data
Health Expenditures / trends
Health Policy
Humans
Infant Care / economics,  organization & administration,  standards,  trends
Infant Mortality* / trends
Infant, Newborn
Comments/Corrections
Erratum In:
Health Policy Plan. 2013 Oct;28(7):786-8

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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