Journal
BULLETIN OF THE WORLD HEALTH ORGANIZATION
Volume 94, Issue 10, Pages 752-758Publisher
WORLD HEALTH ORGANIZATION
DOI: 10.2471/BLT.15.160945
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Funding
- WHO through United States Agency for International Development (USAID)
- Department of Maternal, Newborn, Child and Adolescent Health (MCA) of WHO
- Centre for Intervention Science in Maternal and Child Health (RCN project) [223269]
- University of Bergen's Centre for International Health
- United Nations Children's Fund in New Delhi
- Research Council of Norway's GLOBVAC programme [183722]
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Objective To estimate neonatal mortality, particularly within 24 hours of birth, in six low- and lower-middle-income countries. Methods We analysed epidemiological data on a total of 149 570 live births collected between 2007 and 2013 in six prospective randomized trials and a cohort study from predominantly rural areas of Bangladesh, Ghana, India, Pakistan, the United Republic of Tanzania and Zambia. The neonatal mortality rate and mortality within 24 hours of birth were estimated for all countries and mortality within 6 hours was estimated for four countries with available data. The findings were compared with published model-based estimates of neonatal mortality. Findings Overall, the neonatal mortality rate observed at study sites in the six countries was. 30.5 per 1000 live births (range: 13.6 in Zambia to 47.4 in Pakistan). Mortality within 24 hours was 14.1 per 1000 live births overall (range: 5.1 in Zambia to 20.1 in India) and 46.3% of all neonatal deaths occurred within 24 hours (range:36.2% in Pakistan to 65.5% in the United Republic of Tanzania). Mortality in the first 6 hours was 8.3 per 1000 live births; i.e. 31.9% of neonatal mortality. Conclusion Neonatal mortality within 24 hours of birth in predominantly rural areas of six low- and lower-middle-income countries was higher than model-based estimates for these countries. A little under half of all neonatal deaths occurred within 24 hours of birth and around one third occurred within 6 hours. Implementation of high-quality, effective obstetric and early newborn care should be a priority in these settings.
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