Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities

English version České info

Background:
Historically, the main focus of studies of childhood mortality has been the infant and under-five mortality rates. Neonatal mortality (deaths <28 days of age) has received limited attention, although such deaths account for about 41% of all child deaths. To better assess progress, we developed annual estimates for neonatal mortality rates (NMRs) and neonatal deaths for 193 countries for the period 1990–2009 with forecasts into the future.

Methods and Findings:
We compiled a database of mortality in neonates and children (<5 years) comprising 3,551 country-years of information. Reliable civil registration data from 1990 to 2009 were available for 38 countries. A statistical model was developed to estimate NMRs for the remaining 155 countries, 17 of which had no national data. Country consultation was undertaken to identify data inputs and review estimates. In 2009, an estimated 3.3 million babies died in the first month of life—compared with 4.6 million neonatal deaths in 1990—and more than half of all neonatal deaths occurred in five countries of the world (44% of global livebirths): India 27.8% (19.6% of global livebirths), Nigeria 7.2% (4.5%), Pakistan 6.9% (4.0%), China 6.4% (13.4%), and Democratic Republic of the Congo 4.6% (2.1%). Between 1990 and 2009, the global NMR declined by 28% from 33.2 deaths per 1,000 livebirths to 23.9. The proportion of child deaths that are in the neonatal period increased in all regions of the world, and globally is now 41%. While NMRs were halved in some regions of the world, Africa's NMR only dropped 17.6% (43.6 to 35.9).

Conclusions:
Neonatal mortality has declined in all world regions. Progress has been slowest in the regions with high NMRs. Global health programs need to address neonatal deaths more effectively if Millennium Development Goal 4 (two-thirds reduction in child mortality) is to be achieved.

: Please see later in the article for the Editors' Summary

Vyšlo v časopise: Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities. PLoS Med 8(8): e32767. doi:10.1371/journal.pmed.1001080
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001080

Souhrn

Zdroje

1. LawnJECousensSZupanJ 2005 4 million neonatal deaths: when? Where? Why? Lancet 365 891 900

2. ShiffmanJ 2010 Issue attention in global health: the case of newborn survival. Lancet 375 2045 2049

3. TinkerAten Hoope-BenderPAzfarSBustreoFBellR 2005 A continuum of care to save newborn lives. Lancet 365 822 825

4. BlackRECousensSJohnsonHLLawnJERudanI 2010 Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375 1969 1987

5. ZupanJAahmanE 2005 Perinatal mortality for the year 2000: estimates developed by the WHO Geneva WHO

6. DarmstadtGLBhuttaZACousensSAdamTWalkerN 2005 Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 365 977 988

7. KnippenbergRLawnJEDarmstadtGLBegkoyianGFogstadH 2005 Systematic scaling up of neonatal care in countries. Lancet 365 1087 1098

8. MartinesJPaulVKBhuttaZAKoblinskyMSoucatA 2005 Neonatal survival: a call for action. Lancet 365 1189 1197

9. LawnJECousensSNDarmstadtGLBhuttaZAMartinesJ 2006 1 year after The Lancet Neonatal Survival Series—was the call for action heard? Lancet 367 1541 1547

10. HillKThomasKAbouZahrCWalkerNSayL 2007 Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet 370 1311 1319

11. United Nations 2010 The Millennium Development Goals Report 2010 New York United Nations

12. 2010 Trends in maternal mortality: 1990 to 2008. Estimates developed by WHO, UNICEF, UNFPA and The World Bank Geneva WHO

13. HoganMCForemanKJNaghaviMAhnSYWangM 2010 Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 375 1609 1623

14. YouDJonesGHillKWardlawTChopraM 2010 Levels and trends in child mortality, 1990–2009. Lancet 376 931 933

15. RajaratnamJKMarcusJRFlaxmanADWangHLevin-RectorA 2010 Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet 375 1988 2008

16. Editorial 2010 Can we count on global health estimates. PLoS Medicine 7 e1001002 doi:10.1371/journal.pmed.1001002

17. BoermaTJMathersCAbou-ZahrC 2010 WHO and global health monitoring: the way forward. PLoS Medicine 7 e1000373 doi:10.1371/journal.pmed.1000373

18. ByassP 2010 The imperfect world of global health estimates. PLOS Medicine 7 e1001006 doi:10.1371/journal.pmed.1001006

19. MurrayCJLLopezAD 2010 Production and analysis of health indicators: the role of academia. PLoS Medicine 7 e1001004 doi:10.1371/journal.pmed.1001004

20. GrahamWJAdjeiS 2010 A call for responsible estimation of global health. PLoS Medicine 7 e1001003 doi:10.1371/journal.pmed.1001003

21. SankohO 2010 Global health estimates: stronger collaboration needed with low- and middle-income countries. PLoS Medicine 7 e1001005 doi:10.1371/journal.pmed.1001005

22. McCarthyBJTerryJRochatRWQuaveSTylerCWJr 1980 The underregistration of neonatal deaths: Georgia 1974–77. Am J Pub Health 70 977

23. LumbiganonPPanamontaMLaopaiboonMPothinamSPatithatN 1990 Why are Thai official perinatal and infant mortality rates so low? Int J Epidemiol 19 997

24. BangAReddyMHDeshmukhMD 2002 Child mortality in Maharashtra. Econ Polit Weekly 4947 4965

25. United Nations Population Division (nd) World Population Prospects: The 2008 Revision New York United Nations

26. MathersCDMa FatDInoueMChalapatiRLopezAD 2005 Counting the dead and what they died from: an assessment of the global status of cause of death data. B World Health Organ 83 171 177

27. HastieTTibshiraniRFriedmanJ 2010 The elements of statistical learning: data mining, inference, and prediction. 2nd edition New York Springer

28. MurrayCJLLaaksoTShibuyaKHillKLopezAD 2007 Can we achieve Millennium Development Goal 4? New analysis of country trends and forecasts of under-5 mortality to 2015. Lancet 370 1040 1054

29. RudanIChanKYZhangJSFTheodoratouEFengXL 2010 Causes of deaths in children younger than 5 years in China in 2008. Lancet 375 1083 1089

30. Measure DHS ICF Macro 2011 Malawi demographic and health survey 2010. Preliminary report Calverton (Maryland) ICF Macro

31. LawnJEBlencoweHPattinsonRCousensSKumarR 2011 Stillbirths: where? When? Why? How to make the data count. Lancet 377 1448 1463

32. LawnJEGravettMGNunesTMRubensCEStantonC 2010 Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth 10 Suppl 1 S1

33. LawnJEKinneyMLeeACCChopraMDonnayF 2009 Reducing intrapartum-related deaths and disability: can the health system deliver? Int J Gynaecol Obstet 107 S123 S142

34. LawnJKerberK 2006 Opportunities for Africa's newborns: practical data, policy and programmatic support for newborn care in Africa Geneva WHO on behalf of Partnership for Maternal, Newborn and Child Health (PMNCH)

35. WallSNLeeACCNiermeyerSEnglishMKeenanWJ 2009 Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up? Int J Gynaecol Obstet 107 S47 S62, S63–S64

36. HillKChoiY 2006 Neonatal mortality in the developing world. Demographic research 14 429 452