Innovations for improving newborn survival in developing countries: Do integrated strategies for maternal and newborn care matter?

Each year millions of women, newborns and children die from preventable diseases. Worldwide, more than 60 million women deliver at home every year without a skilled birth attendant and about 530000 women die from pregnancy-related complications, with about 68000 of these deaths resulting from unsafe abortion. About 4 million babies die within the first month of life and more than 3 million are stillborn. An estimated 9.2 million children die under the age of five, of which 40% of deaths occur during the neonatal period. Three-quarters of all neonatal deaths (3 million) occur within the first week of life and at least I million babies die on their first day of life. With only 5 years left to achieve the Millennium Development Goals (MDGs), many obstacles stand in the way. Inequality, poverty, illiteracy, civil unrest and the absence of good-quality care are the major obstacles in progressing towards better health of mothers and children, a key component of the MDGs. Achieving MDG to reduce the under-five mortality by two-thirds from the level in 1990 by the year 2015 is not only critically dependent on a substantial reduction in neonatal mortality but also on measures to address high burdens of maternal morbidity and mortality, which also have a major effect on newborn survival and child health. Achieving MDG 5 of reducing the maternal mortality by three-quarters from the level in 1990 by 2015 requires concrete measures that may go way beyond the health sector.