TY - JOUR
T1 - Neonatal survival
T2 - A call for action
AU - Martines, Jose
AU - Paul, Vinod K.
AU - Bhutta, Zulfiqar A.
AU - Koblinsky, Marjorie
AU - Soucat, Agnes
AU - Walker, Neff
AU - Bahl, Rajiv
AU - Fogstad, Helga
AU - Costello, Anthony
N1 - Funding Information:
VP was supported by the Bill & Melinda Gates Foundation through a grant to Save the Children/USA for the Saving Newborn Lives initiative. Additional work for the paper was supported by the Gates Foundation; the Office of Health, Infectious Diseases and Nutrition, Global Health Bureau, United States Agency for International Development, Washington, DC (award number GHS-A-00-03-00019-00); the Departments of Child and Adolescent Health and Development and Making Pregnancy Safer, WHO; and United Nations Children's Fund. The funding sources had no role in determining the content of the paper. The opinions expressed herein are those of the authors and are not necessarily the views of any of the agencies.
PY - 2005/3/26
Y1 - 2005/3/26
N2 - To achieve the Millennium Development Goal for child survival (MDG-4), neonatal deaths need to be prevented. Previous papers in this series have presented the size of the problem, discussed cost-effective interventions, and outlined a systematic approach to overcoming health-system constraints to scaling up. We address issues related to improving neonatal survival. Countries should not wait to initiate action. Success is possible in low-income countries and without highly developed technology. Effective, low-cost interventions exist, but are not present in programmes. Specific efforts are needed by safe motherhood and child survival programmes. Improved availability of skilled care during childbirth and family/community-based care through postnatal home visits will benefit mothers and their newborn babies. Incorporation of management of neonatal illness into the integrated management of childhood illness initiative (IMCI) will improve child survival. Engagement of the community and promotion of demand for care are crucial. To halve neonatal mortality between 2000 and 2015 should be one of the targets of MDG-4. Development, implementation, and monitoring of national action plans for neonatal survival is a priority. We estimate the running costs of the selected packages at 90% coverage in the 75 countries with the highest mortality rates to be US$4·1 billion a year, in addition to current expenditures of $2·0 billion. About 30% of this money would be for interventions that have specific benefit for the newborn child; the remaining 70% will also benefit mothers and older children, and substantially reduce rates of stillbirths. The cost per neonatal death averted is estimated at $2100 (range $1700-3100). Maternal, neonatal, and child health receive little funding relative to the large numbers of deaths. International donors and leaders of developing countries should be held accountable for meeting their commitments and increasing resources.
AB - To achieve the Millennium Development Goal for child survival (MDG-4), neonatal deaths need to be prevented. Previous papers in this series have presented the size of the problem, discussed cost-effective interventions, and outlined a systematic approach to overcoming health-system constraints to scaling up. We address issues related to improving neonatal survival. Countries should not wait to initiate action. Success is possible in low-income countries and without highly developed technology. Effective, low-cost interventions exist, but are not present in programmes. Specific efforts are needed by safe motherhood and child survival programmes. Improved availability of skilled care during childbirth and family/community-based care through postnatal home visits will benefit mothers and their newborn babies. Incorporation of management of neonatal illness into the integrated management of childhood illness initiative (IMCI) will improve child survival. Engagement of the community and promotion of demand for care are crucial. To halve neonatal mortality between 2000 and 2015 should be one of the targets of MDG-4. Development, implementation, and monitoring of national action plans for neonatal survival is a priority. We estimate the running costs of the selected packages at 90% coverage in the 75 countries with the highest mortality rates to be US$4·1 billion a year, in addition to current expenditures of $2·0 billion. About 30% of this money would be for interventions that have specific benefit for the newborn child; the remaining 70% will also benefit mothers and older children, and substantially reduce rates of stillbirths. The cost per neonatal death averted is estimated at $2100 (range $1700-3100). Maternal, neonatal, and child health receive little funding relative to the large numbers of deaths. International donors and leaders of developing countries should be held accountable for meeting their commitments and increasing resources.
UR - http://www.scopus.com/inward/record.url?scp=15744379507&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(05)71882-1
DO - 10.1016/S0140-6736(05)71882-1
M3 - Review article
C2 - 15794974
AN - SCOPUS:15744379507
SN - 0140-6736
VL - 365
SP - 1189
EP - 1197
JO - The Lancet
JF - The Lancet
IS - 9465
ER -