Newborn health

Fact sheet

Key facts

• Each year, an estimated 2.955 million babies in the world die before they reach the age of one month, and 3 million more are stillborn.
• Nearly 43% of all under-five child deaths in the world are among newborn infants, babies in their first 28 days of life or the neonatal period.
• Three quarters of all newborn deaths occur in the first week of life.
• Neonatal mortality has been declining worldwide. The number of deaths among babies 0-28 days old decreased from 4.4 million in 1990 to 2.955 million in 2011. There was also a 32% reduction in neonatal mortality rates (NMRs) over the same period of time, from an estimated 32 deaths per 1000 live births to 22 deaths per 1000 live births.
• Up to two thirds of newborn deaths can be prevented if known, effective health measures are provided at birth and during the first week of life.
• In developing countries, nearly half of all mothers and newborns do not receive skilled care during and immediately after birth.
• Preterm birth, intrapartum-related complications (birth asphyxia or lack of breathing at birth), and infections cause most neonatal deaths.
• The Millennium Development Goal on child survival (MDG4) aims at reducing child mortality by two thirds by 2015 from the 1990 level.
• Reaching the MDG4 target will require universal coverage with effective, affordable interventions, including:
• The Millennium Development Goal on child survival (MDG4) aims at reducing child mortality by two thirds by 2015, from the 1990 level.
• Care for newborns and their mothers;
• Infant and young child feeding;
• Vaccines;
• Prevention and case management of pneumonia, diarrhoea and sepsis;
• Malaria control;
• Prevention and care of HIV/AIDS.
• In countries with high mortality, these interventions could reduce the number of deaths by more than half.
• Expanding access to skilled care at birth, to essential newborn care and to management of newborn complications will contribute to progress towards MDG4 and MDG5.

The situation

• Viet Nam has made remarkable progress in reducing child mortality and is on track to achieve MDG4 targets. Nationally, the under-5 mortality rate dropped from 53 per 1000 live births in 1990 to 16 per 1000 live births in 2011. In the same period, infant mortality decreased from 44 to 12 per 1000 live births
• The neonatal mortality rate (NMR) has declined over the past decades and is now estimated to be 12 per 1000 live births at national level.
• However, in Viet Nam about 18,000 newborn babies die every year (UNICEF, WHO, WB, UN report Level and trends in Child Mortality, 2011) .
• MOH data indicate that while NMR in urban areas is 9 per 1000 live births, in mountainous areas it can be as high as 17 per 1000.
• Neonatal mortality represents 60% of all under-5 deaths in Viet Nam (WHO estimates 2011). Therefore the MOH has identified newborn health as a priority in the National Plan of Action for Child Survival 2009-2015 and in the National Plan on Reproductive Health, with a focus on Safe Motherhood and Newborn Care 2011-2015.
• Policies and guidelines for newborn care have been updated, training materials have been developed and standards for setting newborn care corners at primary level and newborn care units at district and provincial level have been developed and scaled-up by the MOH.
• These materials will be used for national scaling up. Moreover, Training programmes to scale up international and national recommendations are ongoing with financial support from national target program and international partners.

WHO's response

• The National Plan of Action for Child Survival 2009-2015, and in the National Plan on Reproductive Health with focus on Safe Motherhood and Newborn Care 2011-2015, both developed with WHO support, have set the ambitious targets of reducing NMR to less than 10 per 1000 live births by 2015.
• WHO supports the MOH in fulfilling its commitments to the UN Global Strategy for Women's and Children's Health and to implemening the recommendations of the United Nations Commission on Information and Accountability for Women and Children Health which include newborn health.
• In the area of immunization, WHO has assisted in ensuring a high coverage of tetanus immunization and the introduction of a birth dose of hepatitis B vaccination.
• Neonatal tetanus was eliminated in 2005 and isolated cases are reported only in hard-to-reach districts.
• WHO has worked with the MOH in the development and dissemination of national standards and guidelines on newborn care for different levels of the health system.
• WHO provided support to adapt the training package on Essential Newborn Care, targeting health workers in health facilities at commune and district levels. The course has been introduced in two provinces with high neonatal mortality.
• WHO assisted in adapting and introducing the training Course on Community-based Newborn Care and Community-based Management of the Sick Child, targeting community volunteers.
• WHO has provided technical and financial support to set up a newborn care unit in three district hospitals situated far from the provincial hospital in Cao Bang.
• Under the current One UN programme, WHO advocates equity analysis and development of policies aiming at reaching communities that are excluded from maternal and newborn care services.