NEW DELHI : Global deaths of newborn babies remain alarmingly high, particularly among the worldÂs poorest countries, UNICEF said today in a new report on newborn mortality. Babies born in Japan, Iceland and Singapore have the best chance at survival, while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds.

ÂWhile we have more than halved the number of deaths among children under the age of five in the last quarter century, we have not made similar progress in ending deaths among children less than one month old, said Henrietta H. Fore, UNICEFÂs Executive Director. ÂGiven that the majority of these deaths are preventable, clearly, we are failing the worldÂs poorest babies.Â

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.

The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.

Unequal shots at life 

More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. However, a shortage of well-trained health workers and midwives means that thousands donÂt receive the life-saving support they need to survive. For example, while in Norway there are 218 doctors, nurses and midwives to serve 10,000 people, that ratio is 1 per 10,000 in Somalia.

This month, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the worldÂs newborns. Through the campaign, UNICEF is issuing an urgent appeal to governments, health care providers, donors, the private sector, families and businesses to keep every child alive by:

·         Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;

·         Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;

·         Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and

·         Empowering adolescent girls, mothers and families to demand and receive quality care.

ÂEvery year, 2.6 million newborns around the world do not survive their first month of life. One million of them die the day they are born,” said Ms. Fore. 

“We know we can save the vast majority of these babies with affordable, quality health care solutions for every mother and every newborn. Just a few small steps from all of us can help ensure the first small steps of each of these young lives. 

India has shown impressive progress in reduction of under-five mortality, nearly meeting its MDG target, with a 66 per cent reduction in under-five deaths during 1990 to 2015. IndiaÂs progress has been far better than the worldÂs; the global decline in the under-five mortality during the MDG period was 55 per cent.  The recent progress is even better, with 120,000 fewer deaths in 2016 as compared to 2015. The number of annual under-five deaths in India has gone below one million for the first time in 2016.

The gains for reduction of neonatal mortality have been comparatively modest, with 55 per cent reduction during the MDG period. The progress has also been inequitable for girls in the neonatal period. India is the only big country in the world to have a higher mortality for girls as compared to boys. Poor care seeking for female newborn, with only 41 per cent of admissions in Special Newborn Care Units being females. 150,000 fewer female admissions in SNCUs as compared to male. Source  SNCU online database.

Ensuring gender equity with equal focus on boys and girls and addressing gaps in quality of care are now going to be the next frontiers for newborn survival. The issue of neglect of the girl child is much broader and needs interventions beyond health, to also address the social norms and cultural practices. It would require working both at the policy level to create an enabling environment, and at the community level, to build awareness and bring emphasis on the value of the girl child. Addressing gender inequity is everyoneÂs responsibility, we need to create a social movement around this. There is an urgent need to intensify our combined efforts to further bridge this gap and ensure equitable access to care for the newborn girl. There is a need to create a social movement involving all stakeholders  Government, Professional bodies, civil societies, media, political leaders and communities  truly leaving no one behind.