Healthy Newborn
Partnership
JULY 2002
Achievement of the Millennium
Development Goal for child sur-
vival is dependent upon a sub-
stantial reduction in newborn
mortality. Will newborns receive
the attention they deserve?
Facts on Newborn Mortality
• Every minute, eight babies die in
the first month of life and eight
babies are stillborn somewhere in
the world.
• Newborn deaths now account for
almost two-thirds of children who
die under one year of age – and 40
percent of all under-five deaths.
• More than half the babies who die
are low birth weight (under 2,500
grams), a reflection of multiple
causes, including maternal malnu-
trition.
• Currently, 50 million women de-
liver with no skilled health care,
and many more mothers and new-
borns go without any care during
the most vulnerable first days and
weeks after birth.
• Women who give birth when they
are too young, too old, or have
babies too closely spaced place
themselves and their newborns at
increased risk of complications.
Brian Moody, Malawi
Newborn Survival: Time for Action
“We do not know how many newborns die [each year]…but we
estimate it is almost four million. Four million too many.”
Dr. Gro Harlem Brundtland, WHO Director-General
Too Many Newborn Deaths
For many mothers and new babies in developing coun-
tries, childbirth is a risky business. During pregnancy,
childbirth, and the first days after delivery, mothers and
newborns face a series of threats to their health and sur-
vival. Too many die. Each year, 4 million newborns die
before they are one month of age and an equal number
Thomas Kelly, Nepal
are stillborn. Ninety-eight percent of these deaths occur
in developing countries, where 90 percent of babies are
born. A newborn in West Africa is almost 20 times more
likely to die in the first month of life than a baby born in
Northern Europe.
Newborn deaths now represent almost 40 percent of all deaths of children under age
five. If the Millennium Development Goal for child survival is to be met, priority must
be given to reducing the neonatal mortality rate.
Will newborns — often overlooked by health programs — receive the attention they
deserve? The majority of these deaths are preventable — and the solutions do not lie in
expensive technology or highly trained medical specialists. Rather, proven, low-tech
health interventions can make the difference between life and death for the majority of
mothers and newborns.
Women and newborns in many countries often do not reach health centers or hospitals
for reasons of inaccessibility, expense, cultural acceptability, or poor quality of care.
Policymakers need to develop comprehensive, locally appropriate strategies to inte-
grate essential newborn care into existing health systems, and promote healthy new-
born care practices in the home.
Reaching Families and Communities
The key to newborn survival is essential care at the primary health care level during
pregnancy, childbirth, and the postnatal period. To ensure effective care, health work-
ers must have the necessary drugs, supplies and functioning equipment, as well as ac-
cess to referral-level health care for management of complications.
Just as important, however, is working with community and family decision-makers to
address key issues of newborn survival. The promotion and support of healthy home
care practices such as early, exclusive breastfeeding, cleanliness, and warmth help to
prevent illness. Barriers to health care for pregnant women and newborns need to be
identified and addressed, including those related to early recognition of illness, trans-
port availability, and appropriate treatment. Health care providers need competency in
health care provision, but also in working with women, families, and communities to
support them in making healthy choices for maternal and newborn care.
Proven, cost-effective newborn care practices and services can be integrated into exist-
ing safe motherhood and child survival programs, which also benefit women and
older infants and children. However, expansion of services is necessary to ensure care
for all women and newborns who need it. Governments must invest in strengthening
the health care system, improving skills of health providers and ensuring reliable pro-
vision of drugs and equipment. National guidelines for the care of mother and baby
provide a framework to deliver higher quality of care, allowing women and newborns
to survive and thrive.
Effective Newborn
Health Care Interventions
During Pregnancy
• Immunization against tetanus
• Preparation for birth and possible
emergencies
• Strategies to address malaria, and
HIV, and other sexually transmitted
infections
• Strategies to address nutritional
deficiencies, including expansion of
iron-folate supplementation
During Childbirth
• Skilled attendance at birth for clean,
safer delivery
• Appropriate management of mater-
nal and perinatal complications
After Birth
• Essential care of the baby, ensuring
warmth and cleanliness
• Immediate and exclusive breastfeed-
ing for the newborn
• Special support for pre-term and
low birth weight babies
• Vigilance for danger signs, especially
those of infection, and appropriate
care for complications in newborns
and mothers
• Immunization
• Strategies to assist HIV-positive
mothers and their infants
• Counseling regarding birth spacing
for mothers
Many factors that impact newborn health are determined before pregnancy. A truly com-
prehensive response to the problem of neonatal mortality will therefore require a cross-
sectoral approach that aims to improve the health, nutrition, birth spacing, and status of
women.
Broadening Support for Newborn Health
To achieve the Millennium Development Goal for reducing under-five mortality set for
2015, the current global average neonatal mortality rate (34 deaths in the first month of life
per 1,000 live births) will need to be halved, requiring significant and sustained efforts.
The United Nations, the international community, and national leaders must take action
to ensure that newborns are given a chance for a healthy future. In countries with high
rates of newborn death, the commitment, initiative, and capability of decision-makers in
government can have a significant impact on the survival and health of women and new-
borns. In addition, governments can work with local communities, NGOs, and assistance
agencies to introduce and strengthen newborn health policies and programs through:
• Partnering with health care professionals to ensure expanded and strengthened health
care delivery and better information regarding newborn health outcomes;
• Raising awareness among families of the importance of care during pregnancy and
childbirth as well as after delivery; and
• Supporting improved government policies and expenditures for newborn care.
The Healthy Newborn Partnership
Preventing newborn deaths requires partnership among many local, national, and inter-
national institutions. The Healthy Newborn Partnership is an interagency group formed
in 2000 to:
• Promote attention and action to improve newborn health and survival;
• Provide a forum for information exchange on programmatic, research, training, and
communication issues related to newborn care; and
• Partner for joint activities as appropriate.
The Partnership acts in close cooperation with other relevant groups, such as the Inter-
Agency Group for Safe Motherhood. More information regarding the Healthy Newborn
Partnership is available from Saving Newborn Lives initiative at Save the Children/US.
Please forward questions to hnp@dc.savechildren.org. The State of the World’s Newborns
report provides an overview of newborn health with statistics for 163 countries
(www.savethechildren.org).

The Healthy Newborn Partnership advocates improvements in newborn health care,

particularly in settings where newborn deaths are common. This Partnership brings
together representatives from many organizations, including:

• Academy for Educational Development, Washington, DC, USA

• All India Institute of Medical Sciences, New Delhi, India
• BASICS II, Arlington, VA, USA
• Child Advocacy International, Stoke-on-Trent, England
• Department for International Development (DFID), London, England
• Family Care International, New York, NY, USA
• International Confederation of Midwives, Den Haag, The Netherlands
• International Pediatric Association, Paris, France
• International Perinatal Unit, Institute of Child Health, London, England
• John Snow International, London, England
• Malaria Consortium, London School of Hygiene and Tropical Medicine, London, England
• Maternal and Neonatal Health Program (JHPIEGO), Baltimore, MD, USA
• Save the Children/UK, London, England
• Save the Children/US, Washington, DC, USA (Secretariat)
• United Nations Population Fund (UNFPA), New York, NY, USA
United Nations Children's Fund (UNICEF), New York, NY, USA
Jaime Cisneros, Bolivia

•
• United States Agency for International Development (USAID), Washington, DC, USA
• White Ribbon Alliance for Safe Motherhood, Washington, DC, USA
• Women and Children First, London, England
• World Bank, Washington, DC, USA
• World Health Organization (WHO), Geneva, Switzerland

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