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Neonatal Mortality  and Perinatal Health: a Serious Challenge


Currently, 98% of all newborn deaths occur in developing countries where eight mothers lose their newborn infants every minute. A detailed 2006 WHO report on neonatal and perinatal mortality estimates that over 4 million babies die within the first 4 weeks of life, with 3 million of these deaths occuring during the neonatal period. Further, over 3.3 million babies are stillborn each year with 33% of these deaths preventable when occurring during delivery.


The data on neonatal mortality in the emerging world is straightforward. Illiteracy, low income, high fertility and sociocultural constraints create ideal conditions for the poor health and neglect of women (Paul and Singh 2004).  Women in developing nations uniformly suffer from deficiencies of micro- and macro-nutrients and encounter a host of infections such as malaria, UTI’s, and sexually transmitted diseases like HIV. They undergo stress and excessive physical exertion and are frequently exposed to toxic substances including alcohol, tobacco, and recreational drugs. These factors predispose women to fetal loss, low birth weight and neonatal death.


A common misconception persists that neonatal care requires highly technical and costly interventions delivered by specialists. However,  in the Journal of Perinatology, Moss et al (2011) reported that infant and child mortality can be significantly reduced with increased levels of maternal education. They note that two-thirds of all births in developing countries occur at home and in approximately half of these cases skilled care is not available. Achieving reduction in perinatal and neonatal mortality requires a functioning referral system and the availability of a hierarchy of trained health care providers. In this context the authors make it clear that  "interventions to train, monitor and supervise community heathcare workers in the recognition of complications of labor and delivery and appropriate referral of women at risk should be priorities in the emerging world."

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