Organization of neonatal care services and its importance

Universally 4 million newborns die and another 4 million are stillborn every year. 98% of these neonatal deaths take place in the developing countries. Looking at the state of the world's newborns one can see that neonatal mortality rate is about 4-5 per 1000 in the developed countries and nearly 10 fold this in the developing world. Causes that underlie these newborn deaths differ according to a country's development rank. According to the WHO estimates for the year 2001, newborns die due to infections (32%), birth asphyxia and trauma (29%), prematurity (24%) and congenital anomalies (10%), mostly in the developing countries. When organizing neonatal care services in a country or a region, priorities should be decided by looking at neonatal and perinatal mortality rates and causes of neonatal and perinatal deaths. Causes of neonatal and perinatal deaths in the developing countries have been documented and reflect some common underlying problems in the health systems. Starting points in the organization of neonatal health care services seem to include: improving women's health and social status, family planning practices, antenatal care and safe delivery conditions. Attention should also be paid to neonatal resuscitation, essential newborn care and sick newborn care practices. Communities and health professionals should be advocates of newborn health in order to seek and deliver newborn health care. Existing health systems should be re-organized to host regionalized perinatal care.