Neonatal survival: a call for action.

Area of Science:

• Global Health
• Maternal and Child Health
• Neonatal Survival

Background:

• Neonatal mortality remains a significant barrier to achieving the Millennium Development Goal for child survival (MDG-4).
• Existing cost-effective interventions are not adequately integrated into current maternal and child survival programs.
• Health systems in low-income countries face constraints in scaling up essential newborn care.

Purpose of the Study:

• To outline strategies for improving neonatal survival, emphasizing the need for immediate action.
• To highlight the feasibility of success in resource-limited settings using low-cost interventions.
• To advocate for the integration of neonatal care into broader child survival initiatives.

Main Methods:

• Review of existing literature on neonatal mortality and cost-effective interventions.
• Analysis of potential costs for scaling up interventions in high-mortality countries.
• Estimation of the cost per neonatal death averted.

Main Results:

• Effective, low-cost interventions for neonatal survival exist but require programmatic integration.
• Scaling up interventions in 75 high-mortality countries is estimated to cost $4.1 billion annually, in addition to current spending.
• Approximately 30% of the estimated cost is for newborn-specific interventions, with the remainder benefiting mothers and older children.

Conclusions:

• National action plans for neonatal survival are a priority, requiring development, implementation, and monitoring.
• Increased funding and accountability from international donors and developing country leaders are essential.
• Maternal, neonatal, and child health services require greater financial investment relative to the burden of mortality.