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Updated: Aug 13, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Why and how to invest in neonatal health
Viviana Mangiaterra1, Minna Mattero, Erika Dunkelberg
1The International Bank for Reconstruction and Development, The World Bank, Human Development Network, Children and Youth Unit, 1776 G Street, N.W. Floor 8, Washington, DC 20433, USA. vmangiaterra@worldbank.org
Insights
Neonatal deaths are a major cause of child mortality, accounting for 40% of deaths in children under five. Increased investment and implementation of proven neonatal interventions are crucial for reducing these preventable deaths.
Area of Science:
- Neonatal health
- Child mortality reduction
- Global health initiatives
Background:
- Neonatal deaths constitute nearly 40% of all under-five child mortality, highlighting an urgent global health challenge.
- Insufficient investment in neonatal care stems from misconceptions regarding its importance, cost, and feasibility.
- A significant reduction in child mortality necessitates focused attention on decreasing neonatal mortality and morbidity.
Purpose of the Study:
- To underscore the critical need for increased investment and programmatic implementation of neonatal care interventions.
- To advocate for a strengthened continuum of care, from community to clinical services, to address neonatal mortality.
- To emphasize the role of political commitment and robust health systems in improving neonatal outcomes.
Main Methods:
- Review of existing evidence on the effectiveness and cost-effectiveness of neonatal interventions.
- Analysis of factors contributing to underinvestment in neonatal care.
- Examination of successful models for implementing a continuum of care for maternal, newborn, and child health.
Main Results:
- Sufficient evidence exists on the effectiveness and cost-effectiveness of various neonatal interventions.
- Increased investment in neonatal care is justified and achievable with current knowledge.
- A continuum of care approach, supported by political will and strong health systems, is vital.
Conclusions:
- Urgent scaling up of evidence-based neonatal interventions is required.
- Overcoming misconceptions about neonatal care is key to unlocking necessary investments.
- International and national partnerships are essential for expanding neonatal health programs and reducing preventable deaths.
Abstract:
The proportion of neonatal deaths in children has significantly increased, comprising at present almost 40% of all the nearly 11 million deaths of children under the age of five. In order to further reduce child mortality, substantial prompt attention to and reductions in neonatal mortality and morbidity are necessary. The reasons for insufficient investment in neonatal care are mostly based on incorrect assumptions about the importance, cost, and difficulty of tackling the issue. Further research is needed on the cost-effectiveness of neonatal interventions, but there is sufficient knowledge and evidence on the range, effect and cost-effectiveness of interventions to support significant increase in investments and broader programmatic implementation of available approaches. The continuum of care that follows the life-cycle is part of a high impact program delivery, supported by enabling environment, encompassing strong political commitment and strengthened comprehensive health system, from community level to clinical services. The international community needs to increase its funding and extend programs in close coordination with national health programs that are translated into partnerships at national and international level.
