Neonatal and child mortality - are they different in developing and developed countries?

Area of Science:

• Global Health
• Demography
• Perinatal Epidemiology

Background:

• Neonatal and under-five mortality rates (U-5MR) remain critical global health challenges.
• Sustainable Development Goal 3.2 aims to eliminate preventable child mortality by 2030.
• Significant disparities exist in child mortality between high-income countries (HIC) and low-income countries (LIC).

Purpose of the Study:

• To compare neonatal mortality rate (NMR) and U-5MR in HIC versus LIC.
• To examine the potential impact of the COVID-19 pandemic on these mortality indicators.
• To assess progress towards Sustainable Development Goal 3.2.

Main Methods:

• Analysis of published data on NMR and U-5MR from SDG reports and other sources.
• Comparison of mortality rates between HIC and LIC, including sub-Saharan Africa (SSA).
• Evaluation of the proportion of NMR within U-5MR and the role of skilled birth personnel.

Main Results:

• NMR in HIC is approximately 10 times lower than in LIC and SSA.
• U-5MR is 13-15 times lower in HIC compared to LIC.
• While NMR constitutes a larger proportion of U-5MR in HIC (56.3%) than in LIC (40.3%) or SSA (36.8%), the absolute numbers are vastly different.
• Skilled birth attendance is nearly universal in HIC (99.0%) but significantly lower in LIC (58.6%).
• The COVID-19 pandemic is negatively impacting perinatal health indicators, potentially widening the existing mortality gap.

Conclusions:

• A substantial and widening gap in NMR and U-5MR exists between HIC and LIC, irrespective of the COVID-19 pandemic.
• The pandemic poses a threat to achieving SDG 3.2 targets, particularly in LIC.
• Improving skilled birth attendance and addressing pandemic-related disruptions are crucial for reducing child mortality globally.