Maternal, newborn, child and adolescent health

The Lancet Neonatal survival series


The goal of the Lancet Neonatal Survival Series is to provide information that will affect policy globally. The papers also provide a framework for practical action in countries so that these interventions reach families in greatest need. New information is given regarding critical factors related to neonatal deaths, where and why newborns die and assessments of the effectiveness and costs of interventions for newborn care. Practical steps are given to strengthen health care now in countries such as Ethiopia where 135 000 babies die every year, yet only 5 percent of women have a skilled care attendant during childbirth.

Key messages

  • Every year 4 million babies die in the first month of life - most die in developing countries from causes that are rare in rich countries. The Millennium Development Goal for reducing child deaths cannot be met unless we do more to reduce neonatal deaths, especially in Africa and South Asia.
  • Almost 3 million of the 4 million babies who die could be saved with low-tech, low-cost interventions, which would also help save the lives of mothers and prevent stillbirths. Yet these interventions currently do not reach those most in need.
  • These interventions could be provided to 90% of women and babies in poor countries by spending only $1 extra per inhabitant per year. About 70% of this spending would also benefit mothers and older children.
  • Investing in skilled care especially during childbirth is important, but this may take time. Interim, feasible solutions are available that will save newborn lives in community settings whilst health systems are being strengthened. There are low income countries which have reduced neonatal death rates by more than half in during the 1990s.
  • Leaders of poor countries must be held accountable for spending more and spending it better to protect their most vulnerable citizens. Leaders of rich countries and donor and United Nations agencies must also be held accountable for increasing funding and enabling progress in the highest mortality settings.