Advancing the state of the world's newborns.
نویسندگان
چکیده
Despite declines in globalmortality rates in infants and children under five years of age in recent decades, neonatalmortality has remained relatively static. Consequently, approximately twothirds of deaths in infants and over one-third of deaths in under-five-year-olds now occur in the first 28 days of life (i.e., the neonatal period). There are an estimated four million neonatal deaths per year, with a further four million babies dying during the last trimester of pregnancy. The risk of dying in the first month of life is 10–15-fold higher than the risk during the post-neonatal period of infancy (2–12 months) and approximately 30-fold greater than during young childhood (13–60 months). The first week of life is a particularly high-risk period whenmore than two-thirds of neonatal deaths occur. In order to sustain gains in child survival and achieve Millennium Development Goals, as highlighted during the UN Special Session Summit for Children, held inNew York inMay 2002, a new focus is needed on improving neonatal health, particularly outcomes in the late fetal and neonatal periods. A disparity of up to 30-fold exists between the countries with the highest and lowest neonatal mortality rates (NMRs), the highest rates being in sub-Saharan Africa. Although the regional average NMR is lower in Asia, this area accounts for over 60%of the estimated global total. Strategies for advancing neonatal health must prioritize these regions with the worst neonatal health outcomes. Globally, most births and neonatal deaths take place in the home, often outside the formal health care system. The useful model of delays in access to maternal care, involving elements of recognition, decision-making, transport to care and receiving quality care, is also valuable in understanding the underlying causes of fetal and neonatal deaths. Nevertheless, little is known about traditional household practices in the intrapartum and postnatal periods, illness recognition, and the sociocultural and logistic factors that affect care-seeking by families for their newborn infants.
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ورودعنوان ژورنال:
- Bulletin of the World Health Organization
دوره 81 3 شماره
صفحات -
تاریخ انتشار 2003