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Reducing neonatal mortality in developing countries: low-cost interventions are the key determinants

Journal of Perinatology volume 29, pages 74–75 (2009)Cite this article

We read with great interest the recent editorial and the original article published in the May issue of the journal.1, 2 Dr Gadzinowski, even though realizing that the results of the article will be challenging to the neonatologists outside North America, asserts that ‘Improvements in the survival of newborns on the threshold of viability contributes to improved Neonatal mortality rates (NMRs) on an international scale’. However, 98% of neonatal deaths occur in developing countries. NMR are the highest in the Sub-Saharan regions of western, middle and eastern Africa and South-Central Asia with rates between 42 and 49 per 1000 live births.3 More than two-thirds of the causes of neonatal deaths in these countries are due to causes not attributable to prematurity, and an even much smaller proportion can be attributed to extreme prematurity.4 For example, in India extremely low birth weight neonates contribute only 14.5% of neonatal deaths (3680), in live births at 18 network institutions across all regions of India.5

Though, many of us are now saving very and extremely low birth weight preterm neonates in developing countries, the advancement of neonatal care is hampered by marked heterogeneity within and between states, rural and urban gaps and within urban differences.6, 7 Social exclusion, caste, maternal literacy, negative parental attitudes arising from social environment, gender bias, ability to pay, and lack of basic prenatal, natal and postnatal care are the main determinants of newborn survival in developing countries.7, 8, 9, 10

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Authors and Affiliations

  1. Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, Delhi, India. E-mail: pankajparul8@rediffmail.com,

    P Garg & S Gogia

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Garg, P., Gogia, S. Reducing neonatal mortality in developing countries: low-cost interventions are the key determinants. J Perinatol 29, 74–75 (2009). https://doi.org/10.1038/jp.2008.123

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