Two million neonatal deaths take place in two developing regions of the world

The developing areas of South Asia and Sub-Saharan Africa account for more than two million neonatal deaths annually, according to research from the Johns Hopkins Bloomberg School of Public Health. Worldwide, there are an estimated five million deaths, with 98 percent of these deaths taking place in developing countries. South Asia and Sub-Saharan Africa represent 40 percent of all neonatal deaths, which are infants who die in their first 28 days of life. The study, “The burden of disease from neonatal mortality: a review of South Asia and Sub-Saharan Africa” is published in the October 2003 issue of BJOG: an International Journal of Obstetrics and Gynaecology.

Lead author of the study, Adnan A. Hyder, MD, MPH, PhD, assistant professor and the Leon Robertson Faculty Development Chair in the School’s Department of International Health, said, “Not only did our study demonstrate the impact of neonatal mortality in two of the poorest regions of the world, but it also reveals the poor state of data in these regions and the great need for strategic research on this issue. It also highlights a critical problem which is currently not receiving the attention of policy makers.”

Research data for the study was gathered from peer-reviewed literature, reports of Demographic and Health Surveys and websites of country-based organizations. The burden of neonatal deaths was calculated using summary measures of health or health gap measures that estimate the loss of health life from premature mortality. The healthy life year (HeaLY) methodology was also developed 1997 by Dr. Hyder and Richard Morrow, MD, MPH, FACP, a professor in the School’s Department of International Health.

Neonatal mortality ranged from 41 to 56 per 1,000 live births in South Asia. A significant lack of data from Sub-Saharan Africa resulted in a highly variable rate ranging from 13 per 1,000 live births in Kenya to 108 per 1,000 live births in Senegal. The mean regional rate in Sub-Saharan Africa was 38 per 1,000 live births.

The researchers also found that community- and hospital-based studies were severely lacking in Sub-Saharan Africa. Twenty-five papers were included in the study to evaluate South Asia and 35 for Sub-Saharan Africa. The researchers explain in their article that the lack of data was a major limitation.

“This study is just one step in raising the profile of neonatal issues and the need for investments in this arena of public health. The lack of valid data on neonatal mortality potentially could allow countries to undercount the impact of this public health problem. The next step for these areas is greater investments in neonatal research and health programs,” said Dr. Hyder.

The study was funded by Saving Newborn Lives – Save the Children, USA.

Salman A. Wali and Jeffery McGuckin co-authored the article.