Surviving the first day of life

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Surviving the first day of life

Posted 10/05/2013 by Joanne Simon-Davies

Every year three million babies die within the first month of life, with one million dying on the day they are born.

Most babies die from preventable causes such as infections. 

Every day, 800 women die during pregnancy or childbirth.

These statistics, released this week, are published in the 14th annual State of the World’s Mothers report by the organisation Save the Children. This FlagPost will show that the new born baby is still the most vulnerable and at risk of dying in both the developing and industrialised nations.

To determine in which country a baby is most likely to survive, Save the Children have caculated their first ever “Birth Day Risk Index” to identify the safest and most dangerous places to be born across 186 countries. In addition, the report also contains the annual "Mother's Index" (first published in 2000), which ranks 176 countries using five indicators to determine which countries have the best outcomes for mother and baby, these being:

Maternal health —  lifetime risk of material death
Children’s wellbeing —  under five mortality rate
Educational status — expected years of formal education
Economic status — gross national income per capita
Political status — participation of women in national government

For more information on the methodology, see page 75 of the report.

Below are some of the key findings from the report:

1. The first day of life is the most dangerous for both the mother and her baby; babies born in Somalia has the highest risk of dying on day one (18 deaths per 1 000 live births), followed by Democratic Republic of the Congo, Mali and Sierra Leone (all with 17 deaths per 1 000 live births). A mother in sub-Saharan Africa is 30 times more likely than a mother in an industrialised country to lose a newborn baby at some point in her life. On average, 1 in 6 African mothers are likely to lose a newborn baby.

2. Babies born to mothers living in the greatest poverty face the biggest challenges of survival. Virtually all (98 per cent) of newborn deaths occur in the developing world. Almost two-thirds (65 per cent) of the three million deaths in the first month of life occur in just ten countries:

Deaths of infants in the first month
First day mortality rate (per 1 000 live births)
First month mortality rate (per 1 000 live births)
876 200
254 100
169 400
143 400
DR Congo
137 100
81 700
79 700
66 300
51 000
48 100

However, whilst the number of deaths is still very high, according to Save the Children:  “The world has made unprecedented progress since 1990 in reducing maternal and child deaths. Working together, governments, communities, nongovernmental organisations and families have reduced the annual number of children under five who die each year by over 40 per cent — from 12 million to 6.9 million. Progress for mothers has been even greater, with deaths declining almost 50 per cent since 1990 — from 543 000 to 287 000 per year.

3. Low cost equipment such as antibiotics to treat infection, resuscitation devices to assist with breathing, plus basic education in regards to proper hygiene and breastfeeding along with trained health workers, saves lives of both mothers and babies. According to the report, there is a shortage of five million health workers …. in particular those trained in midwifery skills. Also, 40 million women each year give birth at home without the help of a skilled birth attendant increasing the risk of death of either the mother or child.

4. In the industrialised world, the USA has the most first-day deaths with an estimated 11 300 babies dying each year (three deaths per 1 000 live births). This compares to two deaths per 1 000 live births in Australia (or 480 deaths per year). Of those countries ranked the highest in the index, all are from industrialised countries with Australia being the only country outside Europe.

Mother's Index rankings: top ten countries:

1. Finland
2. Sweden
3. Norway
4. Iceland
5. Netherlands
6. Denmark
7. Spain
8. Belgium
9. Germany
10. Australia

Whilst Australia was ranked 10th, this is not shared across the whole population. According to the Australian Bureau of Statistics, infant mortality within the Indigenous population (7.2 per 1 000 live births in 2011) is still much higher compared with the total population (3.8 per 1 000 live births).

Despite overall infant death statistics looking bleak, particularly in developing countries, the report indicates that gains have been made. In Peru, the newborn death rate was 26 per 1 000 live births in 1990; dropping to nine deaths in 2011 (65 per cent decline). Bangladesh has declined by 49 per cent from 52 per 1 000 live births to 26 per 1 000 live births over the same period.

There is further information on the Save the Children report here.

Surviving the First day, State of the world’s mothers, 2013
ABS, Deaths Australia, 2011, Cat no. 3302.0

Image source: By Oxfam East Africa (Flickr: Halima Ahmed Ali holds her newborn baby) [CC-BY-2.0 (], via Wikimedia Commons

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