KARACHI: Pakistan is the riskiest place to be born in in the world as measured by its newborn mortality rate. For every 1,000 babies born in Pakistan in 2016, 46 died before the end of their first month, a staggering 1 in 22, says a Unicef report released on Tuesday.

Titled Every child alive, the urgent need to end newborn deaths, the report once again highlights the lack of countries’ progress in saving the lives of newborn babies — those aged less than one month.

According to the report, while newborn mortality rates have fallen in recent decades, they still lag behind the impressive gains made for children one month to five years old. Between 1990 and 2016, the mortality rate in this age group dropped by 62 per cent — almost two thirds.

In contrast, the newborn mortality rate declined by only 49pc. As a result, newborn deaths now account for a greater, and growing, share of all deaths among children below the age of five years.

Report highlights lack of progress by countries in saving the life of those aged less than one month

“Every year, 2.6 million babies die before turning one month old. One million of them take their first and last breaths on the day they are born. Another 2.6 million are stillborn. Each of these deaths is a tragedy, especially because the vast majority are preventable.

“More than 80 per cent of newborn deaths are the result of premature birth, complications during labour and delivery and infections such as sepsis, meningitis and pneumonia. Similar causes, particularly complications during labour, account for a large share of stillbirths,” the report says.

On the reasons behind high newborn mortality rate, the report says that this is partly because newborn deaths are difficult to address with a single drug or intervention and they require a system-wide approach. It is also due to a lack of momentum and global commitment to newborn survival.

It also highlights that the risk of dying as a newborn varies enormously depending on where a baby is born and newborn survival is closely linked to a country’s income level.

“High-income countries have an average newborn mortality rate (the number of deaths per thousand live births) of just three. In comparison, low-income countries have a newborn mortality rate of 27. This gap is significant: If every country brought its newborn mortality rate down to the high-income average, or below, by 2030, 16 million newborn lives could be saved,” it says.

Of the 10 countries with the highest newborn mortality rates, eight are in sub-Saharan Africa and two in South Asia.

The 10 countries which reported the highest number of newborn deaths in 2016 are: India, Pakistan, Nigeria, Democratic Republic of the Congo, Ethiopia, China, Indonesia, Bangladesh, Tanzania and Afghanistan.

At the other end of the spectrum, Japan, Iceland and Singapore are the three safest countries in which to be born, as measured by their newborn mortality rates. In these countries, only one in 1,000 babies dies during the first 28 days. A baby born in Pakistan is almost 50 times more likely to die during his or her first month than a baby born in one of these three countries.

But a country’s income level explains only part of the story, the report says. In Kuwait and the United States of America, both high-income countries, the newborn mortality rate is four.

“This is only slightly better than lower-middle-income countries such as Sri Lanka and Ukraine, where the newborn mortality rate is five. Rwanda, a low-income country, has more than halved its newborn mortality rate in recent decades, reducing it from 41 in 1990 to 17 in 2016, which puts the country well ahead of upper-middle-income countries like the Dominican Republic, where the newborn mortality rate is 21,” the report says.

Millions of young lives, the report says, could be saved every year if mothers and babies had access to affordable, quality health care, good nutrition and clean water.

Published in Dawn, February 21st, 2018