Ending preventable deaths for neonatal and child health: The findings from the Global Burden of Disease Study 2019

University of Embu researcher Dr. Josephine Ngunjiri, Department of Biological Sciences, in collaboration with Institute of Health Metrics and Evaluation based at the University of Washington in Seattle, USA, tracked the progress of Sustainable Development Goal 3.2. This goal targets to end preventable neonatal mortality rate (NMR) and for Under-5 mortality rate (U5MR) for all countries to have as low as 12 deaths per 1,000 live births and as low as 25 per 1,000 deaths for U5MR by 2030.Thus, the main aim of the study was to present a detailed, comprehensive numerical assessment of progress towards SDG 3.2 targets for all-cause NMR and U5MR at the global, regional, and national level.

In this study, there was a notable global decline in U5MR and NMR in 2019. Global U5MR declined from 71·2 (95% UI 68·3–74·0) in 1990 to 37·1 (95% UI 33·2–41·7) deaths per 1,000 livebirths in 2019, with corresponding changes in NMR from 28·0 (95% UI 26·8–29·5) in 1990 to 17·9 (16·3–19·8) deaths per 1,000 live births. Therefore in 2019, neonatal disorders remained the leading cause of death in U5MR, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. Hence, it was projected by 2030, that 154 countries (75%) will most likely meet the U5MR SDG target, and fewer countries, 139 (68%), will likely meet NMR goal target. This was based on the evidence which indicated an accelerated reduction in global U5MR and relative progress in neonatal mortality between 2015 and 2019 compared to earlier years. However, slowest progress for the early neonatal age group and a higher number of deaths for the same group was observed. This means that the reduction of early neonatal mortality progress was still slower in 2019 compared to overall under-5 progress in low Socio-demographic Index (SDI) settings. It was also evident that sub-Saharan Africa and south Asia will have to put a lot of effort into being on track to meet SDG 3.2 target by 2030.

 Therefore, to sustain gains made over the years despite expected effects associated with COVID-19, it was emphasized that there was need to have focused improvements in perinatal and newborn care. Further, essential interventions include vaccination and managing the leading causes of mortality. This underscores the need to strengthen health systems, promote infection prevention, equity, poverty reduction, and improved access to education globally and more so for sub-Saharan Africa and south Asia.

The results were published in Lancet ,2021; 398: 870–905( https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01207-1/fulltext)

under the title: Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019.

The study was funded by Bill & Melinda Gates Foundation.