What is the Global Burden of Neonatal Death and Disease?

Craig Rubens, MD, PhD, co-founder and executive director of GAPPS at Seattle Children’s Hospital, discusses the importance of understanding the global burden of neonatal death and disease.

Interview Transcript (slightly modified for readability)

“It’s a good question about whether or not what we’re seeing around the globe now is really an increase in the number of newborn deaths or whether it’s because we’re now focusing more [on them]. In the last 10 years, there’s been a lot more effort by various governments, the World Health Organization (WHO), and others to really try and understand what the burden of disease of newborn deaths is around the globe.

It turns out that prematurity and infections are the two leading causes of death under the newborn period. We’ve done a great job of actually reducing mortality in kids under the age of 5, but there is this newborn window that has not been dealt with well and now it makes up 44% of the deaths around the globe. So, we really need to start turning our attention to how we take care of moms and babies, especially around the childbirth period, because that’s the [period with] highest risk of mortality, both for the mother and for the newborn.

What we’re learning is, a lot of births, because they occur at home, we’re not counting [death rates for]. We’re assuming that the 800,000 deaths due to infection and over 1 million deaths due to pre-term birth are an accurate number, but actually these are estimates. Because more than 50% of births occur at home in the developing world, we’re probably undercounting. We may be actually losing more kids than we realize. It may be a reporting issue but we also may have a true problem with actually counting accurately, so we need to really increase our investments in understanding what is really going on around the time of pregnancy and early newborn period for these low and middle income settings.”