Each year 5.5 million babies enter and leave the world without being recorded and one in three newborns - over 45 million babies - do not have a birth certificate by their first birthday, according to new research co-led by the London School of Hygiene & Tropical Medicine.
Half of the newborn deaths worldwide occur in just five countries: India (779,000), Nigeria (276,000), Pakistan (202,400), China (157,000), and the Democratic Republic of Congo (118,000), although global and national figures conceal huge variations within and between different countries.
In 2012, eight of nine countries with neonatal death rates greater than 40 for every 1,000 live births were in sub-Saharan Africa; half of these countries were affected by conflict.
The findings, from the new Every Newborn Series, published in The Lancet, provide the clearest picture to date of a newborn's chance of survival and the steps that must be taken to end preventable infant deaths.
The series provides comprehensive new data for 195 countries regarding neonatal deaths, stillbirths, rankings for countries, rates of progress and coverage of birth certification.
New analyses indicates that three million maternal and newborn deaths and stillbirths could be prevented annually with proven interventions - including the promotion of breastfeeding, neonatal resuscitation, kangaroo mother care for preterm babies, antenatal corticosteroids, and the prevention and treatment of infections.
These interventions can be implemented for an annual cost of USD 1.15 per person. Providing quality care at birth yields a triple return on investment - saving mothers and newborns, and preventing stillbirths - and protects babies from disability, researchers said.
According to Professor Joy Lawn, who co-led the series, the results highlight an important, yet largely unacknowledged global problem.
Over the last decade, the rate of reduction for newborn deaths has been about half the rate of reduction achieved for children under age five, said the researchers.
As a result, newborn deaths now account for a larger proportion of under-five child deaths - 44 per cent in 2012, compared to 36 per cent in 1990. In most regions of the world, more than half of child deaths are among newborns.
If current trends continue, it will be more than 110 years before an African baby has the same chances of survival as a baby born in North America or Europe, researchers said.
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