The three primary reasons for newborn deaths are prematurity, birth complications, and severe infections. To measure this statistic globally, Save The Children compiled the Birth Day Risk Index, which ranks 186 countries by the survival rate of newborns on their first day, first month, and first five years. According to the BDR index, it appears the ten worst countries in the world to be a newborn are all in Africa.
9,000 children under the age of five die annually with ten percent of deaths occurring on the first day. UNICEF describes Guinea Bissau as a “fragile post-conflict country with weak infrastructures and private sector." The greatest contributor to infant mortality is the lack of health care. To combat this, from 2008 - 2012 UNICEF attempted to strengthen the health care private sector and educate rural communities on health practices.
In Burundi, 15 out of every 1000 children die within the first day, amounting to 11% of all under-five deaths. A UNICEF country profile states that mortality rates are largely due to malaria and respiratory infections compounded by malnutrition. The Burundian government, encouraged by UNICEF, created a National Children's Forum to address these issues.
7,600 Chadian newborns die within the first day - 79,000 Chadian children under the age of five die annually. UNICEF in partnership with the EU is working to address the serious issue of drought and malnutrition in Chad by dispatching 200 trained paramedics and doubling the number of medical treatment centers from 210 to 425.
7. Cote D'Ivoire
15 in every 1,000 Ivorian children die within the first day. Save the Children attributes these deaths to a lack of access to health care and medical supplies, largely due to recent conflicts and mass displacement. To provide greater access to health care, Save the Children recently delivered medical supplies to treat over 40,000 expecting mothers and newborn children.
Though Angola is experiencing an oil boom, child mortality rates remain high. The first-day mortality rate amounts to 15 deaths per 1,000 live births. UNICEF is working in the country to reduce neonatal problems stemming from low birth weights, high rates of infections, and other birth complications.
5. Central African Republic
49 in every 1,000 children born in the Central African Republic die within the first month. UNHCO attributes this to the lack of an effective health care system, making preventable diseases like malaria or sleeping sickness fatal. Ongoing violence from rebel groups further deteriorates health care access within the country.
4. Sierra Leone
Sierra Leone has a first-day mortality rate of 17 deaths per 1,000 children as well as a number of first-month deaths amounting to over 11,000 annually. The World Health Organization states that these high levels of infant mortality are due to a combination of disease prevalence, poverty,and lack of education among expecting mothers. Preventable diseases such as malaria and pneumonia also contribute to mortality rates.
The state of children in Mali is similar to the Sierra Leone where the first-day mortality rate is 17 deaths per 1,000 children. Save the Children is working on a comprehensive development plan to cater to the needs of newborn children and their mothers. This initiative includes health programs for newborns, education programs, nutrition plans and addressing poverty.
2. Democratic Republic of the Congo (DRC)
17 out of every 1000 live births result in death in the DRC. The number of first-day deaths amounts to over 48,000 on an annual basis. The Ministry of health within the DRC recently launched an initiative in conjunction with UNICEF to reduce child mortality within the country. The country's health minster stated that such a reduction can be achieved through global partnership and health sector reforms.
Somalia, according to the Birth Day Risk Index, is the worst place in the world to be a newborn child. With 18 deaths per 1,000 live births, five percent of Somali newborns die within the first month of life, and one in six do not live to age five. UNICEF states that the majority of child deaths in Somalia are due to illnesses such as pneumonia, diarrhea and measles. Limited access to child and maternal care also contributes to the high mortality rate. Only nine percent of births are conducted by a skilled birth attendant.