Neonatal mortality in countries of the Americas, 2000–2020: trends, inequalities, and target-setting

Author:

Duran Pablo1,Soliz Patricia2,Mujica Oscar J.2,Cueva Daniel A.3,Serruya Suzanne J.1,Sanhueza Antonio2

Affiliation:

1. Latin American Center for Perinatology, Women’s Health, and Reproductive Health, Montevideo, Uruguay.

2. Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, D.C., United States of America.

3. Independent Consultant, Tarragona, Spain.

Abstract

Objective.

To analyze temporal trends and inequalities in neonatal mortality between 2000 and 2020, and to set neonatal mortality targets for 2025 and 2030 in the Americas.

Methods.

A descriptive ecological study was conducted using 33 countries of the Americas as units of analysis. Both the percentage change and average annual percentage change in neonatal mortality rates were estimated. Measurements of absolute and relative inequality based on adjusted regression models were used to assess cross-country social inequalities in neonatal mortality. Targets to reduce neonatal mortality and cross-country inequalities were set for 2025 and 2030.

Results.

The estimated regional neonatal mortality rate was 12.0 per 1 000 live births in 2000–2004 and 7.4 per 1 000 live births in 2020, representing a percentage change of –38.3% and an average annual percentage change of –2.7%. National average annual percentage changes in neonatal mortality rates between 2000–2004 and 2020 ranged from –5.5 to 1.9 and were mostly negative. The estimated excess neonatal mortality in the 20% most socially disadvantaged countries, compared with the 20% least socially disadvantaged countries, was 17.1 and 9.8 deaths per 1 000 live births in 2000–2004 and 2020, respectively. Based on an extrapolation of recent trends, the regional neonatal mortality rate is projected to reach 7.0 and 6.6 neonatal deaths per 1 000 live births by 2025 and 2030, respectively.

Conclusions.

National and regional health authorities need to strengthen their efforts to reduce persistent social inequalities in neonatal mortality both within and between countries.

Publisher

Pan American Health Organization

Reference19 articles.

1. Pan American Health Organization. Sustainable Health Agenda for the Americas 2018–2030: a call to action for health and well-being in the Region. Washington, D.C.: PAHO; 2017 [cited 2023 Mar 12]. Available from: https://iris.paho.org/handle/10665.2/49170

2. United Nations Children’s Fund. Levels & trends in child mortality. Report 2021. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF; 2021 [cited 2023 Mar 12]. Available from: https://www.who.int/publications/m/item/levels-and-trends-in-child-mortality-report-2021

3. United Nations Children's Fund. Ending preventable newborn deaths and stillbirths by 2030. Moving faster towards high-quality universal health coverage in 2020-2025. New York: UNICEF

4. 2020 [cited 2023 Mar 12]. Available from: https://www.unicef.org/reports/ending-preventable-newborn-deaths-stillbirths-quality-health-coverage-2020-2025

5. Enriquez Nava MF, Esquivel Velasquez AD, Paton Sanjines M, Pooley Ayarza BC, Alarcon R, Hernandez Munoz R, et al. Behavior and social inequalities in prioritized indicators of Sustainable Development Goal 3 in Bolivia. Rev Panam Salud Publica. 2020;31(44):e101. https://doi.org/10.26633/RPSP.2020.101

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