Lancet. 2014 May 19. pii: S0140-6736(14)60750-9. doi: 10.1016/S0140-6736(14)60750-9. [Epub ahead of print]

From evidence to action to deliver a healthy start for the next generation.

Mason E1, McDougall L2, Lawn JE3, Gupta A4, Claeson M5, Pillay Y6, Presern C2, Lukong MB7, Mann G8, Wijnroks M9, Azad K10, Taylor K11, Beattie A8, Bhutta ZA12, Chopra M13; for The Lancet Every Newborn Study Group; on behalf of the Every Newborn Steering Committee.

Author information

• 1World Health Organization, Geneva, Switzerland. Electronic address: masone@who.int.
• 2The Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland.
• 3MARCH, London School of Hygiene and Tropical Medicine, London, UK; Saving Newborn Lives, Save the Children, Cape Town, South Africa; Research and Evidence Division, Department for International Development, London, UK.
• 4Ministry of Health and Family Welfare, Government of India, New Delhi, India.
• 5Bill & Melinda Gates Foundation, Seattle, WA, USA.
• 6Department of Health, Government of South Africa, Pretoria, South Africa.
• 7Ministry of Public Health, Government of Cameroon, Yaoundé, Cameroon.
• 8Research and Evidence Division, Department for International Development, London, UK.
• 9The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
• 10Perinatal Care Project, Diabetic Association of Bangladesh, Dhaka, Bangladesh.
• 11United States Agency for International Development, Washington, DC, USA.
• 12Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan; Center for Global Child Health Hospital for Sick Children, Toronto, ON Canada.
• 13UNICEF, New York, NY, USA.

Abstract

Remarkable progress has been made towards halving of maternal deaths and deaths of children aged 1-59 months, although the task is incomplete. Newborn deaths and stillbirths were largely invisible in the Millennium Development Goals, and have continued to fall between maternal and child health efforts, with much slower reduction. This Series and the Every Newborn Action Plan outline mortality goals for newborn babies (fewer than ten per 1000 livebirths) and stillbirths (fewer than ten per 1000 total births) by 2035, aligning with A Promise Renewed target for children and the vision of Every Woman Every Child. To focus political attention and improve performance, goals for newborn babies and stillbirths must be recognised in the post-2015 framework, with corresponding accountability mechanisms. The four previous papers in this Every Newborn Series show the potential for a triple return on investment around the time of birth: averting maternal and newborn deaths and preventing stillbirths. Beyond survival, being counted and optimum nutrition and development is a human right for all children, including those with disabilities. Improved human capital brings economic productivity. Efforts to reach every woman and every newborn baby, close gaps in coverage, and improve equity and quality for antenatal, intrapartum, and postnatal care, especially in the poorest countries and for underserved populations, need urgent attention. We have prioritised what needs to be done differently on the basis of learning from the past decade about what has worked, and what has not. Needed now are four most important shifts: (1) intensification of political attention and leadership; (2) promotion of parent voice, supporting women, families, and communities to speak up for their newborn babies and to challenge social norms that accept these deaths as inevitable; (3) investment for effect on mortality outcome as well as harmonisation of funding; (4) implementation at scale, with particular attention to increasing of health worker numbers and skills with attention to high-quality childbirth care for newborn babies as well as mothers and children; and (5) evaluation, tracking coverage of priority interventions and packages of care with clear accountability to accelerate progress and reach the poorest groups. The Every Newborn Action Plan provides an evidence-based roadmap towards care for every woman, and a healthy start for every newborn baby, with a right to be counted, survive, and thrive wherever they are born.