JOHANNESBURG/GENEVA -- Sub-Saharan Africa remains the most dangerous region in the world for a baby to be born – with 1.16 million babies dying each year in the first 28 days of life – but six low-income African countries, Burkina Faso, Eritrea, Madagascar, Malawi, Uganda and the United Republic of Tanzania, have made significant progress in reducing deaths among newborn babies, according to a new report published today.

The report, Opportunities for Africa's newborns, brings together new data and analysis from a team of 60 authors and nine international organizations from the Partnership for Maternal, Newborn and Child Health, (PMNCH). The Partnership represents developing and donor countries, non-governmental agencies, foundations and multi-lateral organizations, including the World Health Organization.* "Good news does come out of Africa," said Dr. Joy Lawn, co-editor of the report, who works in Africa for Saving Newborn Lives/Save the Children-US. "Whilst the survival of the African child has shown almost no improvement since the 1980s, the fact that during 2006 several large African countries have reported a dramatic reduction in the risk of child deaths gives us new hope of more rapid progress to save Africa's children."

Although no measurable progress has been made in reducing newborn mortality rates for babies during the first month of life in Africa at regional level, a turnaround has been seen in the six countries highlighted in the report, with an average reduction of 29% over the last 10 years. Across the six countries, the reduction ranges from 20% in Tanzania and Malawi to 39% in Burkina Faso and 47% in Eritrea.* The authors identified factors that contributed to this progress. For example:

• In Malawi, there is presidential-level commitment to maternal newborn and child health and increased investment by partners to address the lack of human resources.
• United Republic of Tanzania has recorded a 30% reduction in child mortality and a 20% fall in newborn deaths over the last 5 years. District health managers set local budget priorities based on deaths in each district and this has meant increased government spending on essential maternal and child healthcare.
• In Uganda, the performance of district health services is ranked each year and published in the national newspaper.
• Eritrea has made consistent progress over 20 years in reducing child and newborn deaths with an average annual reduction of around 4% over the last decade through a focus on reaching high coverage of basic public health services, including to the poor.
• Burkina Faso ensures that poor women do not pay for the catastrophic cost of an emergency caesarean section – often more than an average family income for the year.

Up to half a million African babies die on the day they are born – most at home and uncounted. According to the report, Liberia has the world's highest newborn mortality rate at 66 deaths per 1,000 births compared to less than 2 deaths per 1,000 births in Japan and 6 deaths per 1,000 births in Latvia. Half of Africa's 1.16 million newborn deaths occur in just five countries – Nigeria, Democratic Republic of the Congo, Ethiopia, United Republic of Tanzania and Uganda. Nigeria alone has over 255,000 newborn deaths each year.

"The health of newborn babies has fallen between the cracks – Africa's un-named, and uncounted, lost children," said Dr Francisco Songane, Director of the Partnership. "We must count newborn deaths and make them count, instead of accepting these deaths as inevitable. The progress of these six African countries demonstrates that even the world's poorest countries can look after their newborns, their most vulnerable citizens. They have shown the way – we must seize the opportunity."

The President of the Pan-African Parliament, Hon. Amb. Gertrude Mongella, is spearheading action in maternal, newborn and child health through the African Union and the Pan African Parliament in Johannesburg. "Reaching every woman, baby and child in Africa with essential care will depend on us, the users of this publication. We all have a role to play as governments to lead, as policymakers to guarantee essential interventions and equity, as partners and donors to support programmes," she said.

The authors warn that opportunities to save newborn lives within existing programmes are often missed. For example two-thirds of women in Africa attend antenatal care yet only 10% receive preventive treatment for malaria and a mere 1% of mothers with HIV receive the recommended treatment to prevent mother to child transmission of HIV/AIDS.

The report found that two-thirds of newborn deaths in sub-Saharan Africa – up to 800 000 babies a year – could be saved if 90 % of women and babies received feasible, low-cost health interventions. These include immunizing women against tetanus, providing a skilled attendant at birth, treating newborn infections promptly and educating mothers about hygiene, warmth and breastfeeding for infants. Saving these lives would take only an estimated US $ 1.39 per capita – or US $1 billion per year. According to the report, this cost would benefit others, in particular the one million stillborns and 250 000 mothers who also die each year.