In modern times, improvements in knowledge and technological advances have greatly improved the
health of mother and children. However, the past decade was marked by limited progress in reducing
maternal mortality and a slow-down in the steady decline of childhood mortality observed since the mid
1950s in many countries, the latter being largely due to a failure to reduce neonatal mortality.
Every year, over four million babies less than one month of age die, most of them during the critical first
week of life; and for every newborn who dies, another is stillborn. Most of these deaths are a
consequence of the poor health and nutritional status of the mother coupled with inadequate care
before, during, and after delivery. Unfortunately, the problem remains unrecognized or- worse- accepted
as inevitable in many societies, in large part because it is so common.
Recognizing the large burden of maternal and neonatal ill-health on the development capacity of
individuals, communities and societies, world leaders reaffirmed their commitment to invest in mothers
and children by adopting specific goals and targets to reduce maternal and childhood-infant mortality
as part of the Millennium Declaration.
There is a widely shared but mistaken idea that improvements in newborn health require sophisticated
and expensive technologies and highly specialized staff. The reality is that many conditions that result in
perinatal death can be prevented or treated without sophisticated and expensive technology. What is
required is essential care during pregnancy, the assistance of a person with midwifery skills during
childbirth and the immediate postpartum period, and a few critical interventions for the newborn during
the first days of life.