Health Status Statistics: Mortality
Maps and graphs
Neonatal mortality rate (per 1000 live births)
Rationale for use
Neonatal deaths account for a large proportion of child deaths. Mortality during neonatal period is considered a good indicator of both maternal and newborn health and care.
Number of deaths during the first 28 completed days of life per 1,000 live births in a given year or period.
Neonatal deaths may be subdivided into early neonatal deaths, occurring during the first seven days of life, and late neonatal deaths, occurring after the seventh day but before the 28 completed days of life.
The neonatal period commences at birth and ends 28 completed days after birth.
Live birth refers to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life - e.g. beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles - whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live born.
Neonatal mortality rates are calculated from birth and death data derived from vital registration or from household surveys:
Vital registration: The number of live births and number of neonatal deaths are used to calculate age specific rates.
Surveys: Calculations are based on birth history - a series of detailed questions on each child a woman has given birth to during her lifetime. The estimates are generally presented as period rates for the five-year periods preceding the survey. The total number of births in the survey provides the denominator.
Methods of estimation
Empirical data are used. When no survey or registration data point is available, the neonatal mortality rate is estimated from the under-5 mortality using a regression adjusted for AIDS.
By sex, location (urban/rural, major regions/provinces), and socio-economic characteristics (e.g. mother's education level, wealth quintile).
Estimated completeness of mortality data for latest year
World Health Organization. WHO Statistical Information System (WHOSIS). Estimated completeness of mortality data for latest year.
Perinatal and neonatal mortality. In preparation. Geneva. World Health Organization. 2005.
Demographic and Health Surveys (DHS)
WHO, European Office. HFA database
The World Health Report 2005: make every mother and child count. Annex Table 8. Geneva, World Health Organization, 2005.
The reliability of the neonatal mortality estimates depends on accuracy and completeness of reporting and recording of births and deaths. Underreporting and misclassification are common, especially for deaths occurring early on in life.
Perinatal mortality, defined as number of stillbirths and deaths in the first week of life per 1,000 live births, is a useful additional indicator, and work is ongoing to improve estimates of stillbirth rates, a major component of perinatal mortality.