ISLAMABAD – Pakistan has the world’s third highest number of newborn deaths (194,000 in 2010) and between 2000 and 2010, neonatal mortality declined by only 0.9 per cent whilst maternal and child deaths after the first month reduced more significantly, revealed a multi-country analysis disseminated Monday. 
The supplement, first of its kind analysis of newborn health around the world, was published in the medical journal, Health Policy and Planning on June 13, 2012. The study has been conducted by Save the Children in collaboration with Advocacy and Advisory Network for Newborns (AANN).
The journal ‘ the Decade of Change for Newborn Survival in Pakistan (2000-2010)’ called on government, researchers, development partners and communities to address newborn survival in order to accelerate progress in reducing child deaths in line with the country’s MDG 4 targets.
The study highlighted that the coverage of newborn care interventions increased marginally, with wide socio-economic variations. ‘There was little focus on newborn health until 2000 when considerable policy change occurred including integration of newborn care into existing community-based maternal and child packages delivered by the Lady Health Worker Programme and national behavior change communications strategies and programmes. The National Maternal, Newborn and Child Health Programme catalyzed newborn services at both facility and community levels’.
It also highlighted that while progress for under-five mortality has been shown, neonatal mortality has not declined at the same pace. Neonatal deaths, three-quarters (74 percent) of which occur in the first week of life, accounted for around half (47 percent) of under-five deaths in 2010 in Pakistan.
The three leading causes of neonatal deaths-complications of preterm birth, infection and intrapartum-related account for over 90 per cent of all deaths in Pakistan and deaths due to infections appear to be decreasing. Many neonatal deaths occur in babies who are born with low birth weight and many of these are also likely to be preterm. Pakistan also ranks among the top three countries globally with the highest percentage of babies born with low birth weight.
Dr Zulfiqar A Bhutta from Aga Khan University Karachi who is one of the lead authors of the paper evaluated the changes for newborn survival in Pakistan and talked about the reasons of comparatively slow progress that is 0.9 per cent annual reduction in newborn mortality which is less than the global average (2.1 percent annual reduction) despite considerable policy change.     
He said the progress has been made in terms of integration of newborn care into existing community-based maternal and child health packages delivered by the Lady Health Workers   Programmes.  The National Maternal, Newborn and Child Health Programme catalyzed newborn services at both community and facility levels. But at the same time, country has country has also faced national challenges including several humanitarian disasters, political instability and others.
The report suggested that provincial leadership and innovative models of financing and effective action are required to accelerate scale up of care, with perhaps even greater innovation in how to shift social norms so that families demand that their babies survive.