Newborn Care in Developing Countries: Too Little, Too Late and Unequal

Background. Maternal and Neonatal mortality continue to be high in the developing world. More than two-thirds of newborn deaths occur within the first week after delivery. Yet, there is little information about the occurrence and timing of postnatal care (PNC).

Methods. This study uses data from Demographic and Health Surveys (DHS) conducted in developing countries in the last 5 years. Analyses focus on the postnatal period, up to six weeks after delivery. Data are on occurrence and timing of postnatal care, at times in comparison with mothers' postpartum care, and selected characteristics of mothers and their households.

Findings. About one-half of births occur outside health institutions and approximately 7 in 10 births do not receive PNC. Timing of first care is between two to three days after birth. Newborns who receive postnatal care live in wealthier households, and their mothers had received previous antenatal care, are educated beyond primary level, live in urban areas and have had more media exposure. For some countries, newborn care is received earlier, while mothers' postpartum care is provided later, usually after the first week.

Discussion. Postpartum and postnatal care are still scarcely provided, especially where home deliveries are predominant. Where available, care is generally late to prevent deaths of mothers from postpartum hemorrhage, and of neonates from asphyxia, hypothermia, infections and conditions associated with low birth weight. Increased attendance of delivery or within 2 hours after birth by a trained professional, and upgrading of primary health institutions are advocated.