title: Neonatal mortality within 24 hours of birth in six low- and lower-middle-income countries.
abstract: OBJECTIVE
  To estimate neonatal mortality, particularly within 24 hours of birth, in six low- and lower-middle-income countries.
  
  
  METHODS
  We analysed epidemiological data on a total of 149 570 live births collected between 2007 and 2013 in six prospective randomized trials and a cohort study from predominantly rural areas of Bangladesh, Ghana, India, Pakistan, the United Republic of Tanzania and Zambia. The neonatal mortality rate and mortality within 24 hours of birth were estimated for all countries and mortality within 6 hours was estimated for four countries with available data. The findings were compared with published model-based estimates of neonatal mortality.
  
  
  RESULTS
  Overall, the neonatal mortality rate observed at study sites in the six countries was 30.5 per 1000 live births (range: 13.6 in Zambia to 47.4 in Pakistan). Mortality within 24 hours was 14.1 per 1000 live births overall (range: 5.1 in Zambia to 20.1 in India) and 46.3% of all neonatal deaths occurred within 24 hours (range: 36.2% in Pakistan to 65.5% in the United Republic of Tanzania). Mortality in the first 6 hours was 8.3 per 1000 live births, i.e. 31.9% of neonatal mortality.
  
  
  CONCLUSIONS
  Neonatal mortality within 24 hours of birth in predominantly rural areas of six low- and lower-middle-income countries was higher than model-based estimates for these countries. A little under half of all neonatal deaths occurred within 24 hours of birth and around one third occurred within 6 hours. Implementation of high-quality, effective obstetric and early newborn care should be a priority in these settings.
authors.affiliation: International Center for Maternal and Newborn Health, Johns Hopkins University, Baltimore, United States of America (USA).
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
authors.affiliation: International Center for Maternal and Newborn Health, Johns Hopkins University, Baltimore, United States of America (USA).
authors.forename: Dipak K
authors.initials: DK
authors.lastname: Mitra
authors.affiliation: International Center for Maternal and Newborn Health, Johns Hopkins University, Baltimore, United States of America (USA).
authors.forename: Nazma
authors.initials: N
authors.lastname: Begum
authors.affiliation: Division of Population Medicine, Cardiff University School of Medicine, Cardiff, Wales .
authors.forename: Lisa
authors.initials: L
authors.lastname: Hurt
authors.affiliation: Department of Population Health, London School of Hygiene and Tropical Medicine, London, England .
authors.forename: Seyi
authors.initials: S
authors.lastname: Soremekun
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Perth, Australia .
authors.forename: Karen
authors.initials: K
authors.lastname: Edmond
authors.affiliation: Department of Population Health, London School of Hygiene and Tropical Medicine, London, England .
authors.forename: Betty
authors.initials: B
authors.lastname: Kirkwood
authors.affiliation: Centre for Health Research and Development, Society for Applied Studies, New Delhi, India .
authors.forename: Nita
authors.initials: N
authors.lastname: Bhandari
authors.affiliation: Centre for Health Research and Development, Society for Applied Studies, New Delhi, India .
authors.forename: Sunita
authors.initials: S
authors.lastname: Taneja
authors.affiliation: Centre for Health Research and Development, Society for Applied Studies, New Delhi, India .
authors.forename: Sarmila
authors.initials: S
authors.lastname: Mazumder
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Muhammad Imran
authors.initials: MI
authors.lastname: Nisar
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Fyezah
authors.initials: F
authors.lastname: Jehan
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ilyas
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Murtaza
authors.initials: M
authors.lastname: Ali
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Imran
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Shabina
authors.initials: S
authors.lastname: Ariff
authors.affiliation: Department of Paediatric and Child Health, The Aga Khan University, Karachi, Pakistan .
authors.forename: Sajid B
authors.initials: SB
authors.lastname: Soofi
authors.affiliation: International Center for Maternal and Newborn Health, Johns Hopkins University, Baltimore, United States of America (USA).
authors.forename: Sunil
authors.initials: S
authors.lastname: Sazawal
authors.affiliation: International Center for Maternal and Newborn Health, Johns Hopkins University, Baltimore, United States of America (USA).
authors.forename: Usha
authors.initials: U
authors.lastname: Dhingra
authors.affiliation: Center for Public Health Kinetics, New Delhi, India .
authors.forename: Arup
authors.initials: A
authors.lastname: Dutta
authors.affiliation: Public Health Laboratory Ivo de Carneri, Pemba, United Republic of Tanzania .
authors.forename: Said M
authors.initials: SM
authors.lastname: Ali
authors.affiliation: Public Health Laboratory Ivo de Carneri, Pemba, United Republic of Tanzania .
authors.forename: Shaali M
authors.initials: SM
authors.lastname: Ame
authors.affiliation: BetterBirth Program, Ariadne Labs, Boston, USA .
authors.forename: Katherine
authors.initials: K
authors.lastname: Semrau
authors.affiliation: BetterBirth Program, Ariadne Labs, Boston, USA .
authors.forename: Fern M
authors.initials: FM
authors.lastname: Hamomba
authors.affiliation: BetterBirth Program, Ariadne Labs, Boston, USA .
authors.forename: Caroline
authors.initials: C
authors.lastname: Grogan
authors.affiliation: Center for Global Health and Development, Boston University, Boston, USA .
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
authors.affiliation: Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland .
authors.forename: Rajiv
authors.initials: R
authors.lastname: Bahl
authors.affiliation: Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland .
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland .
authors.forename: Alexander
authors.initials: A
authors.lastname: Manu
mesh_terms: D015331:Cohort Studies; D016208:Databases, Factual; D003906:Developing Countries; D016021:Epidemiologic Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D036801:Parturition; D016032:Randomized Controlled Trials as Topic; D012424:Rural Population; D013997:Time Factors