Neonatal mortality rate (per 1000 live births)
Rationale for use
Neonatal deaths account for a large proportion of child deaths. Mortality during the neonatal period is considered to be a useful indicator of maternal and newborn health and care.
Number of deaths during the first 28 completed days of life per 1000 live births in a given year or period.
The neonatal period commences at birth and ends 28 completed days after birth.
Neonatal deaths (deaths among live births during the first 28 completed days of life) may be subdivided into early neonatal deaths, occurring during the first 7 days of life, and late neonatal deaths, occurring after the 7th day but before the 28th completed day of life.
Live birth in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD 10) is defined as 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 such as heartbeat, umbilical cord pulsation, or definite movement of voluntary muscles, whether the umbilical cord has been cut or the placenta is attached.
Civil registration: the number of live births and number of neonatal deaths are used to calculate age-specific rates. This system provides annual data.
Household surveys: calculations are based on birth history—a series of detailed questions on each child a woman has given birth to during the 5 or 10 years preceding the survey. The total number of live births surveyed provides the denominator.
Methods of estimation
Empirical data from civil registration and household surveys are compiled and adjusted in order to maintain consistency with the estimates of probability of dying at less than age 5 years. When no survey or registration data point is available, the neonatal mortality rate is estimated from the probability of dying at less than age 5 years, using a regression corrected for AIDS.
By sex, location (urban/rural, major regions/provinces), and socioeconomic characteristics (e.g. mother’s level of education, wealth quintile).
Neonatal and perinatal mortality
The world health report 2005—make every mother and child count
International Classification of Diseases
The reliability of the estimates of neonatal mortality depends upon the accuracy and completeness of reporting and recording of births and deaths. Underreporting and misclassification are common, especially for deaths occurring early in life.