New Research on Community Management of Severe Neonatal Infections

Efforts by developing countries, backed by international support, are helping achieve a steady decline in under-5 mortality. Recent estimates suggest that under-5 deaths fell from 9.6 million to 6.9 million between 2000 and 2011, with the under-5 mortality rate falling from 73 to 51 per 1000 live births.1 This progress, though slower than hoped in some countries, nevertheless gives cause for optimism. Of note, as postneonatal mortality has declined, an increasing proportion of under-5 deaths are occurring in the neonatal period, underscoring the importance of prevention of neonatal mortality to overall infant and under-5 mortality. Research must focus on the design of innovative solutions that are both efficacious and effective for preventing neonatal deaths. Prematurity and clinical infections are major causes of neonatal deaths. Neonatal infections, including pneumonia, sepsis and meningitis, are estimated to cause over 700,000 deaths each year.2 Until recently, neonatal deaths associated with clinical infections were considered difficult to address, but several advances are paving the way for the design of a concrete strategy and action plan to address infectious causes of neonatal mortality.