Infant mortality decreases in low-income countries, but still inequalities

The study published in Plos Medicine reveals a decline in fetal and early neonatal mortality rates among low- and middle-income countries between 1990 and 2023. However, progress remains uneven, with significant socioeconomic disparities persisting. The research, which analyzed data from 17 countries, Ghana, Kenya, Malawi, Mali, Nigeria, Rwanda, Senegal, Tanzania, Uganda, Zambia, Zimbabwe, Egypt, Jordan, Bangladesh, Indonesia, Colombia, and Peru, found that while overall mortality has decreased, challenges remain in addressing these inequalities. The findings highlight key factors associated with lower fetal and perinatal mortality. Living in urban areas, higher maternal education levels, greater household socioeconomic status, and better national welfare systems were linked to reduced risks. Conversely, maternal age of 30 years or older was found to increase the risk. Despite improvements, fetal and early neonatal deaths continue to pose a major global health challenge, particularly in low- and middle-income nations. Most cases occur in these regions, where civil registry systems often lack completeness, making accurate tracking difficult. Household survey data, such as Demographic and Health Surveys (DHS), are commonly used for estimation, though they tend to underreport and misclassify cases of stillbirths and early neonatal deaths, limiting their utility for planning maternal and child health interventions. The study examined 93 DHS conducted between 1990 and 2023 across the 17 countries, covering 1,019,253 pregnancies declared by 733,181 women. Researchers from the University of Trieste collaborated with experts including Mohammed Ali of the World Health Organization and Saverio Bellizzi of the United Nations University Institute for Water, Environment and Health. Luca Cegolon, a professor of Hygiene and Preventive Medicine at the University of Trieste, contributed to the analysis. Their work underscores the importance of strengthening maternal and newborn care services and improving data collection systems in low- and middle-income countries to accelerate progress toward reducing perinatal mortality. The researchers emphasize that although many countries have recorded reductions in perinatal mortality, the pace and extent of improvement vary widely. Socioeconomic disparities continue to influence outcomes, highlighting the need for targeted interventions. Strengthening healthcare infrastructure, increasing access to quality maternal care, and enhancing data accuracy through improved surveillance mechanisms are critical steps. These efforts could help ensure more equitable reductions in perinatal mortality, aligning with global sustainable development goals aimed at improving maternal and child health worldwide. The study’s findings reflect broader trends in global health, where progress in reducing infant and maternal mortality has been substantial but uneven. While advancements in medical technology, public health campaigns, and increased funding have contributed to declines in mortality rates, persistent gaps remain. In particular, rural and impoverished communities face greater barriers to accessing essential care, exacerbating existing inequalities. Addressing these disparities requires sustained investment in healthcare systems, community-based programs, and policies that promote social equity. Looking ahead, the researchers suggest that continued monitoring and evaluation will be crucial in identifying effective strategies for further reduction. They call for expanded collaboration between international organizations, governments, and local stakeholders to develop context-specific solutions. As the global health landscape evolves, ensuring that all populations benefit equitably from advances in maternal and child health remains a priority. The study serves as a foundation for future research and policy initiatives aimed at achieving more inclusive and lasting improvements in perinatal outcomes.