Rwanda remains the safest country for mothers and their newborns in East Africa, a report by the United Nations International Children’s Emergency Fund indicates.

Unicef said Rwanda’s success in reducing child mortality rate in the country by half lies in its political will to invest in health systems that prioritise newborns and reaching out to the poorest and most marginalised.

For every 1,000 babies born in 2016, for example, the report states, 16 died before the end of their first month. This is a major improvement from 41 deaths per 1,000 births in 1990.

According to the Unicef report titled Every child alive, the urgent need to end newborn deaths, Uganda was the second best country after recording 21 deaths, followed by Tanzania, with 22 children dying per 1,000 births before their first month.

For every 1,000 babies born in Kenya in 2016, 23 died before their first month.

But the region still has countries with the highest newborn mortality rates, such as South Sudan. For every 1,000 babies born in South Sudan in 2016, 38 died before the end of their first month.

Worldwide, Pakistan was ranked as the riskiest place for a child to be born where for every 1,000 babies born in 2016, 46 died before the end of their first month.

Out of the 10 countries with the highest newborn mortality rates, eight are in sub-Saharan Africa while two are in South Asia.

The report considered the eight countries as fragile states where crises, including conflict, natural disasters, instability and poor governance, have often impaired health systems.

The report listed primary causes of newborn deaths as prematurity, complications around the time of birth and infections such as sepsis, meningitis and pneumonia.

“More than 80 per cent of the newborns who died in 2016, the deaths were caused by preventable and treatable diseases. They require a system-wide approach,” the report says.

Training

According to the report, countries like Rwanda offer hope and lessons to others committed to keeping every child alive by increasing access to affordable healthcare and improving the quality of the care.

To achieve quality care and improve outcomes, the report suggests that doctors, nurses and midwives must have the training, resources and incentives to provide timely, effective and treatment for every mother and every child.

Unicef is calling for universal health coverage, starting with four main pillars including functional health facilities, with electricity and clean water, midwives and other health workers equipped with training and tools, life-saving drugs and equipment.

The care must start during pregnancy, birth and the first days and weeks of life. A child’s birth and the 28 days that follow are the most dangerous period of her life. Almost half of all under-five children who died in 2016 were newborns.

“Take action, we believe that a future where every child is born to thrive is not only possible but necessary. Together with you, we will work to make this a reality,” reads the report.