That title goes to Rwanda and Tanzania, which have the highest survival rates of children within the first month.
In the two countries, only 19 newborns for every 1,000 live births die within their first 28 days.
In Kenya, the neonatal mortality rate is 21 deaths for every 1,000 live births, according to the Demographic and Health Survey.
Sub-Saharan Africa has the highest neonatal mortality rate in the world (27 deaths per 1000 live births) with 43 per cent of global newborn deaths, according to Unicef.
Unicef says 80 per cent of all newborn deaths result from three preventable and treatable conditions: complications due to prematurity, intrapartum- related deaths (including birth asphyxia) and neonatal infections.
“Proven, cost-effective interventions exist to prevent and treat each of these main causes of death,” Unicef says.
The rate in Burundi is 25, while Uganda's neonatal mortality has stagnated at 27 deaths per 1,000 live births over the past decade, according to the country’s demographic and health survey.
The second-worst place to bear a child in East Africa is DR Congo where 30 out of every 1,000 children do not complete one month of life.
In South Sudan, the rate worsens to 40.2 deaths per 1,000 live births.
According to Unicef, the first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival.
Children face the highest risk of dying in their first month of life at an average global rate of 18 deaths per 1,000 live births in 2021, down by 51 per cent from 37 deaths per 1,000 live births in 1990.
But according to the World Health Organization, global progress in reducing deaths of pregnant women, mothers and babies has flatlined for eight years due to decreasing investments in maternal and newborn health.
“Pregnant women and newborns continue to die at unacceptably high rates worldwide, and the Covid-19 pandemic has created further setbacks to providing them the healthcare they need,” said Dr Anshu Banerjee, director of maternal, newborn, child and adolescent health and ageing at WHO.
“If we wish to see different results, we must do things differently. More and smarter investments in primary healthcare are needed now so every woman and baby — no matter where they live — has the best chance of health and survival.”
The Covid-19 pandemic, rising poverty and worsening humanitarian crises have intensified pressures on stretched health systems, WHO says. Since 2018, more than three-quarters of all conflict-affected and Sub-Saharan African countries report declining funding for maternal and newborn health.
Just one in 10 countries (of more than 100 surveyed) report having sufficient funds to implement their current plans. Moreover, according to the latest WHO survey on the pandemic’s impacts on essential health services, around a quarter of countries still report ongoing disruptions to vital pregnancy and postnatal care and services for sick children.
“As is too often the case, vulnerability, fear, and loss are not spread equally around the world,” Steven Lauwerier, Unicef director of health, said.
"The Covid-19 pandemic, babies, children and women who were already exposed to threats to their well-being, especially those living in fragile countries and emergencies, are facing the heaviest consequences of decreased spending and efforts on providing quality and accessible healthcare.”
