The neonatal mortality rate measures the probability that a child will die in the first 28 days of life and is an important indicator of how health systems address risks related to the social determinants, coverage, and quality of health care.

The regional rate declined from 8.0 deaths per 1000 live births in 2017 to 6.9 in 2024, representing a 14.1% reduction over the period. The average annual percent change for 2017–2024 was a decline of 2.2%. It is projected that by the end of 2025, the rate reached 6.7 deaths per 1000 live births. From a regional perspective, these findings suggest that the Strategic Plan 2020–2025 target of 6.9 deaths per 1,000 live births has been achieved. This reflects sustained progress in neonatal survival across the Region. 

Despite this favorable regional trend, significant gaps persist. Analysis for 2024 indicates that 22 countries remained above the 2025 regional target (6.9 deaths per 1000 live births), while 8 countries remained above the corresponding global target (12 deaths per 1000 live births), underscoring persistent disparities both between and within countries. 

Preventable causes continued to account for a substantial share of neonatal deaths, particularly complications of prematurity, congenital anomalies, sepsis and infections, and birth asphyxia. These patterns point to persistent bottlenecks in access to timely, quality preconception, maternal and newborn care, as well as remaining gaps in disaggregated and subnational data needed to guide targeted action. 

Countries, in collaboration with PASB and partners, have continued efforts to strengthen maternal and newborn health policies and services, improve the prevention and management of the leading causes of neonatal mortality, and reinforce monitoring frameworks to assess progress and identify areas requiring accelerated action. This indicator continues in the PAHO Strategic Plan 2026–2031.

Recommendations 

1. Strengthen and scale up access to quality preconception, maternal and newborn care, with a primary health care approach, particularly during pregnancy, childbirth, and the immediate postnatal period, with priority attention to countries and populations that remain above the target.

2. Intensify interventions aimed at preventing, detecting early, and effectively managing the leading causes of neonatal mortality, especially prematurity-related complications, congenital anomalies, sepsis and infections, and birth asphyxia.  

3. Promote sustained coordination to expand the implementation of evidence-based strategies, in collaboration with PASB and partners, recognizing that further reductions in neonatal mortality will also contribute substantially to progress in under-five mortality and to reductions in the burden of disease and disability associated with neonatal conditions.

4. Reinforce health information systems to improve the completeness, quality, timeliness, and disaggregation of neonatal mortality data, thereby enabling more precise targeting of interventions.