* Since the last assessment in 2024, updated information became available that required a change in the baseline.
EOB 2024-2025
IMPACT INDICATOR
Neonatal mortality rate
Baseline
2017
8.03 deaths per 1000 live births*
Target
2025
6.9 deaths per 1000 live births
Status
2024
6.9 deaths per 1000 live births
Rating
Achieved
% annual change required to achieve target
-2.10%
% annual change recorded as of last year available
-2.17%
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 of health and the 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%. The rate was projected to have declined to 6.7 deaths per 1000 live births by the end of 2025. From a regional perspective, these findings suggest that the target under the PAHO Strategic Plan 2020–2025 of 6.9 deaths per 1000 live births has been achieved, reflecting 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 related to prematurity, congenital anomalies, sepsis and infections, and birth asphyxia. These patterns point to bottlenecks in access to timely, quality preconception, maternal, and newborn care, as well as persistent gaps in the disaggregated and subnational data needed to guide targeted action.
Countries, in collaboration with the Pan American Sanitary Bureau and partners, continued their efforts to strengthen maternal and newborn health policies and services, improve the prevention and management of the leading causes of neonatal mortality, and strengthen monitoring frameworks to assess progress and identify areas requiring accelerated action. This indicator will continue to be monitored under the PAHO Strategic Plan 2026–2031.
Recommendations
Strengthen and expand access to quality preconception, maternal, and newborn care through 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.
Intensify interventions to prevent, enable early detection of, and effectively manage the leading causes of neonatal mortality, in particular complications related to prematurity, congenital anomalies, sepsis and infections, and birth asphyxia.
Promote sustained coordination to expand the implementation of evidence-based strategies in collaboration with the Bureau and partners, recognizing that further reductions in neonatal mortality will also contribute substantially to reductions in the under-5 mortality rate and in the burden of disease and disability associated with neonatal conditions.
Strengthen health information systems to improve the completeness, quality, timeliness, and disaggregation of neonatal mortality data, thereby enabling more targeted interventions.