BACKGROUND: The number, rates and causes of early neonatal deaths in South Africa were not
known. Neither had modifiable factors associated with these deaths been previously documented.
An audit of live born infants who died in the first week of life in the public service could help in
planning strategies to reduce the early neonatal mortality rate.
METHODS: The number of live born infants weighing 1000 g or more, the number of these infants
who die in the first week of life, the primary and final causes of these deaths, and the modifiable
factors associated with them were collected over four years from 102 sites in South Africa as part
of the Perinatal Problem Identification Programme.
RESULTS: The rate of death in the first week of life for infants weighing 1000 g or more was
unacceptably high (8.7/1000), especially in rural areas (10.42/1000). Intrapartum hypoxia and
preterm delivery are the main causes of death. Common modifiable factors included inadequate
staffing and facilities, poor care in labour, poor neonatal resuscitation and basic care, and difficulties
for patients in accessing health care.
CONCLUSION: Practical, affordable and effective steps can be taken to reduce the number of infants
who die in the first week of life in South Africa. These could also be implemented in other under