Beyond Neonatal Mortality: Neonatal Near Miss concept as a clinical tool in Australia

Name: Tahir Ahmed Hassen

Supervisors: Dr Catherine Chojenta, Prof Deborah Loxton


Neonatal health is one of the unfinished health agenda. Globally, about 2.6 million neonatal deaths occur every year, of which, one million deaths are within the first day of birth. Traditionally, neonatal mortality has been used to measure and evaluate the perinatal health service quality. However, using neonatal mortality is becoming rarely applicable particularly in developed settings where there is low neonatal mortality and another alternative indicator; neonatal near miss is being recommended.

Neonatal near miss (NNM) defined as ‘an infant who nearly died but survived a severe complication that occurred during pregnancy, birth or within 7 days of extra-uterine life’. Though NNM is not well studied, the existing few literature suggested that; when combined with neonatal mortality, NNM is very helpful to evaluate and identify points of deficiencies in obstetrics and newborn care particularly in developed nations. In many developed nations like Australia, Neonatal mortality has been declined to a single digit. However, recently published evidence from different settings suggested that for a single neonatal death there might be as many as severe acute morbidities which calls for the inclusion of neonatal near miss. Nevertheless, despite the recommendations, neonatal near miss concept is not studied in Australia using the recently proposed markers. Therefore, this study aims to bring and contextualize the neonatal near concept to Australia and to further enhance the health of newborns by revealing the magnitude of the problem and its determinants. Further, this study aims to contribute for the worldwide standardization process of neonatal near miss tool.