Newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds; India ranks below Sri Lanka, Bangladesh, Nepal, and Bhutan.

India ranks 12th among 52 low-middle income countries having highest infant mortality rates with over 6 lakh children dying within the first month of their birth in 2016, a report by the United Nations Children’s Fund says.

With the neonatal mortality rate being recorded at 25.4 deaths per 1,000 live births in 2016, India ranked below Sri Lanka (127), Bangladesh (54), Nepal (50) and Bhutan (60) but was above Pakistan, which was ranked among the lowest in the list with 45.6 deaths per 1,000 live births, according to the report released on February 19.

Babies born in Japan, Iceland and Singapore have the best chance of survival, while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds, the report stated.

“While we have more than halved the number of deaths among children under the age of five in the last quarter century, we have not made similar progress in ending deaths among children less than one month old,” said Henrietta H. Fore, UNICEF’s Executive Director. “Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies.”

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says.

In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.

However, a Health Ministry official said India has shown impressive progress in reduction of under-five mortality, nearly meeting its MDG target, with a 66% reduction in under-five deaths during 1990 to 2015.

India’s progress has been far better than the world’s, the global decline in the under-five mortality during the MDG period was 55%, the official said, adding the number of annual under-five deaths in India has gone below one million for the first time in 2016.

Ensuring gender equity with equal focus on boys and girls and addressing gaps in quality of care are now going to be the next frontiers for newborn survival. The issue of neglect of the girl child is much broader and needs interventions beyond health, to also address the social norms and cultural practices.

“There is an urgent need to intensify our combined efforts to further bridge this gap and ensure equitable access to care for the newborn girl. There is a need to create a social movement involving all stakeholders — government, professional bodies, civil societies, media, political leaders and communities — truly leaving no one behind,” UNICEF India representative Yasmin Ali Haque said.

For the first time, UNICEF has come out with rankings based on their newborn mortality rate (the number of deaths per 1,000 live births).