88 The World Health Report 2005 actively promote breastfeeding. Where quality is satisfactory, such places are much safer for mother and child than a home birth without professional assistance Universal access to professional, skilled care at birth for all mothers has, in combina- tion with antenatal care, an enormous potential for reducing the burden of stillbirths and early neonatal deaths that form the majority of fetal and neonatal mortality. In most countries, the mortality of babies whose mothers benefit from antenatal care and skilled care at childbirth tends to be less than half that of babies whose mothers do not benefit from such care(see Figure 5.5). The consistency of these differences across a wide range of countries suggests that it is access to a continuum of skilled care that makes the difference Caring for the baby at home Professional care at birth has less effect however on later neonatal deaths which occur when the mother and newborn are at home, without professional support. Care within the household is very important for the newborns health. If the mother has good parenting skills(which can be enhanced during the antenatal care consultations)and if it will not a disease. In societies where women have extensive social networks, mobility, and ne autonomy to control resources as well as access to good health care and informa tion, mothers are in a better position to care for their babies. To move in that direction it helps to mobilize communities, for example through women s groups (34). In Bolivia encouraging women to participate in groups involved in promoting the health of the newborn contributed to a reduction in perinatal mortality from 117 to 44 per 1000 live births ( 35). In Nepal, the development of a network of womens groups led to a 30% eduction in neonatal mortality rates, mainly through better uptake of services(36) Figure 5.5 Neonatal mortality is lower when mothers have received professional care g140 ≌品z 0 children of hildren of women who received wi o antenatal or Among who received childbirth care childbirth care childbirth care 27 African countries 29 other countries Data source: Demographic and Health Surveys88 The World Health Report 2005 actively promote breastfeeding. Where quality is satisfactory, such places are much safer for mother and child than a home birth without professional assistance. Universal access to professional, skilled care at birth for all mothers has, in combina￾tion with antenatal care, an enormous potential for reducing the burden of stillbirths and early neonatal deaths that form the majority of fetal and neonatal mortality. In most countries, the mortality of babies whose mothers benefit from antenatal care and skilled care at childbirth tends to be less than half that of babies whose mothers do not benefit from such care (see Figure 5.5). The consistency of these differences across a wide range of countries suggests that it is access to a continuum of skilled care that makes the difference. Caring for the baby at home Professional care at birth has less effect, however, on later neonatal deaths, which occur when the mother and newborn are at home, without professional support. Care within the household is very important for the newborn’s health. If the mother has good parenting skills (which can be enhanced during the antenatal care consultations) and if she can breastfeed and keep the baby warm, it will be mostly fine: being a newborn is not a disease. In societies where women have extensive social networks, mobility, and the autonomy to control resources as well as access to good health care and informa￾tion, mothers are in a better position to care for their babies. To move in that direction it helps to mobilize communities, for example through women’s groups (34). In Bolivia, encouraging women to participate in groups involved in promoting the health of the newborn contributed to a reduction in perinatal mortality from 117 to 44 per 1000 live births (35). In Nepal, the development of a network of women’s groups led to a 30% reduction in neonatal mortality rates, mainly through better uptake of services (36). 27 African countries Neonatal deaths per 1000 live births 200 Figure 5.5 Neonatal mortality is lower when mothers have received professional care 180 160 140 120 100 80 60 40 20 0 29 other countries Data source: Demographic and Health Surveys. Among children of women who received no antenatal or childbirth care Among children of women who received both antenatal and childbirth care Among children of women who received no antenatal or childbirth care Among children of women who received both antenatal and childbirth care