Centre for International Health
New Publications

“A Legacy for Life”

We have 1000 days to get it right for every child: from conception to toddlerhood.

1000 days
1000 days to get it right

Main content

Researchers in newborn, child and maternal health have established that the first 1000 days of life are our most critical development period. These 1000 days, from conception to toddlerhood, impact the rest of our lives. Care, or lack thereof, given during this period has more influence on a child’s future than any other period during life. It is a unique window of opportunity for “getting it right”. We can and must invest more in the first 1000 days; it is our own human capital.

The Lancet has recently published the first paper in a series of 5 entitled “Every Newborn”.  Jose Martines, a researcher and Scientific Coordinator with the Centre for Intervention Science in Maternal and Child Health (CISMAC), a Centre of Excellence based at the Centre for International Health (CIH), at the Department of Global Health and Primary Care, is an author in 2 of the articles:



Establishing newborn health research priorities

Martines and many other CISMAC and CIH researchers were part of a research team that worked to establish evidence-based research priorities for the WHO’s new global priority period for reducing mortality among newborn babies and children, post 2015. He is an author on the publication “Newborn health research priorities beyond 2015”, which is part of the special Lancet series entitled “Every Newborn”.

The study addressed the question of how to establish research priorities that are both evidence-based and representative of consensus from the global research community in newborn health.  They adapted and used a method developed by the Child Health and Nutrition Research Initiative (CHNRI).

Briefly they identified a pool of experts (researchers, programme experts, etc.) and asked a large and representative sample to submit their 3 best research ideas. These ideas were collated into a list of questions that were sent for scoring to the expert pool against a set of 5 predefined criteria. Analyses of the responses identified priorities in 3 research domains of interventions to improve newborn health and survival: delivery, development and discovery.

Concluding with a challenge!

The authors challenge the many partners and participants in the WHO-UNICEF led Every Newborn Action Plan to ensure that the top-ranked research priorities they have identified are further evaluated and considered for  implementation in the next priority period, post 2015. They argue that implementation of these research priorities will accelerate progress in this field and result in an improvement of what is essentially our collective human capital world-wide. According to Martines, CISMAC researchers are already working with many of the research priorities the study identified.

Read the article: Newborn health research priorities beyond 2015


Setting newborn health on global health agendas

Preterm birth and neonatal health issues are globally the most common cause of death and disability in children – constituting over 10% of the Global Burden of Disease. Yet, as recently as the 1990’s there was hardly any mention of neonatal deaths in official statistics or publications. Neonatal care and death prevention were not seen as being a viable, cost-effective health priority for low-income countries.

However, research has shown that it is, in fact, a myth that newborn health is always highly technical and expensive. Simple, effective, low-cost solutions exist. A number of these inexpensive measures can lead to significant improvements in neonatal care and survival. (See Fact Box to the right.)

Some research in this area has been presented in The Lancet’s special series, Child Survival 2003, and Neonatal Survival 2005. Despite some improvements in the visibility of neonatal health and deaths in the last decade, Jose Martines and fellow authors of “Who has been caring for the baby”, write that stillbirths still remain “invisible” and uncited in scientific literature.

Being active about newborn health

In their paper, the authors summarise how the Lancet’s first “call to action” concerning newborn health has had an impact over the past 10 years (Martines was the first author of the paper, "Neonatal survival: a call for action" in the Lancet 2005 series).

In "Who has been caring for the baby", the authors note that agenda-setting and policy-formulation activity now routinely use ‘maternal, newborn and child health’ as their standard, instead of ‘maternal and child health’, and that “newborn health is now widely recognised as a crucial element of the reproductive, maternal, newborn and child health and nutrition continuum of care”.

The authors underline that it remains a myth, however, that investment in maternal and child health will have a trickle-down effect on newborn health, and urge that neonatal health issues receive their own prioritising in funding, agenda setting and policy formation.

They conclude by noting that action, amount of intervention, and information is variable between regions and countries, as well as within countries and that the situation is often poorly documented. Initiatives are frequently dependent on individual leader efforts. The paper wraps up with information about the many opportunities there are for intentional engagement and action to improve newborn health. Again, this is an area where CISMAC researchers are active.

Read the article Who has been caring for the baby?


Other links:

Child Health and Nutrition Research Initiative (CHNRI)

UN: Millennium Development Goals


Every Newborn Action Plan

Born Too Soon: The Global Action Report on Preterm Birth

Global Burden of Disease


The Lancet:

Child Survival Series 2003

Neonatal Survival Series 2005

Stillbirth Series 2011

Newborn health research priorities beyond 2015


1,000 Days: The Period That Decides the Health and Wealth of the World the Atlantic May 2014

Saving Every Woman Every Child: Within Arm's Reach Canadian Broadcasting Corporation May 2014

Saving women, saving children   Doctors Without Borders / National Post May 2014