INTRODUCTION The Sustainable Development Goal (SDG) 3.2 aims for every country to reach a neonatal mortality rate (NMR) of ≤12/1,000 live births by 2030. More than 60 countries are off track, and 2.3 million newborns still die each year. Urgent action is needed, but varies by context, notably mortality level. METHODS We applied a five-phase NMR transition model based on national analyses for 195 UN member states: I (NMR >45), II (30-<45), III (15-<30), IV (5-<15), and V (<5). We analyzed data over the last century from selected countries to inform strategies to reach SDG3.2. We also undertook impact analyses for packages of care using the Lives Saved Tool software. RESULTS An NMR of <15/1,000 requires firstly wide-scale access to maternity care and hospital care for small and sick newborns, including skilled nurses and doctors, safe oxygen use, and respiratory support, such as CPAP. Neonatal mortality could be reduced to the SDG target of ≤12/1,000 with further scale-up of small and sick newborn care. To reduce neonatal mortality further, more investment is required in infrastructure, device bundles (e.g., phototherapy, ventilation), and careful attention to infection prevention. To reach phase V (NMR <5), which is closer to ending preventable newborn deaths, additional technologies and therapies such as mechanical ventilation and surfactant replacement therapy are needed, as well as higher staffing ratios. CONCLUSIONS Learning from high-income country is important, including what not to do. Introduction of new technologies should be according to the country's phase. Early focus on disability-free survival and family involvement is also crucial.

中文翻译：

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终结可预防的新生儿死亡：多国证据为 2030 年可持续发展目标的加速进展提供依据。

简介 可持续发展目标 (SDG) 3.2 的目标是到 2030 年每个国家的新生儿死亡率 (NMR) 达到≤12/1,000 活产儿。有 60 多个国家偏离了目标，每年仍有 230 万新生儿死亡。需要采取紧急行动，但因具体情况而异，尤其是死亡率水平。方法 我们应用了基于 195 个联合国成员国国家分析的五相 NMR 转变模型：I (NMR >45)、II (30-<45)、III (15-<30)、IV (5-<15)和 V (<5)。我们分析了选定国家上个世纪的数据，为实现可持续发展目标 3.2 的战略提供信息。我们还使用 Lives Saved Tool 软件对护理包进行了影响分析。结果 NMR <15/1,000 首先需要广泛获得孕产妇护理和小病新生儿的医院护理，包括熟练的护士和医生、安全氧气使用和呼吸支持，如 CPAP。通过进一步扩大小型和患病新生儿护理规模，新生儿死亡率可降至≤12/1,000 的可持续发展目标。为了进一步降低新生儿死亡率，需要对基础设施、设备包（例如光疗、通气）进行更多投资，并认真关注感染预防。为了达到第五阶段（NMR <5），即更接近结束可预防的新生儿死亡，需要额外的技术和疗法，例如机械通气和表面活性剂替代疗法，以及更高的人员配备比例。结论 向高收入国家学习很重要，包括不该做什么。新技术的引进要根据国家的阶段。尽早关注无残疾生存和家庭参与也至关重要。