Research Article Neonatal Death and National Income in Developing Countries: Will Economic Growth Reduce Deaths in the First Month of Life? Sarah Neal and Jane Falkingham Department of Social Statistics and Demography, Social and Human Sciences, University of Southampton, Southampton SO17 1BJ, UK Correspondence should be addressed to Sarah Neal; sn1c09@soton.ac.uk Received 17 May 2013; Revised 3 September 2013; Accepted 15 September 2013; Published 2 February 2014 Academic Editor: Alberto Davila Copyright © 2014 S. Neal and J. Falkingham. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te relationship between national income and child mortality has been understood for many years. However, what is less well known is whether the association difers for neonatal mortality compared to postneonatal and early childhood deaths. Our study extends knowledge by analysing the relationship between gross national income (GNI) and neonatal, postneonatal, and early child mortality. Te study draws on mortality estimates from Demographic and Household Surveys and World Bank data for GNI. It uses multivariate multiple regression analysis to examine the relationship between GNI and neonatal, postneonatal, and early child mortality rates (NMR, PNMR, and ECMR) using cross-sectional data from 65 countries and trend data from 49 countries. No signifcant relationship can be found between NMR and GNI for cross-sectional data once adjusted for region. Te trend data confrms that increases over time in GNI are associated with lower reductions in NMR than other component rates. Tus, economic growth alone may have a weaker efect on reducing neonatal deaths than for older age groups; achieving improvements in neonatal mortality requires investment in maternal and new born health services alongside growth. 1. Introduction Over the last few decades neonatal mortality (death of an infant before 28 days) has fallen at a slower rate than postne- onatal or early childhood mortality (death of a child between the ages of 28 days and 12 months and between 12 and 60 months, resp.). As a result around 40% of all child deaths now occur in the frst month of life [1]. Despite this high burden of mortality, relatively little is known about the relationship between wealth or economic growth and neonatal mortality at the national level. Te relationship between national income and overall child mortality (deaths in all children under the age of fve) has been understood for many years. A strong negative rela- tionship between national income level (using per capita gross domestic product or gross national income: GDP or GNI) and child mortality has been well documented in a number of studies using both cross-sectional and trend data that examines the association between change over time. One of the most frequently cited studies is Pritchett and Summers’ analysis [2], which estimates the efect of wealth on infant and child mortality using regression methodology based on cross- country time series data. It found that an increase in GDP by 10% was associated with a reduction in child mortality of 4%. Te study concludes that in 1990 alone over 0.5 million child deaths in developing countries could be attributed to poor economic performance during the 1980s. A more recent study which examines the association between change in GDP and child mortality over time using data from 15 Indian states found that the composition of GDP growth is also important: growth within the nonagricultural sector has a greater impact on mortality [3]. Evidence on the relationship between GDP and neonatal mortality is, however, extremely sparse. A broader study using principal component analysis suggests that contextual factors (income, female literacy, sanitation, and access to Hindawi Publishing Corporation International Journal of Population Research Volume 2014, Article ID 989485, 6 pages http://dx.doi.org/10.1155/2014/989485