Modern medicine has made significant advancements in the care and treatment available to humans.

Cancer is no longer the death sentence it was once deemed.

AIDS and HIV are considered treatable diseases now.

Even the surgery required to clear clogged arteries is about two steps away from being an outpatient procedure.

But, despite these scientific breakthroughs, there is one health issue that remains a troubling trend across our planet: Infant deaths.

Each year approximately one million infants die on the day they are born, according to a 2014 report, Ending Newborn Deaths, from the Save the Children Foundation.

The number was highlighted again this year when Bill and Melinda Gates mentioned the findings in their foundation’s annual letter.

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A variety of reasons

Experts say infant deaths occurs in both developing nations and industrialized nations.

There are a variety of causes.

Some infants who die on their first day of life succumb to birth defects, said Dr. Jose Cordero, MPH, of the University of Georgia.

But ultimately, most deaths can be traced back to the type of healthcare that pregnant women have access to.

“What we’re really talking about is what you have at the local level,” Cordero told Healthline. “It has to do with prenatal care, and it has to with delivery with an appropriately trained attendant.”

In developing nations medical care for pregnant women is usually administered by midwives or healthcare attendants, compared with industrialized nations where doctors and nurses commonly provide care.

The Save the Children report states, “half of first-day deaths around the world could be prevented if the mother and baby had access to free healthcare and a skilled midwife.”

Infant deaths occur when these attendants haven’t received proper training in emergency life-saving procedures, according to Cordero. This can include resuscitation, if the baby is born not breathing.

According to the Save the Children report, “skilled care during labor could reduce the number of stillbirths during labor by 45 percent and prevent 43 percent of newborn deaths.”

Adequate training can teach healthcare attendants how to identify high-risk pregnancies, Cordero noted. Conditions like placenta previa, a ruptured placenta, or preeclampsia can lead to complications for the baby and the mother.

A healthcare attendant that has the training to detect any early stage complications can “recognize that because of these complications [the mother] needs a higher level of care,” such as a hospital,” Cordero said.

Aside from pregnant and delivery care, birth defects are also a major factor in infant death, he noted.

Some of these birth defects, such as spina bifida, may be prevented if pregnant women ingest enough folic acid. For example, women could eat wheat products that are fortified with this important vitamin

It’s a simple solution that isn’t standard practice throughout the world. And not just in developing nations, Cordero added.

“Only about one-third of the flour in the world is fortified, so a lot of progress can be made,” he said. “The U.K. still is not doing it.”

Read more: Get the facts on birth defects »

High infant death rate in the U.S.

The United States does fortify its flour supply. However, the country still struggles to improve its infant death rate.

A 2014 report by the National Center for Health Statistics compared the infant death rates of 22 industrialized countries. The United States came in last.

As in developing countries, infant death rates in the United States are also tied to access to healthcare.

“It’s about economic and social conditions that women struggle with every day,” Alicia Leatherman, director of Infant Wellness at Nationwide Children’s Hospital (NCH), told Healthline.

In Columbus, Ohio, where NCH is located, African-American babies are two times more likely than Caucasian babies to die in their first year. The county is working to reduce that number through a program called “Celebrate One,” which was rolled out in 2014.

“Our goal is to decrease infant mortality rates by 40 percent,” Leatherman said.

The program takes into consideration a host of situations and scenarios that hinder access to prenatal care. They include neighborhood conditions, smoking, and even the spacing between pregnancies.

In 2014, the county’s infant death rate was 8.4 percent. By 2015 that number dropped to 7.7 percent. However, Leatherman said preliminary numbers for 2016 show an uptick.

She said they suspect that some of these deaths are due to prematurity or sleep related issues caused by situations such as co-sleeping.

“There are many different reasons,” Leatherman said.

Even so, the county is pleased with the response that the program has received.

“We’ve seen an increase in getting [pregnant women] into prenatal care, early,” she said.

While there is still much to be done when it comes to infant death rates, both Leatherman and Cordero say there has been significant improvement in access to prenatal care for women throughout the world.

“Twenty years ago, our concern was there were a million babies in Africa alone that were dying of measles,” Cordero said. “So, a lot of progress has been made.”

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