  In recent years, much of the focus in monitoring child mortality has been on
assessing changes in the under-five mortality rate (U5MR). However, as the U5MR
decreases, the share of neonatal deaths (within the first month) tends to
increase, warranting increased efforts in monitoring this indicator in addition
to the U5MR. A Bayesian splines regression model is presented for estimating
neonatal mortality rates (NMR) for all countries. In the model, the
relationship between NMR and U5MR is assessed and used to inform estimates, and
spline regression models are used to capture country-specific trends. As such,
the resulting NMR estimates incorporate trends in overall child mortality while
also capturing data-driven trends. The model is fitted to 195 countries using
the database from the United Nations Interagency Group for Child Mortality
Estimation, producing estimates from 1990, or earlier if data are available,
until 2015. The results suggest that, above a U5MR of 34 deaths per 1000 live
births, at the global level, a 1 per cent increase in the U5MR leads to a 0.6
per cent decrease in the ratio of NMR to U5MR. Below a U5MR of 34 deaths per
1000 live births, the proportion of deaths under-five that are neonatal is
constant at around 54 per cent. However, the relationship between U5MR and NMR
varies across countries. The model has now been adopted by the United Nations
Inter-agency Group for Child Mortality Estimation.
