Malawi's progress in reducing deaths in children under five years (between 1992 and 2016) is spectacular: a drop of 73% (from 234 deaths per 1,000 live births to 63 deaths). Over the same period, however, deaths during the first month of life held firm at 27 per 1,000 live births ― one of the highest rates in the world. Malawi also has the world's highest rate of premature births (babies born before the 37th week of pregnancy). More than half of these babies will develop respiratory distress syndrome, which increases the risk of serious infections such as neonatal pneumonia and sepsis.