摘要:The low priority that most low-income countries give to neonatal mortality, which now constitutes more than 40% of deaths to children younger than 5 years, is a stumbling block to the world achieving the child survival Millennium Development Goal. Bangladesh is an exception to this inattention. Between 2000 and 2011, newborn survival emerged from obscurity to relative prominence on the government’s health policy agenda. Drawing on a public policy framework, we analyzed how this attention emerged. Critical factors included national advocacy, government commitment to the Millennium Development Goals, and donor resources. The emergence of policy attention involved interactions between global and national factors rather than either alone. The case offers guidance on generating priority for neglected health problems in low-income countries. In 2001 United Nations member states agreed to 8 Millennium Development Goals (MDGs), poverty alleviation objectives to achieve by 2015. Goal 4 concerns child survival: “Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.” 1 Although analysts expect the world to achieve many of the 8 goals, 2 only 31 of 137 developing countries are predicted to reach MDG 4. 3 A stumbling block is the slow decline in deaths to newborn babies—those aged 28 days and younger. Early neonatal mortality (0–6 days) has declined at a rate of only 1.7% per year since 1990, slower than the pace for children older than 28 days. 3 In consequence, newborns now constitute more than 40% of all deaths to children younger than 5 years. This slow decline may be partly because of the low priority most low-income countries afford neonatal mortality reduction. Although many governments have addressed child survival, few have focused on the neonatal period. 4 Bangladesh is an exception. Between 2000 and 2011, newborn survival rose from near obscurity to a prominent place on the government’s health policy agenda. This change is surprising, as there was no swift spread of a pathogen harming neonates or sudden rise in the number of newborn deaths; on the contrary, newborn death rates have been declining in the country, if slowly. 5 We analyzed how newborn survival emerged as a health priority in Bangladesh. We drew on a public policy framework previously developed to explain political attention for maternal mortality reduction in 5 developing countries. 6 The appearance of an issue on a national policy agenda is only 1 of multiple factors that stand behind policy effectiveness and is hardly enough to ensure that the political system will carry out plans or that these plans will be successful in reducing neonatal mortality. However, reaching the policy agenda facilitates policy effectiveness and is therefore useful to study.