The UN children’s agency has singled out Pakistan as the riskiest country for newborns, saying that for every 1,000 infants, 46 die at birth.

Dr Ghazna Khalid, a leading obstetrician in Pakistan’s north-western Khyber Pukhtunkhwa province, described the situation outlined in the Unicef report as “abysmal”, adding: “We don’t need front-line medical doctors. We have plenty of them. We need skilled midwives.”

The report shows that South Asia and sub-Saharan Africa are the worst places for a child to be born. It forms part of Unicef’s new campaign, launched to raise awareness to bring down neo-natal mortality rates.

Henrietta H Fore, Unicef’s executive director, said that although the world has more than halved the number of deaths among children under the age of five in the last quarter of a century, “we have not made similar progress in ending deaths among children less than one month old”.

She added: “Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies.”

Unicef’s report said that after Pakistan, the Central African Republic is the next riskiest country for newborns, while Afghanistan is third.

The report said: “Babies born in Japan, Iceland and Singapore have the best chance at survival, while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds.”

The report noted that more than 80% of all newborn deaths are caused by three preventable and treatable conditions: premature births, complications such as lack of oxygen at birth, and neonatal infections, including sepsis and pneumonia.

Unicef said as many as three million children could be saved each year with more investment in quality care at delivery.

In Pakistan, Dr Khalid said 80% of newborn deaths could be prevented with skilled birth attendants.

She said that “no matter what tools we send, or how much money you spend, unless you improve the quality and the skill of midwives”, babies in Pakistan will continue to die.

“We have midwives in government hospitals who cannot deliver a baby,” she added. “We don’t need more doctors, we need more skilled midwives.”

Unicef also called for better access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition.

Dr Khalid, who has conducted extensive research into mother and child health and has written international papers on the subject, said that lack of funding, corruption and misplaced government priorities all contribute to insufficient investments in the training of midwives.

Ms Fore said: “Every year, 2.6 million newborns around the world do not survive their first month of life.

“One million of them die the day they are born.”