Background: Despite recent achievements to reduce child mortality, neonatal deaths continue to remain high, accounting\r\nfor 41% of all deaths in children under five years of age worldwide, of which over 90% occur in low- and middle-income\r\ncountries (LMICs). Infections are a leading cause of death and limitations in care seeking for ill neonates contribute to high\r\nmortality rates. As estimates for care-seeking behaviors in LMICs have not been studied, this review describes care seeking\r\nfor neonatal illnesses in LMICs, with particular attention to type of care sought.\r\nMethods and Findings: We conducted a systematic literature review of studies that reported the proportion of caregivers\r\nthat sought care for ill or suspected ill neonates in LMICs. The initial search yielded 784 studies, of which 22 studies\r\ndescribed relevant data from community household surveys, facility-based surveys, and intervention trials. The majority of\r\nstudies were from South Asia (n = 17/22), set in rural areas (n = 17/22), and published within the last 4 years (n = 18/22). Of\r\nthe 9,098 neonates who were ill or suspected to be ill, 4,320 caregivers sought some type of care, including care from a\r\nhealth facility (n = 370) or provider (n = 1,813). Care seeking ranged between 10% and 100% among caregivers with a\r\nmedian of 59%. Care seeking from a health care provider yielded a similar range and median, while care seeking at a health\r\ncare facility ranged between 1% and 100%, with a median of 20%. Care-seeking estimates were limited by the few studies\r\nconducted in urban settings and regions other than South Asia. There was a lack of consistency regarding illness, careseeking,\r\nand care provider definitions.\r\nConclusions: There is a paucity of data regarding newborn care-seeking behaviors; in South Asia, care seeking is low for\r\nnewborn illness, especially in terms of care sought from health care facilities and medically trained providers. There is a need\r\nfor representative data to describe care-seeking patterns in different geographic regions and better understand\r\nmechanisms to enhance care seeking during this vulnerable time period.
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