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Low birthweight (LBW; <2500 g) is an important predictor of health outcomes throughout the life course. We aimed to update country, regional, and global estimates of LBW prevalence for 2020, with trends from 2000, to assess progress towards global targets to reduce LBW by 30% by 2030.

Despite major achievements in child survival, the burden of neonatal mortality has remained high and even increased in some countries since 1990. Currently, most neonatal deaths are attributable to being born preterm, small for gestational age (SGA), or with low birthweight (LBW). Besides neonatal mortality, these conditions are associated with stillbirth and multiple morbidities, with short-term and long-term adverse consequences for the newborn, their families, and society, resulting in a major loss of human capital. Prevention of preterm birth, SGA, and LBW is thus critical for global child health and broader societal development. Progress has, however, been slow, largely because of the global community's failure to agree on the definition and magnitude of newborn vulnerability and best ways to address it, to frame the problem attractively, and to build a broad coalition of actors and a suitable governance structure to implement a change. We propose a new definition and a conceptual framework, bringing preterm birth, SGA, and LBW together under a broader umbrella term of the small vulnerable newborn (SVN). Adoption of the framework and the unified definition can facilitate improved problem definition and improved programming for SVN prevention. Interventions aiming at SVN prevention would result in a healthier start for live-born infants, while also reducing the number of stillbirths, improving maternal health, and contributing to a positive economic and social development in the society.

The continued use of basic, manual anthropometric tools (e.g., boards and tapes) leaves anthropometry susceptible to human error. A potential solution, 3-dimensional (3D) imaging systems for anthropometry, has been around since the 1950s. In the 1980s, 3D imaging technology advanced from photographs to the use of lasers for body digitization; and by the 2000s, the falling price of 3D scanners made commercial application feasible. The garment sector quickly adopted imaging technology for surveys because of the need for numerous measurements and large sample sizes. In the health sector, 3D imaging for anthropometry was not widely adopted; its use was limited to research and specialized purposes. The different cost and logistical requirements for measurement in the garment and health sectors help to explain why the technology was adopted in one sector and not the other. Despite reductions, the price of 3D imaging systems remained a barrier to the use of 3D imaging for regular nutritional assessment in the health sector. Additional barriers in the health sector were that imaging systems required dedicated space and were not designed for capturing measurements in young children. In recent years, the development of light-coding technology may have removed these barriers, and a handheld imaging system was developed specifically for young children. There are not yet recommendations to replace manual equipment with 3D imaging for nutritional assessment, and there is a need for more research on low-cost, handheld imaging systems—particularly research that evaluates the ability of 3D imaging to improve the quality of anthropometric data and indicators.