Introduction:

Reducing social and geographical inequalities in neonatal mortality is the purpose of the sustainable development agenda.

Objective:

To analyze the geographical trend at the departmental level of the change in neonatal mortality according to low weight in Colombia between 2008 and 2017.

Methods:

An ecological study based on vital statistics records. Through the generalized mixed linear model, neonatal mortality and absolute and relative differences were analyzed together according to low birthweight following Blakely’s typology. The geographical variation between departments was analyzed using Median Mortality Ratio (MRM) and maps.

Results:

At the national level between 2008-2010 and 2015-2017 adjusted neonatal mortality decreased by 0.67 (95% CI 0.52-0.81) deaths and excess deaths among low birth weight births decreased by 4.92 (IC95 % 3.53-6.33) deaths per thousand live births; mortality rate did not change significantly (RRM 1.03; 95% CI 0.97-1.09). This pattern of change is desirable according to Blakely’s typology. However, in ten departments mortality and differences according to low birth weight did not decrease. During the 2015-2017 period, the departmental variation in neonatal mortality was quantified in MRM = 2.13 (95% CI 1.63-2.64) without change between periods; Neonatal mortality was higher in peripheric departments.

Conclusion:

Despite advances at the national level in reducing neonatal mortality, onethird of the departments where a quarter of births were registered showed no desirable changes. The high territorial variability observed raises the need to implement surveillance and intervention strategies with a focus on both perinatal factors and geographic location to reduce gaps in newborn survival.