Hanoi, Vietnam ? Worldwide about 4 million babies die in their first month of life – about half of those in the first 24 hours, a global report on newborn mortality says.

Simple measures like knit caps to keep babies warm could help save many of those lives, according to the report released Monday by the U.S.-based group, Save the Children.

Expectant mothers also fare poorly in undeveloped countries, with half a million women dying annually from complications during pregnancy or birth often because they have no care before, during or after their babies are born, the report said. A huge number of women give birth at home alone or with no skilled attendant.

“In most of the developing world, childbirth is a dance with death for both mother and baby, even though 70 percent of those deaths could be prevented,” said co-author Anne Tinker, director of the organization’s Saving Newborn Lives Initiative. “The secret is really knowledge.”

The 50-page report released ahead of Mother’s Day compiles data from the world’s nations as well as the World Health Organization and UNICEF. It presents a bleak look at the challenges pregnant women and newborns face in impoverished countries, where up to 99 percent of deaths occur – illustrating the wide gap between rich and poor nations.

For instance, 1 in every 5 women in sub-Saharan Africa has lost a baby in the first month of life, along with 1 in every 7 women in South Asia.

Out of 78 low- and middle-income countries examined, Liberia had the highest newborn mortality rate with 65 out of 1,000 babies dying in a country where forced teen marriages are common and many women die during pregnancy or childbirth.

Liberia was closely followed by Afghanistan, Sierra Leone, Iraq, Pakistan and Ivory Coast – countries known for conflict and widespread violence against women.

In the Afghan village of Rabat north of Kabul, a woman explained that her seventh child, a daughter, died just 14 days after birth two months ago.

“I am not sure why she died, but she was not able to breast-feed and I was not receiving prenatal medical care,” said Nagis, who uses just one name. Like all of her children, the baby was delivered at home because there was no female doctor or midwife to aid her at the clinic.

Dr. Noorullah Moussazai, who runs a local health clinic that recently set up a program using trained midwives, said, “Consultations by male doctors remain a problem for obstetrical and gynecological procedures.”

The Save the Children report acknowledges the challenges of cultural and traditional practices. In some countries there are rituals such as using cow dung on umbilical cords or immediately bathing newborns and letting them dry in the cold.

“In many countries, the birth process, particularly in Asia, is considered very dirty,” Tinker said. “We’ve tried to adapt the cultural practice to what can be safer. In Nepal and Bangladesh, we proposed just gently wiping the baby for the first week and then doing a bath.”

The report highlights the need for better education and nutrition among expectant mothers, along with the importance of breast-feeding. It offers cost-effective options, including tetanus shots, which cost about 40 cents, to protect moms and babies against infection, especially from dirty instruments that may be used during birth.