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To the Editor: The article ‘Reducing neonatal deaths in South Africa: Progress and challenges’[1] in the March 2018 SAMJ Maternal and Child Health Supplement reviews recent neonatal estimates, causes and ways of reducing preventable deaths in this age category in the context of the Sustainable Development Goals.[2] While the article acknowledges the increasing contribution of ‘congenital anomalies’ as a cause of neonatal death, it fails to acknowledge the proportion of ‘congenital disorders’(CDs) as a collective. No definition is included, but the literature defines congenital anoma lies as macroscopic morphological anomalies present at birth,[3, 4] refer ring to clinically obvious structural abnormalities as classified in Chapter XVII:‘Congenital malformations, deformations and chromosomal abnormalities’ of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).[5] This excludes ‘nonsyndromic congenital disability (intellectual, physical, visual and auditory disability and epilepsy), common single gene disorders such as the haemoglobin disorders, glucose-6 phosphate dehydrogenase deficiency, cystic fibrosis, oculocutaneous albinism, spinal muscular atrophy and inborn errors of metabolism’[4] and teratogens. These are distributed throughout the ICD-10 system, accounting for a third of CDs globally.[6] Presenting only a subset of CDs to represent the totality of CDs has implications, particularly for cause-of-death rankings and planning of services and interventions. While the role of congenital anomalies is indicated as a notable cause of death in neonates in South Africa (SA), ranking fourth after …