Caught between life and death

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Study urges global action to prevent 5.5 million invisible new born deaths, stillbirths

Each year, 5.5 million babies enter and leave the world without being recorded and one in three newborns over 45 million babies do not have a birth certificate. Babies who are stillborn, born too early, or who die soon after birth are least likely to be registered, even in high-income countries says a report issued by Agha Khan Medical University on Tuesday.

This lack of registration and official recognition reflects acceptance of these deaths as inevitable and is a key reason for slower progress in recent decades in reducing new born deaths and stillbirths versus reducing maternal and child mortality, the statement further said.

Findings from the Every Newborn Series, published this day in The Lancet, a medical science journal, paint the clearest picture to date of a newborn’s chance of survival and the steps that must be taken to end preventable infant deaths the statement quoted.

New analyses indicate that 3 million maternal and newborn deaths and stillbirths can be prevented each year with proven intervention including the promotion of breastfeeding, neonatal resuscitation, kangaroo mother care for preterm babies, antenatal corticosteroids, and the prevention and treatment of infections. These interventions can be implemented for an annual cost of US$1.15 per person.

The research was led by Professor Joy Lawn, at the London School of Hygiene & Tropical Medicine and Save the Children, UK, with Professor Zulfiqar Bhutta at the Centre of Excellence in Women and Child Health, the Aga Khan University, Pakistan and Centre for Global Child Health, The Hospital for Sick Children, Canada in collaboration with more than 54 experts from 28 institutions in 17 countries. AKU was also represented by researchers Dr Jai K Das, Rehana A Salam and Arjumand Rizvi.

It provides the foundation for the forthcoming Every Newborn Action Plan, an evidence-based roadmap towards care for every woman, and a healthy start for every newborn baby, which will be launched in June 2014.

“Evidence and experience from some of the most improved, as well as the worst affected, countries shows that maternal and newborn deaths are preventable,” says Professor Bhutta.

“Our research shows that 3 million lives can be saved by 2025 if achievable interventions are scaled up to nearly universal coverage. Improving care at the time of birth gives a triple return on investment saving mothers and newborns and preventing stillbirths. Care of small and sick newborns is the next highest impact package, yet this has received little attention up to now, despite extremely cost effective solutions such as antenatal steroids and kangaroo mother care.

A systematic assessment of challenges in eight high-burden countries Afghanistan, Bangladesh, Democratic Republic of Congo, India, Kenya, Nigeria, Pakistan and Uganda – which together account for more than half of all newborn and maternal deaths revealed important differences as well as several common bottlenecks impeding progress.

Countries that have made recent, rapid reductions in newborn and maternal deaths, such as Malawi, Nepal, and Peru, have done so by expanding their skilled workforce (especially midwives and nurses), rolling out innovative mechanisms to reach the poorest families, and focusing on improving care for small and sick newborns.

“In Pakistan, the rate of neonatal deaths has not changed for almost three decades. But with the required focus on integrating community-based approaches to newborn care through the Lady Health Workers’ programme, and improved linkages and transfers to district referral facilities, we have the potential in a decade to save 158,000 newborn lives, 80 per cent of all annual newborn deaths,” said Professor Bhutta.

 

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