Health systems failing newborns
No newborn is born to die – 3-million newborns die annually. No baby must be stillborn, but 2.6-million are stillborn annually. No children must be stunted or dying of hunger, however 2.9-million die annually from these conditions.
‘These are our delivery goals, yet there are 10-million deaths every year,’ says Professor Joy Lawn, delivering a plenary address at the Newborn2013 meeting yesterday (TUES).
Of the 10-million, more than 3.5-million die within days of being born.
Terming it the ‘Big 5’, Lawn, a Professor at the London School of Hygiene and Tropical Medicine, identified the underlying conditions responsible for 75% of the deaths.
These include childbirth complications (bleeding and obstructed labour), preterm birth complications, infections (mother and baby), maternal chronic conditions (hypertension and diabetes) and nutrition (undernutrition and obesity). All of these conditions have tested and cost-effective interventions, yet health services are failing to deliver.
Lawn points out that the ‘best buy’ would be to significantly improve the quality of services at hospital and clinic level.
Stella Abwao of MCHIP, a US-government led programme to address maternal, neonatal and child health, shared details of a survey in several African countries, which found that there was poor healthworker knowledge of newborn care and management of complications.
All these countries, which did not include South Africa, had great policies in place and skilled birth attendants, but the care at facility level was often poor. Similar scenarios occur in South Africa, where most women deliver at facilities, but the newborn death rate remains high and stagnant.
Some of the facilities surveyed by Abwao (not in South Africa) were still using archaic methods such as slapping newborns and hanging them upside down.
‘Skilled birth attendants does not equal quality newborn care,’ said Abwao.
Experts at the meetings have also repeated the message that keeping the mother alive is one of the most critical interventions.
A study from Bangladesh calculated the cumulative probability of child survival to age 10 years when linked to the parents’ mortality.
If the mother is alive, the probability of the child surviving to 10 years is 89%, however it plummets to 24% if the mother dies.
The probability remains around 89% whether the father dies or not.
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Health systems failing newborns
by healthe, Health-e News
April 16, 2013