By Patrick Aliganyira
IN Uganda today, 131,000 children still die every year before celebrating their fifth birthday. Needless to say, the majority of these deaths are due to preventable causes. Of these, 43,230 die before they make 28 days of life.
That is 3,600 per month and 118 each day. Most of these babies die at birth or within 24 hours of birth.
An almost equal number – 39,000 are born dead per year – they are stillborn. Unfortunately, this is not only an unheard cry but also a missed count when the world is tracking progress on reducing child deaths. Every newborn should be counted.
The causes of newborn deaths are known. Premature birth claims 16,427 newborns per year, infections 10,375 and complications during birth 12,100.
There is no such opportunity to solve a problem like the one you have when you know the cause. Research has identified high impact, cost-effective solutions to tackle each of these causes.
If a mother at the risk of premature labour is given an injection of dexamethasone (a drug that is already being used in health facilities for other clinical conditions), the maturation of her baby’s lungs will be fastened and its chances of initiating breathing at birth increased.
When born, premature and low-birth weight babies can be cared for through Kangaroo Mother Care (KMC), where they are continuously kept in skin-to-skin contact on the chest of the mother or caregiver.
This method helps maintain the baby’s temperature, prevents infections and promotes breastfeeding, enhancing the baby’s chances of survival. If practiced well, KMC is said to reduce deaths in preterm babies by 50%.
For a baby with an infection, an antibiotic – gentamicin – is recommended to be provided by a skilled health worker in a heath facility. This, along with other supportive care, can save its life.
However, is gentamicin available at levels where these babies have the first contact with the health system? Are all health workers able, if allowed, to provide this life-saving injection?
The time of birth and immediately after birth present the best opportunity to save even more lives yet, paradoxically that is when we lose most of them. Sometimes babies are born and are unable to breathe, but the health workers are not able to assist them to breathe.
If able, the health workers may not have the basic equipment to use. Investment in solutions at the time of birth and immediately after birth will yield triple returns – it will prevent mothers from dying, stillbirths and early neonatal death. Investing in improving new born survival is an investment in the future and impacts the whole health system performance.
Considering the life continuum, pregnancies need to be planned and spaced. Every pregnancy should be monitored by a skilled health provider. So should each delivery be attended by a skilled health worker in a health facility and best home care practices prevail for mothers and their babies.
If these solutions were available to all mothers and babies at the right time, we would be able to save up to 80% of all the needless deaths of new borns.
We need not do business as usual; we have a promise to keep pertaining to the lives of women and children, especially since we have less than 900 days to the MDG deadline.
Donor agencies, implementers and the Government should target the poor and invest in increasing reach of evidence-based solutions, especially at the time of birth and immediately afterwards.
Today, more than ever, we are better placed to make a difference for we know the causes of the majority of deaths and hence the solutions.
The solutions are effective and applicable to our settings. The death of a new born baby is not inevitable, should not be acceptable and is preventable. Everyone has a role to play.
Writer is a Program Specialist – Saving Newborn Lives, Save the Children