Simple interventions to improve newborn survival rates in Africa

ONE THIRD of all neonatal deaths occur in Africa, according to a new World Health Organisation (WHO) report.

What you need to know:

  • Approximately three quarters of these occur during the first week, and almost half within the first 24 hours.

ONE THIRD of all neonatal deaths occur in Africa, according to a new World Health Organisation (WHO) report.

Approximately three quarters of these occur during the first week, and almost half within the first 24 hours.

The first 28 days of life, called the neonatal period, is a very risky period for babies. For every newborn baby that dies, another 20 will face illness or disability from conditions such as birth injury, infection, the inability to breathe normally after birth, neonatal tetanus, congenital anomalies, and the complications of premature birth.

Too many babies are also being born to mothers who have not had adequate nutrition and antenatal care during pregnancy, and who were not given skilled care during the birthing process.

These mothers are at the greatest risk of dying during or after delivery – leaving newborns at an even greater risk of dying from inadequate care and suboptimal feeding practices.

According to statistics, quality care with simple, accessible, cost–effective interventions can prevent up to two thirds of all neonatal deaths.

One method that has worked to reduce neonatal deaths in Africa is the kangaroo mother care (KMC). KMC is caring for preterm infants by carrying the baby skin-to-skin, usually by the mother.

“Essential interventions that contribute towards improving the survival of newborn babies include skilled care during delivery, where resuscitation can be performed, if required, exclusive breastfeeding, kangaroo mother care for preterm and low-birth weight babies, and the prevention and treatment of infections,” says Dr Tigest Ketsela Mengestu, director of the Health Promotion Cluster of the World Health Organisation Regional Office for Africa.

Using KMC to care for stable preterm babies has been especially beneficial in resource-poor settings. It has been shown to reduce mortality among preterm babies (weighing less than 2000 g) in hospitals by 51 per cent if started in the first week of life, compared with incubator care.

Malawi is a prime example of where KMC has been successfully used. Reports indicate that infant mortality among newborn babies has been reduced from 40 deaths per 1000 live births in 2000 to 24 deaths per 1000 live births in 2012.

Malawi is one of the few countries in the tegion that has already achieved its 2015 Millennium Development Goal 4 targets.

Another key to success in Africa is boosting community involvement. Many people do not go to a health care facility when they should.

Improving the quality of care at health facilities alone would not reduce neonatal and child mortality rates significantly. One way to improve this is to deliver more services through community providers.

Community health workers (CHWs) are examples of community providers. They are trained to visit pregnant women at home to educate mothers about nutrition, breastfeeding, prevention of mother-to-child transmission (PMTCT) of HIV, and ongoing care requirements.

CHWs also play an important role in saving the lives of newborns through home visits during the postnatal period.

There is an urgent need for newborn health to be placed high on the global political agenda. Strong political commitments, the allocation of adequate resources, and the scaling up of a few known cost-effective interventions will save many newborn lives.

- A WHO Regional Office feature

This allows them to review the health of the newborn and the mother, and to connect them to appropriate health care services.