By Sue Valentine,
A report by Save the Children’s Saving Newborn Lives programme takes a close look at newborn survival rates over the last decade. After three years of analysis, a team of more than 150 authors and contributors, concluded that global funding overlooked a key area for preventing child deaths – newborn care.
The report published by Save the Children says sub-Saharan Africa has reduced deaths among children in the first month of life by a negligible 1.5 percent from 2000 to 2010, a small improvement on the 0.6% reduction between 1990 and 2000. The region has made the least progress worldwide in cutting deaths among newborns.
The authors of the report say that unless improvements are accelerated, it will be more than 150 years before African babies have the same chance of survival as those born in the United States and Europe.
Worldwide, the number of deaths of children up to the age of five has dropped from 12.4 million in 1990 to 7.6 million in 2010. But from 2000 to 2010 the number of newborns who died before they were one month old dropped only slightly, from 3.7 million to 3.1 million.
Entitled, “A Decade of Change for Newborn Survival – Changing the Trajectory for our Future”, the report notes that a handful of African states has made rapid progress in improving the chances of infant survival. Tanzania and Malawi reduced their infant mortality rate by more than a quarter, while Rwanda and Namibia reduced the number of infant deaths by more than 30 percent, and Botswana by almost 40 percent.
Somalia, Mali, the Democratic Republic of Congo and Sierra Leone were the top four countries in the world where a newborn baby had the least chance of survival past its first month of life. And elsewhere across the rest of the continent there has been no significant improvement in the health of infants in the past decade.
The report highlights discrepancies in funding to newborns, who account for 40 percent of child deaths annually. Although official development assistance for maternal, newborn and child healthcare doubled between 2003 and 2008, less than one percent of these funds targeted newborns exclusively, and only six percent of aid grants mentioned newborns at all. Newborns are defined as children younger than a month.
The report, a product of three years’ collaboration among more than 60 health researchers, offers a first-of-its-kind analysis of newborn health around the world and what is needed to speed up progress on ending newborn deaths.
The causes of death among the 3.1 million newborns who die within their first month include complications prior to birth, complications during birth (such as intrapartum asphyxia), and infections.
Adolescent pregnancy, closely-spaced births and frequent pregnancies all place women at higher risk of complications during pregnancy or whilst giving birth. Family planning remains one of the most cost-effective ways to reduce maternal and neonatal deaths as well as stillbirths.
Despite the need for economic growth and improved funding of local health systems in most developing countries, Save the Children says that some of the world’s poorest countries have made great gains in improving the survival of newborns and children. In Africa, this includes Malawi and Rwanda, both of which are on track to meet Millennium Development Goal number four – to reduce child deaths by two thirds by 2015.
Countries that have improved the survival chances of newborns have also improved access to contraceptives and a concurrent reduction in fertility, ensuring that mothers who give birth are healthy and less likely to experience complications in childbirth. They have also improved health facilities, provided greater access to skilled birth attendants, and have improved primary health care.
The report claims that more than three-quarters of newborn deaths could be prevented by 2015 if there were universal coverage of “high-impact interventions” such as Kangaroo Mother Care (wrapping newborns in skin-to-skin contact with their mothers for warmth and improved breastfeeding), antibiotics for babies with infections, exclusive breastfeeding and other basic care.
The report also argues that the rapid progress made by some countries shows that the neonatal mortality rate can be halved within a decade.
“Over the last decade, the global health community and families in countries have changed previously unquestioned beliefs,” the report states. These include access to Aids treatment even in low-income countries, women’s right to life whilst giving birth, and access to contraceptives so that men and women can plan their families.
“As impatient optimists, we believe that the next decade will bring transformational change for newborns and it will no longer be acceptable for babies around the world to die of preventable causes.”