In an address to the World Health Assembly earlier this year Melinda Gates emphasised that the majority of newborn deaths are actually preventable. “I want to be very clear about what I mean when I say preventable,” she added. “I don’t mean theoretically preventable under ideal but unrealistic circumstances. I mean preventable with relatively simple, relatively inexpensive interventions.” Here are four techniques that can save lives.
1. The $5 mask
Asphyxia, which accounts for 25% of newborn deaths, can be avoided if unskilled birth attendants have access to a $5 (£3) resuscitation mask. But these masks are generally more available in urban areas rather than rural, according to Dr Tunde Segun of Evidence for Action, an NGO working on improving maternal and newborn survival. “Taking Nigeria for example, things are actually a lot better in the southern part of Nigeria and then quite bad in the north. These inventions can’t produce homogeneous result until they also flood the rural areas.”
A number of NGOs are now focusing on finding ways of getting the masks into rural communities, including Society for Family Health, Pathfinder International, and Clinton Health Access. Dr Aminu Magashi Garba of the Africa Health Budget Network says: “Having skilled community officers that can use the mask and ensuring state governments buy into the scheme to provide the masks has remained a prevailing challenge.”
2. Breastfeeding
When babies are breastfed within the first few hours of life, this can reduce neonatal mortality by 44% . The obstacles to breastfeeding are: community and cultural pressures, shortage of health workers to support mothers enforce breastfeeding, lack of maternity legislation, breastmilk substitute makers and their powerful marketing influence, family pressures and the belief that colostrum is dirty are barriers to breastfeeding.
Segun explains: “The average rural woman in the remote area in sub-Saharan Africa is illiterate, and there are a couple of biased beliefs about the thick yellow fluid that comes out as breast milk immediately after birth. The major challenge is in getting these women to erase their preconceptions and come to terms with the reality that this first fluid is actually the first immunisation the baby seriously needs and thankfully it has been naturally provided. Women are encouraged to feed their babies with the thick fluid reach in colostrums rather than spill it away with the impression that it is bad and poisonous.”
3. The Kangaroo technique
This technique involves keeping the baby warm on the mother’s chest and is another simple way to increase a baby’s chances of survival. It is more encouraged for premature babies because they need the warmth to survive. “However it can also be done for babies who have had a normal delivery, as they also need warmth at those critical period of first four weeks of life,” says Garba.
It can improve chances of a premature or low birth weight baby surviving by almost 50%. This prevents infections, regulates the newborn’s temperature, brain activity and also breathing. In the Democratic Republic of Congo, where 40 babies die every hour, the Maternal and Child Health Integrated programme implemented a national campaign on the Kangaroo technique. Staff were trained at an established centre for the technique in Mali.
Health workers were initially skeptical about the technique. But there have been success stories, such as that of baby Kaswa who was born underweight in Kinshasa. After his mother kept him on her skin for 24 hours a day and breastfed him exclusively, he gained enough weight to be out of danger. These have encouraged doctors and nurses to spread the word about the technique.
4. The basic antiseptic
Newborn sepsis is responsible for over 500,000 of the 3.1m newborn deaths globally. The infection is usually transmitted when the umbilical cord is removed with unsterilised materials. Applying a basic antiseptic which cost less than $1 helps to stop infections. This action reduces mortality by 23%.
About 47% of the world’s babies are given birth to at home, mostly in poor communities in Africa, and it can be difficult to get local women to get a newborn’s umbilical cord cleaned. The main reason why many newborn babies are lost to tetanus is because in many of these remote communities, midwives don’t sterilise the environment in which labour takes place. Getting clean birth kits into the hands of traditional birth attendants and midwives, and also training them on its usage will go a long way.
Garba says the gel is “easy to use and it is cheap.” The only challenge lies in ensuring that states are buying enough and also in ensuring that it is budgeted for in the annual operational plan so the release of funds can be done on time and at regular intervals.
Lanre Olagunju blogs for the African Union on the Campaign On Accelerated Reduction Of Maternal, Newborn And Child Mortality In Africa. Follow @Lanre_Olagunju on Twitter.
