A call to action for newborn

Many at times the plight of the newborn are underreported as many interventions on Maternal and Newborn Health (MNH), the “M” is usually more prominent than the “N”The report revealed that every day, 18,000 children under five die, and most from preventable causes. It also shows that, in 2012, 2.9 million babies died within 28 […]

Many at times the plight of the newborn are underreported as many interventions on Maternal and Newborn Health (MNH), the “M” is usually more prominent than the “N”
The report revealed that every day, 18,000 children under five die, and most from preventable causes. It also shows that, in 2012, 2.9 million babies died within 28 days of being born: two out of every five child deaths. Of these, 1 million babies died within 24 hours, their first – and only – day of life. Causes of these deaths include premature birth, complications during birth and infections.
It also reveals that the crisis is much bigger than we might think. In 2012 there were another 1.2 million tragic losses: stillbirths where the heart stopped beating during labour. These are not part of the fourth UN Millennium Development goal, which aims to reduce child mortality by two-thirds. However, they deserve to be counted in future maternal, newborn and child health frameworks, especially to understand the specific risks around labour and delivery. This report therefore focuses on the 2.2 million combined newborn deaths on the first day and stillbirths during labour. There’s a huge amount at stake. As the 2015 deadline for the Millennium Development Goals approaches, it is vital that the world acts to make sure more countries can get on-track to achieve MDG4. It has now become clearer we won’t be able to do this unless we urgently tackle the crisis of newborn deaths.

The cause and the cure:
The report highlighted that the causes of stillbirths, newborn and maternal deaths are closely related, and we know what needs to happen. The solution needs specific and urgent attention. The key way to stop newborn deaths is to ensure that essential care is provided around labour, delivery and immediately afterwards when the risks are greatest. That means having a skilled, well-equipped birth attendant available to assist women and newborns during delivery.
In many cases, small but crucial interventions can save lives in danger. Skilled care during labour could reduce the number of stillbirths during labour by 45% and prevent 43% of newborn deaths. The report identifies the essential interventions around birth – including treatment of severe infections and special support for premature babies – which must be made universally available to reduce mortality. All newborns in every country need assistance to begin breathing. 40 million mothers still give birth each year without any help from a midwife or another health worker trained and equipped to save the life of the baby or the mother. Many babies die each year because mothers do not get the good-quality care they need during labour and birth.
Despite global commitments to the universal right to survival and healthcare, in many countries the poorest families are twice as likely to lose a baby as the richest families. Substantial reforms are needed to ensure the poorest and hardest-to-reach communities are able to access proper care at birth. This not only includes the removal of user fees – direct cash payments for maternal, newborn and child health services – which deny mothers and babies the healthcare they need because the family cannot afford them. It also means ensuring public health services are not starved of funding and that there are enough skilled health workers in places they are needed.

2014: The opportunity for life-saving change:
2014 will be a crucial year. Political support for universal health coverage – the availability of a basic package of healthcare for everyone, a package which countries can increase as resources increase – is growing around the world. It also mentioned that for the first time ever, countries and institutions around the world will sit down to agree on an ‘Every Newborn Action Plan’, an agreement to tackle this deplorable problem of lack of attention to babies in their first days of life.  The plan must be followed by concerted political action at the highest levels to achieve its implementation.
This change must happen in the countries where child mortality rates are high, in partnership with donors and other stakeholders. We need a new sense of purpose from the global community. The world must not squander the opportunity that 2014 offers.
The report calls on the world leaders, philanthropists and the private sector – this year – to commit to a Newborn Promise to end all preventable newborn deaths, as follows;
1.      Governments and partners should issue a defining and accountable declaration to end all preventable newborn mortality, saving 2 million newborn lives a year and stopping the 1.2 million stillbirths during labour
2.      Governments, with partners, must ensure that by 2025 every birth is attended by trained and equipped health workers who can deliver essential newborn health interventions
3. Governments should increase expenditure on health to at least the WHO minimum of US$60 per capita to pay for the training, equipping and support of health workers
4.      Governments should remove user fees for all maternal, newborn and child health services, including emergency obstetric care
5.   The private sector, including pharmaceutical companies, should help address unmet needs by developing innovative solutions and increasing availability for the poorest to new and existing products for maternal, newborn and child health.
These 5 calls to action could not just happen unless we are all committed to work together and to continue to advocate and sensitize everybody to be part of the struggle and campaign to put the “Newborn” on the top agenda of every government.

All comments to Dr Aminu Magashi at [email protected]