JOHANNESBURG – Experts from around the globe are gathering this week to address the preventable and unnecessary deaths of newborns, which accounts for almost half of all deaths among children under five.
“No child is born to die. And no mother should have to watch her newborn child suffer and die in that way,” global activist Graca Machel said at the opening plenary yesterday (MONDAY).
Sub-Saharan Africa accounts for nearly 50% of all global under-five deaths. “Too many of our children, especially the newborns here in Africa are dying, too early,” Machel said.
Professor Joy Lawn of the London School of Hygiene & Tropical Medicine said in South Africa alone 20 000 newborns had died within a year with an additional 22 000 stillbirths.
South Africa is praised for its fast progress in increasing post-natal survival rates due to HIV programmes, but Lawn warned that this hid the fact that the country’s newborn death rate was “flatlining.
David Oot of Save the Children said that much of what can be done, and can have an impact, can be delivered or promoted by frontline health workers.
This includes provision of essential newborn care that impact on all three major causes of newborn deaths, preventing and treating life-threatening newborn infections, kangaroo mother care, and management of intra-partum complications, such as a baby that is not breathing at birth – as well as the critical role of mothers, caretakers, and families in providing basic newborn care.
“There is also a growing consensus around under-utilised interventions, such as ante-natal corticosteroids, that offer the potential to further reduce neonatal deaths,” said Oot.
He cautioned that if current rates of reduction in neonatal mortality continued, it would take Africa over 140 years to reach the current rates of neonatal mortality found in high income countries.
The data show that the rate of neonatal mortality - newborn deaths in the first month of postnatal life - is reducing at half the speed of maternal mortality and one third slower than child deaths that occur after the first month of life.
Newborn deaths represent a growing percentage of child deaths – 43 per cent in 2011 – up from 36 per cent in 1990. In 2011, nearly 6.9 million children died before the age of five years; neonatal deaths accounted for three million of these deaths worldwide. Most of these deaths are caused by preterm birth complications and complications during birth, which account for 35 per cent and 23 per cent of all neonatal deaths respectively, and inadequate maternal health care during pregnancy, childbirth and postpartum.
The heaviest burden of neonatal deaths falls on South Asia and Sub-Saharan Africa. Across the two regions, 60 million women give birth outside of a health facility, usually at home; 52 million women give birth without the aid of a skilled birth attendant.
Across all regions, the burden of neonatal mortality falls disproportionately on the poorest families – those who are least able to access the resources needed to keep their women and child alive throughout pregnancy and childbirth.