JOHANNESBURG – Each year, about three million of the 7.7-million children who die before reaching their fifth birthday are newborns who do not survive their first four weeks of life. This situation has led to the top health agencies and child experts meeting in South Africa to formulate what will become the Global Newborn Action Plan.
While South Africa is one of the countries showing sterling outcomes in reducing the under-five mortality rate (overwhelmingly due to the success of the programme which prevents the HIV-positive mother from infecting her baby), it is making very little inroads when it comes to newborns.
The three major causes of neonatal deaths – infections, birth asphyxia and preterm/low birthweight – account for 86% of neonatal deaths worldwide. In South Africa almost half of under-5 deaths were newborns and most were due to these three conditions.
While the world is still searching for healthcare remedies to solve some of the biggest health challenges, it is known that up to two-thirds of all neonatal deaths can be prevented if mothers and newborns receive known, effective interventions during pregnancy, childbirth and in the first hours and days after birth.
Some of the top interventions include handwashing with soap, newborn resuscitation, kangaroo mother care and the management of newborns with sepsis.
The Global Newborn Action Plan (GNAP) comes as countries make their final push towards the Millennium Development Goals. GNAP is defined as a high-level roadmap that focuses specifically on newborn health. It will highlight the latest available evidence on effective interventions and programs, enabling countries to accelerate their domestic plans and move to implementation.
Following widespread consultation, which was kicked off at this week’s Johannesburg meeting, it is expected that the GNAP will be launched mid-November with implementation next year.
“Just because they (newborns) can’t vote, it does not mean they don’t count,” says Professor Joy Lawn, a longstanding advocate for improved newborn interventions.
Lawn, based at the London School of Hygiene & Tropical Medicine, says that for a long time the problem was invisible, but “now we have the numbers and data and we have access to simple things we can use to intervene and turn it around”.
She adds that the problem is not one of lacking solutions, but a lack of “doing them”.
Lawn says years of silence had kept newborn mortality off the international agenda. “It was a silent problem. In most places women are not allowed to shed a tear or have a funeral, they must just move on.”
She says South Africa has the ability to give much more than the basic care needed to make an impact and appealed for the same political commitment directed at HIV, to be aimed at addressing newborn deaths.
The meeting is looking to countries such as Tanzania, Rwanda, Malawi, Nepal and Bangladesh, who have all made massive impacts on newborn death rates through simple, community-based interventions.
There is agreement that access to giving birth in a facility does not always mean the mother and baby has access to quality care – South Africa being a prime example where the newborn death rate is high despite the vast majority of women giving birth in health facilities.