26 December

Neonatal deaths - How can we prevent it?

Neonatal period is the first 4 weeks of life of a newborn. Newborns who are born too soon or too small, or who become sick, are at the greatest risk of death and disability in the first 28 days.  According to the study - Survive and thrive: transforming care for every small and sick newborn. In 2017, an estimated 2.5 million newborns died during the first 28 days of life.

Approximately 80% of these had low birth weight, and two-thirds were born prematurely. In addition, each year, an estimated 1 million small and sick newborns survive with a long-term disability, including cerebral palsy and cognitive delays.

United Nations Sustainable Development Goals (SDGs), through universal health coverage (UHC), by 2030 has a goal of reducing newborn deaths to 12 per 1000 live births, or less, by 2030 in all countries. The global neonatal mortality rate declined from 31 to 18 deaths per 1000 live births between 2000 and 2017. But to reach the goal of fewer than 12 deaths by 2030 governments need to invest more in newborn and maternal health.

Babies who survive with disabilities can cause psychological and financial problems in the family. The scarce services available to care for a sick newborn or lack of awareness of services available can, in turn, have a detrimental effect on the development and care of the newborn. Universal health coverage is crucial for the achievement of SDG, especially in case of a newborn where the cost of inpatient care is pretty steep.

Survival of a premature newborn largely depends on the care he or she receives in the newborn period and it is seen to be as big as 95% if the premature baby is born in a developed country versus very low in developing countries due to lack of basic care.

Most newborns can survive and thrive if they have access to good-quality health care, including admission to a hospital.  All newborns require essential care at birth and over the first days of life, whether in a health facility or at home. The majority of small and sick newborns can be managed with special inpatient care provided in a hospital. Very few of these may require specialized inpatient care which can be managed in a tertiary facility.

Some of the basic newborn care which could be provided by basic staff in every health facility can help the newborn and the mother from complications and sickness -

Immediate newborn care (thorough drying, skin-to-skin contact of the newborn with the mother, delayed cord clamping, hygienic cord care); neonatal resuscitation (for those who need it); early initiation and support for exclusive breastfeeding; routine care (Vitamin K, eye care and vaccinations, weighing and clinical examinations); prevention of mother-to-child transmission of HIV; assessment, management and referral of bacterial infections, jaundice and diarrhoea, feeding problems, birth defects and other problems; pre-discharge advice on mother and baby care and follow-up.

Universal access to quality care could prevent 1.7 million neonatal deaths or 68% of the deaths that will otherwise occur in 2030.  Interventions for both mother and newborn – provided at the same time, in the same place, by the same healthcare provider – will have the highest overall impact, saving 2.9 million women, stillbirths and newborns in 2030 in 81 high-burden countries.

Strengthening parents’ skills and competence in caring for their small, sick or high-risk infant reduces stress and anxiety, and benefits the newborn’s weight gain and neurodevelopmental progress. Parents or caregivers need to be educated on what to expect from their newborn. Basics of newborn care and signs of trouble in the baby, so the parents can identify any abnormalities in the baby immediately and receive appropriate care. Being with the mother will also lead to bonding. They also need vigilant follow up care by health personnel to monitor their health and development to identify disabilities such as cerebral palsy, retinopathy of prematurity (a leading cause of preventable childhood blindness), auditory and visual impairments, and other developmental delays.

Ref : https://apps.who.int/iris/bitstream/handle/10665/276655/WHO-FWC-MCA-18.11-eng.pdf?ua=1

 

 

Last modified on Friday, 28 December 2018 10:22
Dr Padma

Dr Padma is a Family care physician and is the Founder and CEO of MedHealthTV.

www.medhealthtv.com

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