Belfast, Blantyre or Bihar: Nurse Power Could Save Millions of Newborn Lives
Article by Professor Joy Lawn, Director of the Centre for Maternal, Reproductive, Adolescent & Child Health at the London School of Hygiene & Tropical Medicine, originally posted by the Huffington Post
Today in Northern Ireland, over 200 babies will be born, about 20 preterm, but only about three newborns die each week. In Belfast, newborns dying of infection recently precipitated a major media storm. Yet we do not expect birth to be a time for death and so we name our babies, often on the first day. But around the world in many countries, parents take days, even weeks, before they name their babies because surviving birth and the first weeks of life is so uncertain. Most of these deaths are preventable, yet the world still accepts them with little comment.
In Belfast on Friday, at the 8th International Neonatal Nursing Conference, we honour nurses from Pakistan, Kenya and Malawi who are committed to saving newborns and supporting families despite enormous challenges.
Each year three million newborns die during the first month of life, including one million who do not survive their birth day. Another 2.6million babies are stillborn, nearly half of whom die during labour, closely linked to around 250,000 maternal deaths. The moments before, during labour and the first few days are critical for the survival of both mother and baby.
These babies die from treatable conditions - being born too soon (preterm), affected by birth complications or by infections. Most of these deaths can be prevented without intensive care, with simple, cost-effective solutions, such as injection antibiotics, breastfeeding, or "Kangaroo Mother Care (KMC)" which involves continuous skin-to-skin contact between a mother and her baby and could halve the death rate of preterm babies.
Nurses and midwives with the skills to look after women - especially to care for preterm newborns who can die within minutes - are in short supply in Sub-Saharan Africa and South Asia, where 80% of all newborn deaths take place. That is why this week's awards are so important and these three nurses have come to Belfast to be honoured by COINN and Save the Children for excellence against the odds.
In rural Kenya, nursing officer Christine Sammy leads a neonatal care unit at Kitui District Hospital. She has saved lives by training nurses to use newborn resuscitation equipment and to care for newborns as a matter of emergency. Her work has helped her unit reduce infections among newborns and also improve record keeping, which is critical to further improving care.
In Karachi, Pakistan, Anila Ali Bardai as the head of Aga Khan University Hospital's neonatal intensive care unit, also uses evidence to improve newborn care and survival. She supports mothers of sick babies, counseling them on breastfeeding and teaching them how to use KMC to keep their babies warm. Her over 10 years of service at the hospital have resulted in reducing newborn infection rates, which in turn have reduced mortality rates and lessened the lengthy stays of patients. Her work has also resulted in better policies and coordination both in the intensive care unit and well-baby nursery.
In Blantyre, Malawi, nurse Netsayi Gowero has become a role model and mentor to the other newborn nurses and midwives at Queen Elizabeth Central Hospital. The young registered nurse midwife brings an energetic approach to her work. In one particular case, a sick preterm baby orphaned at a health center was brought under her care. She worked tirelessly to monitor and ensure the sick newborn was properly fed, treated and received appropriate warmth. After three months of treatment that baby was healthy enough to go home. Her peers have recognized her enthusiasm and passion and have cited that as a reason for the newborn nursery's improved outcomes.
While these skilled health workers are saving lives every day against the odds, they could save even more with access to basic medicines and supplies. Many frontline workers have not been trained to resuscitate babies at birth or to recognize common newborn infections, or may even lack the simple antibiotics that would save hundreds of thousands of lives. Antenatal steroid injections, costing less than a dollar, are not administered to women in preterm labor, yet many health workers are not aware that these could half deaths from severe breathing problems in preterm babies.
Why is this care missing for so many newborns? The single biggest reason is that newborn survival is only now being recognized as a global health priority. A decade ago newborn deaths were invisible, data lacking. Now the large burden is clear and the solutions are recognized as doable. Yet a recent study donor aid from 2002 to 2010 led by London School of Hygiene & Tropical Medicine showed that, before the year 2005, the word "newborn" barely occurred. While mention of newborns has since increased, only 0.01% of about US$6 billion aid mentions interventions that would reduce newborn mortality.
With less than 1,000 days before the deadline for the Millennium Development Goals, global and national leaders are recognizing the urgency and the opportunity of investing in newborn care. This is increasingly especially important since newborn deaths account for 43% of all deaths of children under five. If newborns survive, their families are more likely to choose to have fewer children. If they are healthy, the nation becomes stronger. Momentum is building to focus on one of the world's most solvable but neglected health issues and more attention to nursing skills for newborn babies in low income countries is critical.
There are important actions we can all take, whether in Belfast, or Blantyre to save children's lives and help by calling on governments, civil society and the private sector, to invest in high quality health services, including nursing skills especially in the world's poorest countries. You or your organization can join "Every Newborn" country-based action plans to end preventable newborn deaths.
Today alone nearly 8,000 newborns and almost as many stillbirths will be lost to grieving parents. We can - we must - do better. The voices of families and leaders all over the world are sparking a movement that no longer accepts that babies are born to die and makes it possible for parents to name every newborn on the day they are born.
The original article posted on the Huffington Post on 4/9/2013 can be found here.
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