Malawi to save more preterm babies: Actions taken on Born Too Soon report

The following post is part of a blog series on preterm birth, leading to World Prematurity Day on November 17 and highlighting the actions needed to prevent and reduce preterm birth, the leading cause of newborn deaths. Join us as we discover that everyone has a role to play. 

Malawi has the highest percentage of pre-term births in the world – over 18%.  Pre–term birth is when a baby is born before completing at least 37 weeks in the womb, and is a leading cause of newborn deaths. According to estimates released last month, over 90% of extremely pre-term babies born in low income countries die within the first few days of life.

Encouragingly, Kangaroo Mother Care centres supported by Save the Children’s Malawi Newborn Health Program have started to report data which shows that the effective management of pre-term births is possible. Joby George, Director of Save the Children’s Health Programs in Malawi, says, “Our data shows an improvement in a number of factors that contribute to survival, such as faster weight gain by pre-term babies put on Kangaroo Mother Care.”

This is good news for other programmes around the world that operate in resource-strapped environments and are trying to achieve Millennium Development Goal 4, which calls for the reduction of child deaths by two-thirds before 2015. Malawi is one of the few countries on track with this target – and not least because there are over 120 Kangaroo Mother Care units in Malawi, at least one every district, supported by Ministry of Health and Save the Children.

Kangaroo Mother Care is an effective low-cost intervention for pre-term babies, where they are held skin-to-skin with the mother to keep warm and breastfeed under constant maternal supervision. Clinics across Malawi have demonstrated that similar low-cost interventions can substantially reduce newborn deaths. Additionally, Malawi has shown improvements in aspects of newborn care made available at these clinics including: extra newborn care for feeding support, neonatal resuscitation, preventing umbilical cord infections, treatment of neonatal infections with antibiotics, and supporting the ability of health workers to manage further newborn complications.

“There are two sides to tackling pre-term birth,” says George. “Besides management, prevention strategies are critical.” Save the Children trains community health workers called Health Surveillance Assistants (HSA) based within communities to assess risk factors for pre-term births including: prior history of pre-term birth, being underweight or obese, hypertension, smoking, infection, maternal age (under 17 or over 40), genetics, multi-foetal pregnancies and pregnancies spaced too closely together. Save the Children has also been supporting the Ministry of Health to develop and implement a community-based maternal and newborn care package, which focuses on home visits during antenatal, and immediate postnatal, periods for the care of mothers and newborns.

Much of Save the Children’s child health work is made possible through grants from USAID, the U.S. Agency for International Development.

EXPERT PANEL DISCUSSION ON ZODIAK RADIO

Recently, Zodiak Radio hosted a special panel discussion in which leaders in Malawi discussed the new report for global action on preterm birth, Born Too Soon, which was released on 2 May, 2012. The panel discussed ways for Malawian families to combat the high incidence of pre-term birth.  Zodiak radio is Malawi's biggest private broadcaster with nearly 90% of Malawi's population tuning in across rural and urban areas. The panel consisted of a range of maternal and newborn health experts in Malawi: Dr. Charles Mwansambo, Principal Secretary Ministry of Health, Dr. Leslie Mgalula of the WHO, Mrs. Grace Mlava of UNICEF, Dr. Kondwani Kawaza from the College of Medicine and Mrs. Evelyn Zimba from Save the Children/SSDI-Services project.

To listen to the Zodiak show click here. It is a 60 minute recording, parts of which are in Chichewa, and parts in English. The panel discussed a range of questions:

• Preterm birth – what does it mean?
• How important is it for us to talk about pre-term births?
• Are preterm births something new? Are we not violating traditional beliefs by talking about (saving) preterm births?
• Unpacking the report – what are its main findings?
• What is Malawi doing to save newborn children?
• What opportunities does Malawi have to overcome the problem of pre-term births?
• How best can this idea (of saving pre-term births) be taken further – to grassroots level?
• What is the way forward?

RELATED RESOURCES

• What is preterm birth? 
• An Executive summary of and the Full Length version of the Born Too Soon report
• Video on how Kangaroo Mother Care saves lives in Malawi

For more information, including program results, please write to Mac Pherson Mdalla at mmdalla@savechildren.org