What’s behind the global momentum for newborn health?

Many public health priorities emerge after a spike in deaths or the fear of the rapid spread of a virus to many countries. Why, then, did a “hidden” public health emergency that was barely mentioned 10 years ago -- newborn health—receive dramatic increases in political and financial attention over the last decade?

Jeremy Shiffman’s Viewpoint in the June 5 issue of the Lancet explains the seemingly sudden popularity of newborn health, charting its origin to a 1999 presentation from Dr. Abhay Bang at Johns Hopkins University. Given to a small group of global health leaders, the presentation and its take-away message-- that newborn deaths could be easily and affordably prevented—inspired Save the Children to launch a $50 million newborn health program funded by the Bill & Melinda Gates Foundation. The program, Saving Newborn Lives, joined a small but passionate informal network of academics and health leaders to tell the world that improving newborn survival was not only feasible, but critical.

Shiffman shows that the “actor power” of this small, informal network was far-reaching. Advocacy, research and collaboration resulted in the 2005 Lancet Neonatal Survival Series, where for the first time, the vast majority of global newborn deaths were broken down into three (tractable) causes: infections, prematurity and birth asphyxia. After the series’ publication, Shiffman writes, 20 African countries requested technical assistance from WHO to address the newborn issue.

Knowing the burden of newborn deaths allowed the actors to frame the newborn issue in terms of something near and dear to the international development community: the Millennium Development Goals. Without significant reductions in newborn deaths – which, the actors argued, were feasible with low-cost, proven interventions – MDG 4 would not be met.

Today, a number of powerful global health organizations – for example, USAID, UNICEF, WHO, Save the Children, and the Bill & Melinda Gates Foundation – have prioritized newborn health with funding and programs. Politicians in a number of developing countries, including those on track to meet MDG 4 like Nepal and Malawi, also note the importance of the newborn.

But, Shiffman points out, this attitude has not reached the grassroots level in most developing countries. “The extent to which these governments have responded with funding, policies, and programmes remains unclear, as does how much difference these global promotional efforts have made in shifting widespread grassroots fatalism surrounding newborn deaths,” he writes.

Shiffman continues: “The fate of newborn health in the next decade depends on the extent to which this unfinished agenda reaches beyond global health actors and is successfully pursued within countries.”
Shiffman’s point is valid: in many high-mortality countries, babies aren’t named until they survive their first month of life, and newborn deaths are not recorded because they simply don’t count. This attitude stifles action, even at the national level.

So, HNN reader, we ask you this: what other actions can we as a community take to better reach families and policy makers and convince them to reject the notion that newborn deaths are a fact of life?

If you’re already a member of HNN, please login and post a comment. If you haven’t yet joined, please do so now!

Check out Shiffman's Viewpoint in the Lancet (Lancet login required).