Addressing Critical Knowledge Gaps in Newborn Health

Why preterm births matter

By Gary Darmstadt on May 10, 2012
Preterm Birth
Malawi

The following post was written by Gary Darmstadt, Amie Newman and Wendy Prosser, originally posted on Impatient Optimists. It is part of a Blog Series leading to World Prematurity Day on November 17, discussing prematurity 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.

Portrait of Grace Ngoto and her daughter Tuntufye in Malawi. Watch their story below. Photo: Living Proof and the ONE Campaign.

Lucky. That’s how I feel about my children being born in a hospital with the best available technology, information, and resources, just in case something went wrong during delivery or immediately after birth. In the case of my second daughter, by the time of her discharge on the third day of life, she had already had an echocardiogram and consultation with a physician that confirmed the source and offered a reassuring prognosis for a heart murmur, which years later, is now completely resolved.

More than a million babies each year are not as lucky. They are born too early (preterm)–and without access to the kind of health care that could save their lives.

But we have the know-how and the impetus to change this.

A new report released last week, Born Too Soon: The Global Action Report on Preterm Birth, notes the astounding occurrence of 15 million preterm births around the world each year and the fact that the number of babies born before 37 weeks of pregnancy is going up.

In a world that has the most advanced technologies to date how do we continue to allow this to happen?

In low-income settings, one million babies are dying each year of complications of preterm birth because they do not have access to known, life-saving interventions. Interventions that are both feasible and cost-effective. An estimated three out of every four preterm deaths could be avoided today with known interventions that do not even include a high-tech, extravagant NICU (Neonatal Intensive Care Unit).

In a world that has the most advanced technologies to date, as well as communication and transportation systems that reach the most rural areas of the most forgotten countries, how do we continue to allow this to happen?

This report challenges us to do more to care for those babies who are born early. We have been talking a lot about achieving lasting impact at scale within the Family Health division of the Gates Foundation, and the challenges that come with that. One of the “A-ha!” moments that came out of a recent convening of global experts in spreading innovations last year was, “Don’t build a Cadillac when a Kia will get the job done.” Simply put, if someone needs a reliable and cost-efficient car to get from one place to the next, a Kia will work; a Cadillac is not necessary.

A number of simple life-saving interventions already exist but are not available to mothers and frontline health workers in many places around the world because the global community hasn’t done enough to adapt and spread their use.

Kangaroo Mother Care, for example, provides warmth, food, love, and life-saving protection from infection, as does exclusive breastfeeding for babies up to six months of age; clean delivery practices include use of soap to wash hands and a clean utensil to cut the umbilical cord, just to name a few.

We know these interventions work, are highly cost-effective, and should be available to every mother of every pre-term baby in the world—but they aren’t.

In the longer term, prevention of preterm birth will be the answer. But because much is still unknown about why babies are born too soon, we don’t have the answers yet, as the report points out. Our inability to prevent preterm births is one of the largest solution gaps that exists in public health.

Meanwhile, while new approaches are being discovered and developed, this report challenges the global health community to be innovative to accelerate progress to reduce the number of preterm babies. The report also makes clear the good news that the world is coming together increasingly to give preterm babies a chance at survival.

Survival of a preterm baby should not depend on the luck of the draw. I hope this new report, the first ever of its kind on preterm birth, generates interest, attention, and nothing less than the will of the world to change the lives of babies born too soon.

Watch the story of Tuntufye, who was born premature in Malawi. Kangaroo Mother Care successfully helped her mother Grace when Tuntufye was born pre-term, weighing only 1.8 pounds: