Addressing Critical Knowledge Gaps in Newborn Health

Blog

By Ian Hurley on April 3, 2014
South Sudan
Africa

Photo: Jenn Warren/Save the Children

Moya Paristo, 30, is a Community Health Worker/Community Based Distributor (CHW/CBD) for Save the Children in Loriwo Village, Lomeyien Payam, Kapoeta North County, Eastern Equatoria State, South Sudan. 

About the new Lomeyien PHCU, Moya says, "The new centre is going to be good. New mothers are already seeking assistance from Regina, our Traditional Birth Attendant. So when the Lomeyien PHCU is opened, pregnant mothers will surely make use of the new facility. Slowly by slowly, we will have a good number of deliveries at the new clinic. Our hope is that let this facility be finished so fast, so that people can migrate there. Where the medications are now is not safe because the white ants, the termites, are there. I want the medications to be shifted to the new facility quickly."

April 7-11th marks the 2nd Annual World Health Workers Week. This week is an opportunity mobilize communities, partners and policy makers in support of their health workers. Despite advances in technology and medicine, millions of newborns and mothers still suffer needlessly from preventable and treatable conditions. 

This past November, at the Third Global Forum on Human Rsources for Health in Recife, Brazil, a WHO report was released highlighting the growing health worker gap.

That gap is now at 7.2 million, and will increase to 12.9 by 2035. It warned that if the issue is not addressed now, it well have serious implications for the health of billions of people across all regions of the world. Being that pregnancy and childbirth are two of the most dangerous times in a person's life, special focus needs to be made for health workers who help mothers and newborns during this critical time. 

We all have a role to play. We all can get involved in collective action that will take place around the world next week to bring attention not only to the health worker gap, but also recognizes their vital role in the health of communities the world over.

Visit the Global Health Workforce Alliance to see how you can get involved

Related:

By Ruth Davidge on April 2, 2014
South Africa
Africa

The Neonatal Nurses Association of Southern Africa’s (NNASA) 7th National Conference will occur on 22nd -24th October 2014 in an environment surrounded by the trappings of wealth and the glitter of gold, Gold Reef City – Gauteng. This is appropriate for our theme:

Neonates- More precious than Gold!

In a world where vast poverty, starvation and suffering are still the experience of the majority, debate rages as to the justification for advanced, costly, neonatal care. There are huge gaps in equity and quality of neonatal care around the world- in some countries 22 week gestation babies are actively managed and live while in other countries late preterm babies between 34 and 37 weeks continue to struggle for survival.

How do you define the value of a child?

In a Thai study, parents were asked the value of children-among a long list the most common responses were:

“They provide companionship and prevent loneliness, they provide help in old age and they continue the family name.”

Nelson Mandela stated, “Our children are the rock on which our future will be built, our greatest assets as a nation. They will be the leaders of our country, the creators of our national wealth and those who care for and protect our people.”

How do we in South Africa optimally use the scarce health resources available, to best deliver quality, neonatal care for all our population? Do the needs of the one out way the needs of the many? Do we pursue life at all costs? How do you put a cost to a life?

We invite all nurses caring for neonates to join with us as we explore these questions amongst others. Abstract submission is open and we look forward to receiving submissions from both within and outside South Africa. NNASA’s vision is to support neonatal nurses at all levels and throughout Southern Africa and we therefore would encourage and welcome delegates from throughout Africa!

This year in an effort to include and interact with the whole multi-disciplinary team we are excited to announce the inclusion of a Neonatal Expo on the first day of the conference (Wed 22nd October). A mini conference on its own-with presentations from the trade and an opportunity to network and interact both with the trade and colleagues. We invite all health professionals working with neonates to join us for this special day-only R100!

We invite you to join with us as we discuss how we can give our Nation’s children their best start in life so that our future truly might be golden!

For further details please contact Helene Uys at helene@confco.co.za or visit us online at http://conf2014.nnasa.org.za/ to register online or submit your abstract.

Learn more about equity and quality of neonatal care through the Healthy Newborn Network Resource pages.

By Mwereti Kanjo on April 1, 2014
Malawi
Africa

This blog was originally published by MamaYe. Written by Mwereti Kanjo. 

The ball is now in our hands. Presidential running mates have given us the power to hold them accountable for promises made.

The promises...

Once elected into power, Richard Msowoya of the Malawi Congress Party (MCP) said they will ensure that women have access to right information on the importance of delivering in hospitals, improve the education levels of women and fight for a change in culture plus attitude to help reduce deaths of mothers and babies. This is after noting that the biggest challenge is that information does not trickle down well to rural communities where it is needed the most.

The Democratic Progress Party (DPP) through its running mate, Saulosi Chilima, will improve primary health care, encourage hospital deliveries and construct more health centers in the country to help reduce distance to the facility. This is one of the leading contributing factors of maternal deaths in Malawi.

The United Democratic Front (UDF) too has spoken. Dr Godfrey Chapola, its running mate agrees with MCP that there is need to ensure that women have access to information to save mothers and babies in Malawi.

For the People’s Party, Sosten Gwengwe feels that the decrease of maternal mortality rate to 675 per 100 000 lives births from 984 in 2009 can be attributed to the construction of waiting homes which his government is leading on. This they will continue with to ensure that more mothers and babies are surviving.

 

The question...

These promises were made in response to MamaYe Malawi National Coordinator Charles Makwenda at a Presidential running mate’s debate that was organized by Zodiak Broadcasting Corporation (ZBS). The debate, first of its kind, provided a platform for Malawians to quiz running mates on pertinent issues before being elected into power.

Makwenda’s question: “Between six to eight women die every day in Malawi due to childbirth related causes, we lose two newborn babies every hour and Malawi ranks the highest in the deaths of preterm babies. We want to know, if elected into power, what will your government do to help save the lives of mothers and babies?”

What they should have said...

While the responses are a little vague it still gives us, Malawian, somewhere to start from should they fail to deliver these commitments.

They have all said, we are the employers and they the employees. Should they fail to deliver we should use the powers given to us by the constitution to hold them accountable.

I must say though, as a citizen and an activist, I would have loved to hear them say that before implementing anything they will look at the existing evidence to see what is really leading to so many deaths of mothers and babies in Malawi.

Yes, they weren’t given enough time to explain themselves but I would have loved it even more, if they explained how they plan to implement these commitments. What different thing would they do?

This is because, so many before them have said the same about saving lives of mothers and babies. Yet, Malawi still ranks amongst the highest in maternal and newborn mortality rates.

I am thinking that maybe, just maybe we should start thinking differently in our approach to making a change. Let us look at the evidence on the ground and start from there.

MamaYe Malawi tried to make this easier for the running mates because they each left with a folder that had all the relevant facts and figures that can help them make better informed decisions.

It is my hope that this is just the beginning of good things to come and that it just wasn’t some political propaganda!!!

By Nadeem Shahid on March 31, 2014
Pakistan
Asia


Women queue to have their children weighed by a Lady Health Worker (LHW) in Pakistan. LHW's regularly checks children's weight and keep an accurate record, thereby allowing them to see the general health of the children over a period of time and pick up on any early signs of malnutrition. Photo: CJ Clarke/Save the Children

Save the Children’s report on neonatal deaths in Pakistan suggests that the rate of intra- partum stillbirths (death during childbirth) and first day neonatal mortality in Pakistan is the highest in the world at 40.7 per 1,000 total births countywide.

But being an infant or mother is not so easy in Balochistan. The women and children of Balochistan province are most ill-fated in this regard.

The recent study Pakistan Demographic Health Survey (PDHS 2012-13) shows that the Infant Mortality Rate (IMR) is 97/1000, the Under 5 Mortality Rate (U5MR) is 111 and neonatal Mortality Rate at 63/1000. Maternal Mortality Ratio (MMR) is 785 /100000.

According to the National Nutrition Survey (NNS) 2011), malnutrition among children under five is ranked as Severe stunting (Height For Age HFA) is 32.20 %, Wasting (Weight For Height WFH) is 18.60% and under weight (Weight For Height WFA) is 41.80%. On the other hand, 63.50% of children are food insecure.

The front line health workers who provide basic health care services, education and prevention include Lady Health Workers (LHWs) Vaccinators and Community Health Midwifes (CMWs).

Balochistan has 167 community midwifes rendering services in the field by the provincial Health Department. Tragically, only 29.1% deliveries are conducted by the skilled birth attendants. Currently there are 6720 Lady Health Workers (LHWs) covering only 43% of the province. Similarly, there are 943 vaccinators and measles coverage is only 22.9%. These poor health indicators further affect the condition of women and child health.

There is a glaring need to increase numbers of the LHWs, CMWs and Vaccinators, allocating fiscal and human resources for LHWs, Expended Programme on Immunization (EPI), Maternal, Newborn and Child Health (MNCH) and Nutrition programs to minimize the IMR, MMR, Neonatal Mortality Rate and Under 5 Mortality Rate (U5MR) to track the province toward achieving MDGs 4 and 5.

Only one intervention promotion of early initiation of Breastfeeding could save 22% of neonatal deaths. Taking a step toward promoting breastfeeding and discouraging bottle feeding a formula milk the Balochistan assembly recently passed legislation on “Protection and Promotion of Breastfeeding and Young Child Nutrition Law 2014” Arshad Mahmood - The Express Tribune Blog. To monitor and implement this in its true letter and spirit the government of Balochistan must notify the Infant Feeding Board and devise its Term Of Reference. Train the LHWs, Lady Health Visitors (LHVs) CMWS and Health Care providers in Infant & Young Child Feeding practices that teach and encourage mothers to practice optimal feeding and exclusive breastfeeding.

To minimize infants and mother deaths in the province the Balochistan government must allocate budget for Nutrition, Lady Health Workers (LHWs) and Expended Programme on Immunization (EPI) programme. Also, the number of LHWs should be doubled. There must be two of vaccinators union council level, and number of Community Midwives (CMWs) be increased.

By Ian Hurley on March 28, 2014
Indonesia
Asia

Photo: David Wardell/Save the Children

First time Mother Tia, holds her 30-minute-old unnamed son. Over the past 15 years, Indonesia has made significant progress in lowering maternal and newborn mortality. The maternal mortality ratio has been steadily declining, from 390 in 1994 to the current level of 228 deaths per 100,000 live births. Skilled attendance at births is reported at 73%. Newborn deaths have declined at a slower pace but still show a steady downward trend with neonatal mortality rates dropping from 30 per 1000 live birhts in 1994 to 19 per 1000 live births in 2007.

A variety of successful initiatives including the placement of midwives at the village level, training and mentoring mechanism for midwives, and social safety net programs such as Jamesmas have resulted in more access to services and the creation of social norms that support skilled attendance at birth and high use of focused antenatal care.

As promising as these trends and achievements are, Indonesia is not on track to achieve Millenium Development Goal (MDG) 5 by 2015, and is at risk of falling off track for MDG 4.