18 in 100 babies born prematurely

Article originally featured in The Daily Times.

About 18 in 100 babies are born prematurely in Malawi, according to a global report released on Wednesday titled Born Too Soon: The Global Action Report on Preterm Birth.

Each year, some 15 million babies in the world, more than one in 10 births, are born too early but 75 per cent of these deaths could be prevented with low cost interventions such as antenatal steroid injection to prevent early labour, which costs US$1 per injection, the report said.

Besides Malawi, other countries with the highest rates of preterm births per 100 births are Zimbabwe at 16.6, Equatorial Guinea at 16.5 and Mozambique-16.4 in Sub-Saharan Africa.

The high number of preterm births in Malawi is caused by infections during pregnancy such as malaria, HIV or syphilis, early pregnancy and short space between pregnancies, according to Dr. Hannah Blencowe of the London School of Hygiene and Tropical Medicine who led the estimates and established Kangaroo mother care in Malawi many years back.

The first ever country statistics for premature births and deaths indicates that estimated three-quarters of those preterm babies who die could survive without expensive care if a few proven and inexpensive treatments and preventions were available worldwide.

"Kangaroo Care can half the chance of dying if a baby is born too soon. Malawi has indeed been a leader in Kangaroo Care and in prioritising the needs of the newborn. This has contributed to Malawi's reduction in neonatal mortality rates," Blencowe said.

The 2010 Demographic Health Survey found that neonatal deaths reduced to 27 per 1000 live births to 44 deaths per 1000 live births in 1990.

Blencowe commended Malawi's progress in the promotion of skilled attendance at birth which has helped to reduce maternal and post natal deaths.

But Blencowe said skilled attendance at birth was not a big enough intervention to have an impact on the number of babies who are born prematurely.

The report has highlighted the role of antenatal care in the prevention of preterm birth when women start early, treating women with syphilis or high blood pressure and use of mosquito nets to prevent malaria.

"Malawi had great potential to prevent preterm births by low cost interventions such as increasing family planning use to prevent early pregnancy among teenagers," she said.

Responding to the report, Ministry of Health Henry Chimbali said premature births and deaths in Malawi were mostly caused by delays by women to seek care during pregnancy; lack of care of premature babies when women deliver at home and low screening of syphilis.

He said services to prevent preterm births and deaths were available but under-utilised.

"The top most intervention we have in health facilities is kangaroo care which has prevented a lot of premature deaths but it is our wish to increase attendance of antenatal clinics and delivery by skilled attendants.

Authors of the report from The March of Dimes Foundation, The Partnership for Maternal, Newborn & Child Health, Save the Children and The World Health Organisation also offered a detailed plan for the actions needed to reduce both the death toll and the numbers of preterm births.