Every Newborn – Country Progress for Preemies

By Nabila Zaka and Kim Dickson, UNICEF 

One baby in every ten live births is born prematurely. World Prematurity Day helps strengthen global resolution to address the needs of the estimated 15 million preterm babies born each year. The Every Newborn Action Plan launched in 2014 ignited global action to end preventable neonatal deaths by 2030 – including addressing those who die from preterm birth complications. The consensus around the new Sustainable Development Goals (SDGs) and UN Secretary General’s Global Strategy for Women’s, Children’s and Adolescents’ Health will further strengthen governments’ commitments to ensure newborns survive and thrive. The new WHO guidelines on “Improving Outcomes for Preterm Births” are timely support for countries. World Prematurity Day 2015 allows us to reflect how the new commitments have brought or will bring good tidings for every premature newborn, everywhere.

Even though we have known, feasible solutions, complications from prematurity are the leading cause of deaths in children under five, with over one million deaths last year. These small tragedies can be largely averted with highly effective, cost-effective interventions, which were analysed earlier this year in the BMC Pregnancy and Child Birth supplement: Every Mother Every Newborn. Robust health management and information systems are needed to accurately collect and report data on high-impact intervention coverage. While the mechanisms like national population based surveys and Inter-Agency Child Mortality Estimates will continue providing comparable country statistics to gauge progress, country progress tracking for reaching the milestones in the Every Newborn action plan has been undertaken by the Every Newborn Country Implementation Group, comprised of representatives from UNICEF, WHO, USAID and other global partners. This year, 16 countries completed a simple tracking tool to measure their impressive progress (see overview of results).

In terms of addressing complications of preterm birth, there has been significant activity around increasing the uptake of Kangaroo Mother Care (KMC). For this intervention, mothers are taught how to keep their newborns warm through continuous skin-to-skin contact on her chest. This encourages the mother and baby to bond emotionally and enables the baby to breastfeed at will, giving the baby the energy to produce its own body heat. KMC is an evidence-based, life-saving way for mothers and fathers to help their preterm babies. Specific country examples of progress in 2015 for KMC scale up include: – Bangladesh initiated the roll out of KMC trainings after two batches of service providers were trained in All India medical institute (AIIMS). – Ghana organized a national newborn forum on preterm and low birth weight baby care which highlighted the need for expanded care for vulnerable newborns. The Government of Ghana in collaboration with Government of Columbia is planning to convert a tertiary hospital into a national KMC training site. – Kenya implemented KMC guidelines in pilot health facilities in January 2015 in collaboration with trainers from Malawi. – Viet Nam scaled up KMC training to 140 additional health care providers (provincial and district hospitals) from seven provinces in 2015.

Efforts are ongoing to facilitate inter-country learning and exchange of experiences. Exposure to existing KMC units in India, Viet Nam and Malawi and regional facilitation efforts have helped multiple “beginner” countries to initiate KMC practice.

In the tracking tool, countries also reported their emerging urgent technical assistance needs. Some examples of technical assistance for KMC includes:

  • Support for KMC protocols and guideline development in Ghana;
  • Training package adaptation for health service providers on preterm and low birth weight newborn care in Myanmar;
  • Development of Policy on Prematurity and Low Birth Weight in the Philippines; and
  • Enhancing supportive coaching for KMC care in Viet Nam and training of neonatologists in Pakistan.

Through the collective efforts of government and partners 2015 reflected progress for premature babies however more investment and focus is required to improve roll-out and uptake of key interventions for preterm babies in high burden countries. No doubt, the key to success lies in the hands of governments and their citizens for ensuring quality care of their newborns and the preemies.

Photo credits:
© UNICEF/GHAA2015-04021/Quarmyne
© UNICEF/UNI161869A/Holt

 


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