Thursday, July 5, 2012

Early births can derail newborn deaths cut,Bangladesh


BANGLADESH NEWS

A new research shows Bangladesh had cut newborn deaths to almost double the regional and global averages last decade, but experts warn rising number of premature births could frustrate the success this decade.

Increased medical check-ups during pregnancies, more skilled birth attendants, increased surgical interventions and effective infection management have been seen instrumental in cutting 4 percent annual newborn deaths between 2000 and 2010.

The regional average was 2 percent while the global average was 2.1 percent annually during that period, the Health Policy and Planning journal of the Oxford University showed.

Save the Children and Saving Newborn Lives disseminated the Bangladesh part of the three-year research findings on Thursday in Dhaka.

Terming the success in cut of newborn deaths 'impressive', neonatologist Prof Mohammad Shahidullah said premature births would be a 'challenge' in the next decade.

"Until recently birth asphyxia (breathlessness) and infections were major factors of newborn deaths, but we have techniques and medicines to check them," he said.

Statistics show at least one out of 10 infants is born weeks before the expected date of delivery on completion of 37 weeks from the pregnancy in Bangladesh, and with less than 2.5 kilogram of weight.

These babies are usually born with underdeveloped organs, which lead to many other short- and long-term complications.

They die of infections and many other complications as their immune system is incapable of fighting various germs.

"Overwork during pregnancy is one of the reasons of premature deliveries," Shahidullah, who was also involved with the research, said.

With women empowerment, he said, "more women are likely to work stressful job in future meaning more premature deliveries."

The research showed 45 percent of the under-1 month deaths were due to complications of premature births.

"There is no acceptable solution to prevent premature births in the world," Dr Ishtiaque Mannan, Chief of Party of Save the Children's Maternal and Child Health Integrated Programme (MCHIP), said.

"What we have (interventions) are still at experimental level," he said, "Unless quality care, it is difficult to save babies born with low birth weight."

The research showed Kangaroo Mother Care (skin-to-skin care) can halve the deaths amongst low birth-weight babies.

Presenting the findings, Save the Children's Asia region's newborn health adviser Uzam Syed said despite increases, Bangladesh had the lowest coverage of skilled attendance at birth among the five counties – Bangladesh, Nepal, Pakistan, Malawi and Uganda - they examined.

The journal showed in the last decade, the skilled birth attendance had risen 129 percent in Bangladesh and pregnant women's medical check-up 127 percent, management of pneumonia rose 60 percent and the caesarian section jumped 613 percent.

Dr Sayed Rubayet, Project Manager, Saving Newborn Lives, said at least 150 experts of five countries had analysed the newborn health issues for the journal while 40 experts were engaged for Bangladesh part.

Although the research does not show how much investment was made in newborn care in the last decade, it showed in 2008 alone, 14 percent of official development assistance for maternal, neonatal and child health was on newborn health.

It also showed 13 large-scale programmes are being rolled out across Bangladesh for newborn health.

Uzam Syed said funding for maternal, neonatal and child health had increased in the last decade, but out-of-pocket expenditure remained the major source of health financing.

She said the government should invest more to make programmes 'sustainable'.

"Donors might not show their interest on priority issues as they work with their own agenda. It is the government that has to prioritise its own issues."

The research used the United Nations statistics that said 27 babies died within the first month of life per 1,000 births in Bangladesh in 2010. It was 41 in 2000.

However, the latest Bangladesh Demographic and Health Survey (BDHS) showed the newborn deaths were 32 per 1,000 births in 2011. It was 42 in 2000.   

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