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Premature birth should not lead to premature death

Friday 16 November 2012

I used to associate premature babies with high-tech incubators. My sister was born six weeks early and my first memories of her are seeing a baby wired up inside what seemed to me to be a kind of fish tank.

Three decades on and the kind of equipment that saved my sister’s life is still far beyond the reach of many babies who were also born too soon.

Simple and effective solutions are available

Last year, 15 million babies were born prematurely and their survival chances varied dramatically depending on where they were born. South Asia and sub-Saharan Africa account more than 80% of the world’s deaths due to preterm birth complications.

The risk of a neonatal death due to complications of preterm birth is at least 12 times higher for an African baby than for a European baby.

But it is not necessarily a lack of high-tech interventions that leads to 1.1 million annual preterm deaths. It is a lack of basic care provided by well-trained health workers.

Earlier this year, a report by Save the Children and our partners found that more than three-quarters of premature babies could be saved with simple, low-cost solutions.

For example, steroid injections for women in preterm labour, antibiotics for newborn infections and Kangaroo Mother Care (wrapping preterm babies in skin-to-skin contact with their mother for warmth and easier breastfeeding) could save hundreds of thousands of lives.

Many preterm babies are out of reach of health workers

One of the major barriers to increasing coverage of these high-impact interventions in the developing world is the global shortage of health workers with appropriate skills working in the places where the need is greatest.

This means that when they are at their most vulnerable, newborns and their mothers are out of reach of even the most basic care.

Even when health workers are in place, these life-saving interventions are rarely used, despite the low cost and proven effectiveness, because health workers are not properly trained on their use.

November 17th is World Prematurity Day, a time to observe the fact that preterm births are now the leading cause of newborn deaths and the second biggest cause of child deaths globally, after pneumonia.

Over the past two decades, there has been a dramatic reduction in child mortality but we haven’t yet seen the same levels of progress in reducing preterm births or newborn deaths.

Achieving the Millennium Development Goal on child survival, and the larger goal of universal health coverage, therefore depends on training and equipping more frontline health workers to deliver appropriate care for mothers and babies in the critical newborn period.

Time for the UK to take action

Almost two years ago, the UK government committed to saving 250,000 newborn babies as part of efforts to improve the health of women and children in the poorest countries. Since that promise was made, British leadership has resulted in global commitments to vaccinate more children and increase women’s access to family planning.

Now is surely the time for the Department for International Development to focus on reducing newborn deaths and ensure that countries have the skilled health workforces in place to prevent and care for preterm babies – as well as the healthcare needs of the wider community.

Being born early should not condemn babies to a premature death. My sister, like millions of others in the rich world, is alive today thanks to expert care provided at the time of birth and during those first crucial weeks. All children deserve the same chance to survive and thrive.

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