Simple Measures Could Save Millions of Infants
Simple Measures Could Save Millions of Infants
March 3, 2005 — Close to 3 million newborns that die each year — mostly in poor countries — could be saved with available and relatively inexpensive medical interventions, a report released Thursday concludes.
Authors estimate that low-tech interventions, such as expanding basic newborn care methods to villages in developing nations and increasing the availability of cheap vaccines and antibiotics, could save up to 72% of the approximately 4 million infants who die within their first four weeks of life each year worldwide.
The Western standard of hospital-based child delivery monitored by a team of nurses and doctors is essentially nonexistent in poor nations, where most women in rural areas give birth at home surrounded by family and sometimes by a local midwife.
The report refers to several studies showing that promotion of basic sanitary conditions during birth and more widespread use of breastfeeding can greatly reduce infant mortality rates. In many cases, a child’s survival depends on mothers or caregivers knowing to keep a child warm following birth, authors say.
“We believe that the vast majority of these deaths can be prevented, can be prevented by the means and the know-how we possess today,” says Vinod Paul, MD, a professor at the All India Institute of Medical Sciences in New Delhi, and an author of the report, published in The Lancet medical journal. “We do not need high-tech neonatal intensive care units to make a difference today.”
Worldwide, the main causes of infant death are estimated to be preterm birth (28%), severe infection (26%), and asphyxia (23%).
The report also points to maternal vaccination programs that have helped cut infant mortality in many countries. Tetanus, for example is estimated to cause 7% of all newborn deaths, and is a disease that is easily preventable with vaccination. Sepsis and pneumonia — largely preventable with clean birth practices and antibiotics — are blamed for more than 26% of all infant deaths.
Greater use of vaccines and drugs, along with distribution of sanitary birthing kits in villages in poor nations are seen as shorter-term goals, Paul says. In the long term, governments and aid organizations must devote resources to training midwives and health care workers on delivery practices and infant care that can spare lives, he says.
Funding ‘Pitifully Low’
The report charges that internationally-funded maternal and child health programs for developing nations have largely ignored newborn deaths, and that funding for the problem is “pitifully low given the size of the problem.”
Recent international resolutions on child mortality focused on children under 5 years of age. Each year almost 11 million children die before reaching the age of 5; of those children 38% die in the first few months of life. Nearly 75% die within the first few weeks after birth, and there are about 4 million stillbirths.
A total of $2 billion is spent annually on improving newborn health conditions, a number which would have to go as high as $4 billion to $11 billion per year to achieve the three-quarters reduction in neonatal mortality, the report estimates.
Advocates put it another way, saying that most of the report’s goals could be met by increasing funding by about $1 per person per year worldwide.
U.S. funding for neonatal health programs stands at $345 million in 2005. President Bush’s Fiscal 2006 budget requests $326 million for the programs through the U.S. Agency for International Development (USAID).
Richard Green, director of USAID’s office of health tells WebMD that despite the cuts, the agency remains strongly committed to child survival programs and will launch a new initiative on newborn health this year.
“In most years Congress provides more money in the end and it turns out to be an increase,” he explains.
Carol Miller, associate vice president of the group Save the Children, says that the U.S. would have to double its funding to $660 million this year and increase it again to $1.2 billion in 2007 to help meet the goals laid out in Thursday’s report.
“When you have a tight budget the way we do now, it’s going to be difficult to get these resources,” she says.
SOURCES: “Newborn Health: A Key to Child Survival,” The Lancet, March 3, 2005. Vinod Paul, MD, professor, All India Institute of Medical Sciences, New Delhi. Richard Green, director, office of health, U.S. Agency for International Development. Carol Miller, associate vice president, public policy and advocacy, Save the Children.
