India reports 29% of newborn deaths in a year globally: report

• Save the Children, UK-based NGO released a Report titled Ending Newborn Deaths on 25 February 2014. 
• India alone accounts for a 29 percent of the global deaths of newborns on their very first day of birth. 
• The report claimed that about one million babies die every year across the world on their first and only day of life. 
• The report also highlighted that if we end preventable newborn mortality than about two million newborn babies could be saved.

Highlights of Report

1. The report said India made considerable progress in the arena of healthcare during the past decade but glaring inequalities still rule the roost. Theses inequalities stem from geographical, social, cultural, and economic factors.
2. Though Under-five mortality, India has reduced more than half since 1990 from 126 per 1000 live births to 56, but it is three times higher among the poorest households of India vis-a-vis the richest.  Also the new born mortality over the same period has come down from 51 per 1000 live births to 31 but it is much higher among the poor.
3. The world has made amazing progress in reducing child mortality during the past decade, nearly halved from 12 million to 6.6 million.
4. 2.9 million Babies died across the world within 28 days of being born in 2012. The number of deaths in this newborn period is four times higher in Africa than it is in Europe.
5. 6.6 million Children died before their fifth birthday in 2012, most from preventable causes. This number has almost been halved since 1990, but still means that 18000 children died every day.
6. 51 percentages of births in sub-Saharan Africa were not attended by a midwife or other properly qualified health worker and 41 percentages in south-east Asia.
7. Meanwhile, Pakistan ranked among the countries with the highest stillbirth rates at 40.7 per 1000 births, followed by Nigeria (32.7), Sierra Leone (30.8) and Somalia (29.7).

ANALYZING THE ISSUE :

• Causes of newborn death

The three major causes of neonatal deaths worldwide are infections (36%, which includes sepsis/pneumonia, tetanus and diarrhoea), pre-term (28%), and birth asphyxia(birth asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain) nearly 23%. There is some variation between countries depending on their care configurations.

• Why has care for newborns fallen between the cracks?

• Lack of continuum of care from maternal to child: a lack of continuity between maternal and child health programmes has meant that care of the newborn has fallen through the cracks. More than half the neonatal deaths occur after a home birth and without any health care.
• In many countries there is no record of neonatal deaths: until recently, there has been little effort to tackle the specific health problems of newborn babies. Most of their deaths are unrecorded.
• Neonatal mortality and gender: reduced care-seeking for girl babies compared with boy babies has been reported, especially in South Asia.

• What can be done?

• Effective care can reduce almost 3 of the 4 million deaths of babies under-one month: the package of essential care includes antenatal care for the mother, obstetric care and birth attendant’s ability to resuscitate newborns at birth. Most of the infection-related deaths could be avoided by treating maternal infections during pregnancy, ensuring a clean birth, care of the umbilical cord and immediate, exclusive breast-feeding. For infections, antibiotics are life-saving and needs to be available locally. Low birth weight babies need to maintain body temperature through skin-to-skin contact with the mother. Several of the above interventions would also help save the lives of mothers and prevent stillbirths.
• Empowering families and communities to close the gap of postnatal care: healthy home practices and empowering families to recognize problems and access care will quickly save many lives. In high mortality settings with low access to care, some interventions may need to be provided closer to home.
• The gap for care of mothers and babies in the first few days of life is important even where women do deliver in facilities. New approaches are required to reach a large majority of these families.
• Political commitment and social visibility. Communities and decision makers need to be informed that neonatal deaths are a huge portion of child deaths, and need therefore to receive adequate attention. Improved registration and increasing the availability and use of relevant information in programmes and to decision makers is essential if health care for newborn babies and their mothers is to be given adequate attention. Stillbirths should also be counted.