By C J Clarke:
In 2012, 2.9 million babies died within 28 days of being born: 2 out of every 5 child deaths. Of these, 1 million babies died within 24 hours, their first, and only day of life.3 causes of these deaths include premature birth,
complications during birth and infections. This is heart-breaking and unacceptable.
We must be clear: newborn deaths are not inevitable. Most are easily avoided if the simplest of interventions are made available to all. Systemic change is needed from governments, donors and health professionals. This year, 2014, offers an unprecedented opportunity to focus on this topic and set in motion the revolutions needed. Together, we can ensure that no baby is born to die.
Dr. Nonika Goyal is Program Manager MCH (Maternal andChild Health), Fortis Hospital Gurgaon, New Delhi India.
India’s out-of-pocket expenditure stands at 60% which means poor cannot access or afford the critical health care readily available for those who can afford. Save the Children report highlights that equity is a critical factor determining newborn and child survival – the newborn mortality rate among the wealthiest 20 percent of India’s population is 26 per 1,000 babies, while among the poorest households 56 newborn babies out of 1,000 die in the very first month of life.
Namit, one month old, was born premature at the Fortis Memorial Research Institute, Gurgaon, New Delhi India, to Manju, 30 and her husband Sanjeev, 34.
Without timely care and attention over 6 lack newborns succumb to birth related complications leading to death. India has made dramatic progress in reducing under-5 mortality, however, there is a real danger that progress in reducing child deaths could stall and we will fail in our ambition to be the generation that can end all preventable child deaths.
Manju, 30, was admitted in intensive care unit at the Fortis Hospital in Gurgaon, New Delhi, with severe medical difficulties which resulted in Manju’s child being delivered pre-term via cesarean. Manju was having trouble breathing with fluid around her lungs. Doctors informed the couple that this was an extraordinary occurrence and they had few options, which, if they didn’t work, would mean death for Manju. Thankfully, procedures worked and Manju is now recovering.
She must feel lucky as there are many women who do not receive crucial medical care and attention, often leading to complications and even death.
Deepanshi, 4, with her brother Namit, one month old, at the Fortis Memorial Research Institute, Gurgaon, New Delhi.
Namit was born pre-term via cesarean while Manju was suffering from a life threatening condition. Thanks to the critical care and attention she received at a medical facility, she survived. In India, every 10 minutes a woman dies while giving birth in the absence of health care she needs.
Hemlata, 27, gave birth to Virika, two months, a healthy baby girl without any major complications.
From the early days of her pregnancy she had access to good medical care via a health insurance programme.
As an educated, informed mother Hemlata was able to make important decisions regarding her pregnancy and the care she was receiving. Not satisfied with the medical advice she was initially given she sought out another Doctor who was able to identify a Vitamin D deficiency, which was causing bad morning sickness.
Upon being born it was found that the child has an infection, which was treated immediately with antibiotics. She was kept in the hospital for seven days after which she was discharged a healthy child.
Evidence shows that neonatal mortality rate among children born to illiterate mothers has been consistently higher than those born to mothers with some education.
The 1,000 days window from the start of a woman’s pregnancy to a child’s second birthday is critical. Low-cost nutrition solutions like exclusive breastfeeding for the first six months can make the difference between life and death for children.
For instance, breastfed children are at least six times more likely to survive in the early months of life than non-breastfed children.
New Delhi is home to almost 17 million people. According to a survey conducted by the Ministry of Housing and Poverty Alleviation, one out of five people in Delhi is a slum dweller.
With poor health care facilities, children are most vulnerable to malaria, diarrhoea and other common ailments, including stomach infections impacting the health and chances of survival of children.
Reshma, 20, Kalander Colony, New Delhi, India. Pregnant for the first time, Reshma lost her child due to complications at the time of birth. The child suffocated in the womb and was still born. Reshma had initially gone to the hospital with her mother and mother-in-law to get all of her initial check-ups and medications but an untrained traditional midwife convinced the whole family that it was better for the child to be born at home.
She scared the family by talking of ‘big operations’ that may occur in the hospital. It was only when it was too late that the traditional midwife recommended going to the hospital.
Sabir, 45, Reshma’s father runs an iron shop for a living. The ironing shop is located in front of their house in Kalander Colony, New Delhi, India. Pregnant for the first time, Reshma is living with her parents.
Shilpi, 24, lives in Shahdara, New Delhi and has two children, a daughter and a son Yash, aged seven months. Before giving birth to Yash, Shilpi was pregnant with a child she lost after six and a half months due to severe internal bleeding and infection. It is only through the intervention of a Community Health Volunteer that she did not suffer the same fate as her child.
During Shilpi’s third pregnancy, her mother-in-law continued with her traditional practices, ignoring the needs of Shilpi. It was only after the intervention of Sunita, Save the Children health volunteer that the family began to understand the need to look after a pregnant mother and to make use of the available medical care.
Sunita, visited the family and persuaded the husband and mother-in-law to allow Shilpi to be taken to the doctor. Her son Yash, was born without complications. He is now seven months old, a happy, healthy child. Health workers are the real ‘foot soldier’ saving precious lives.
Shilpi with her son Yash, now seven months old. There is a close link between the education level of a mother and chances of her child’s survival.
For successive years, neonatal mortality rate among children born to illiterate mothers has been consistently higher than those born to mothers with some education. According to NFHS 3, newborn mortality stands at a high of 45.7 per 1000 live births if the mother has had no education compared to 19.6 per 1000 if the mother has completed 12 or more years of education. This shows that newborn mortality is 2.3 times higher among women who have received no education.
Sunita is a health worker. She works tirelessly, delivering crucial care and counselling that can save precious life of the mother and babies.
A child is five-times more likely to survive to their fifth birthday if they live in a country with enough midwives, nurses and doctors.
India must ensure that there is a health worker within reach of every mother and every child.