Simple changes urged to save newborns
Study says $4b could keep 3 million alive
The lives of 3 million newborn babies in poor nations could be saved annually through simple improvements in birthing procedures and basic healthcare that would cost the world $4.1 billion per year, according to a new study.
The study is the first to place a price, about $2,100 per life saved, on a problem that has been somewhat obscured in the recent rush to tackle global health issues, said public health advocates.
The global community has regarded the deaths of newborns as a second-tier issue behind the AIDS epidemic and other infectious diseases, said researchers and representatives of charities. Seeking to rectify that, a coalition of charities, activist groups, and researchers yesterday released the first broad assessment of the problem, a four-part series of studies published by the Lancet, a British medical journal, and framed as a call-to-arms by its authors.
Lancet editor Richard Horton said the newborn toll was ''10,000 to 11,000 deaths per day, 450 deaths per hour, and seven neonatal deaths per minute, up to three-quarters of which are entirely unnecessary and preventable."
Newborns often enter the world amid squalor in developing nations, vulnerable to many infections, and far from medical care needed to treat complications from childbirth. Their often-impoverished families struggle to feed and care for them in the critical first weeks of life.
Three-quarters of the deaths of newborns occur in the first week after birth, with the first day of life the riskiest, the researchers found.
Two-thirds of the estimated 4 million annual deaths of newborns occur in India, China, Pakistan, Nigeria, Bangladesh, Ethiopia, the Democratic Republic of the Congo, Indonesia, Afghanistan, and Tanzania, the study found.
Most of the deaths are caused by preterm births, infections, breathing problems from a variety of complications, and tetanus, afflictions rarely fatal to newborns in developed countries. The authors said that 16 simple measures -- including widespread tetanus shots, access to antibiotics, breastfeeding education, and sanitary delivery rooms -- could prevent most of the deaths. Also needed were readily accessible basic emergency services, for caesarean sections and blood transfusions, the report said.
The developing world now spends about $2 billion annually on the issue. Another $4.1 billion is needed, the report concluded.
The research effort was spearheaded five years ago by the Bill & Melinda Gates Foundation, the charity funded by the
The US government also funded the research, which involved the United Nations and the World Bank.
Although physicians have long expressed concern about newborns dying, recent organized efforts in the developing world have focused on HIV, other infectious diseases, and women's health, while ''newborns really fell through the cracks," said Anne Tinker of Save the Children USA.
Tinker said the international aid community has discussed setting up a global fund to fight the deaths of newborns. It would pool money from wealthy nations for distribution to poor governments or aid organizations, similar to an effort underway with HIV donations. She stressed bypassing governments that have misused donor money in the past.
''There are some honest governments. And where they are not honest, the money can go to nongovernmental organizations with strings attached," Tinker said. ''Because so much of this can be done at the community level, it would be effective to give the money to nongovernmental groups that work at the local level."
But Dr. Vinod Paul, a senior adviser to India's government on child and maternal health issues, said the money should go directly to government health ministries, who know their respective needs best.
''We have to give money to the countries. It is for the countries to make their own goals and targets," he said. ''The countries have to be in the driver's seat."
The studies released yesterday in essence called upon the developed world to export its own advances in newborn care. For instance, in England, the newborn death rate fell from 30 per 1,000 births in 1940 to 10 in 1975 after officials there introduced free prenatal care, antibiotics for newborns, and improved delivery care. In recent years, such developing countries as Vietnam, Honduras, Indonesia, and Sri Lanka have reduced the deaths of newborns using aid money to enact similar changes.
The authors of the new papers pointed out that, unlike many other medical problems, the deaths of newborns did not require sophisticated medical technology or highly trained specialists to be remedied.
''We needn't hold our breath and wait until the pot is full of money. We can move now," said UNICEF executive director Carol Bellamy. ''We can actually save as many as a million newborns with much less expensive interventions based on family care and community outreach programs."
Material from Globe wire services was used in this story.
