Written by Sandee Minovi and Merce Gasco on behalf of the JSI Maternal, Newborn, and Child Health (MNCH) Center
It is time for international attention to children’s health to shift focus to the newborn period – a crucial time of life that requires specific strategies.
Over the past few decades, the world has made important progress through targeted campaigns to reduce the mortality rate for children under five. One of the UN Millennium Development Goals is to reduce child mortality significantly by 2015, and USAID’s Every Child Deserves a 5th Birthday campaign aims to mobilize public support to end preventable child deaths in a generation. JSI has been a USAID partner in this effort. The international community deserves to be proud of the outcome. According to the most recent MDG report, the mortality rate of under-five-year-olds has declined by 35 percent between 1990 and 2010.
Now, as a result of these efforts, a growing proportion of childhood deaths take place in the first month of life – more than 40 percent. The Bill & Melinda Gates Foundation has noted that nearly 4 million babies die each year before they are a month old, from birth asphyxia or conditions such as prematurity and serious infections, and more than 3 million are stillborn. When stillbirths are included, about half of all deaths of children under 5 occur before the end of the first 28 days of life. By directly targeting the newborn period, we can have the most impact right now.
In the world of public health, neonatal health is packaged with other childhood health or maternal health initiatives. But the pre-natal, delivery, and newborn period is a critical time that requires the development of separate strategies. Newborn infants have specific needs that need to be evaluated at a specific time. This issue must be included in the public health agenda as a separate area of focus.
Often, simple cost-effective interventions are the primary approach. Essential newborn care encompasses a set of basic preventive measures and services including: skilled attendance at birth, immediate and exclusive breastfeeding, temperature maintenance, special care for premature and low birth-weight babies, umbilical cord and eye infection prevention and care, immunization, and prevention of mother-to-child transmission of HIV. Access to newborn neonatal resuscitation is also crucial to reducing newborn deaths. Along with these interventions, families are taught to recognize and act quickly on danger signs.
It is crucial that we take a comprehensive approach to newborn health, working within the community to promote healthy behaviors and at the facility level to increase the capacity of health providers to offer life saving techniques to manage or refer birth complications, serious infections, severe jaundice and very low-birth-weight while also ensuring consistent delivery of drugs, commodities, and equipment. We can make some huge leaps in childhood health with attention to the first 28 days.