Defined levels of emergency obstetric care (EmOC) and standardised measurement of “signal functions” has improved tracking of maternal care in low- and middle-income countries (LMICs). Levels of newborn care, particularly for small and sick newborns, and associated signal functions are still not consistently defined or tracked.
An estimated 14.8 million babies are born preterm every year, before 37 completed weeks of gestation.1 Of these, around a million die because of direct complications,2 another 912 000 have mild to severe neurodevelopmental impairment, and many more have milder disabilities or suboptimal child development.3 A preterm baby’s chance of survival and development depends largely on where they live with the majority of preterm births and related deaths occurring in southeast Asia and sub-Saharan Africa.1, 2,
Neonatal deaths now account for 47% of all deaths in children younger than 5 years globally. More than a third of newborn deaths are due to preterm birth complications, which is the leading cause of death. Understanding the causes and factors contributing to neonatal deaths is needed to identify interventions that will reduce mortality. We aimed to establish the major causes of preterm mortality in preterm infants in the first 28 days of life in Ethiopia.
Evidence shows that breastfeeding has many health, human capital and future economic benefits for young children, their mothers and countries. The new Cost of Not Breastfeeding tool, based on open access data, was developed to help policy-makers and advocates have information on the estimated human and economic costs of not breastfeeding at the country, regional and global levels.
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Only three African countries are expected to meet the global target for exclusive breastfeeding, “an unparalleled source of nutrition for newborns and infants, no matter where they are born,” according to a global health expert.
The three nations, Guinea-Bissau, Rwanda, and São Tomé and Príncipe, are singled out in a new study from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine.
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Catalytic progress fostered by Saving Newborn Lives and other programs helped put newborn health solidly on the global policy agenda. As we celebrate progress, let’s also redouble our efforts to address the unfinished newborn health agenda.
We invite you to read the recently released Newborn Health Legacy, a timeline illustrating some of the important milestones in the newborn health movement over the past two decades and recent research in the field.
Reducing neonatal mortality is an essential part of the third Sustainable Development Goal (SDG), to end preventable child deaths. Between 1990 and 2017, the global NMR decreased by 51% from 36·6 deaths per 1000 livebirths in 1990, to 18·0 deaths per 1000 livebirths in 2017. Between 2018 and 2030, it is projected that 27·8 million children will die in their first month of life if each country maintains its current rate of reduction in NMR. If each country achieves the SDG neonatal mortality target of 12 deaths per 1000 livebirths or fewer by 2030, 22·7 million cumulative neonatal deaths are projected by 2030-saving 6 million babies! More than 60 countries need to accelerate their progress to reach the neonatal mortality SDG target by 2030.
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More mothers are attending health facilities to deliver their babies, yet 2.6 million babies are stillborn every year, more than a third (42%) of those in Sub-Saharan Africa. What approaches can we apply to prevent stillbirths?
Pregnancy should be a time of joyful anticipation about the arrival of a new family member. But each year, 2.6 million babies are stillborn. Half these babies die during labour.¹
More than half a million of these are in Sub-Saharan Africa despite two thirds of all women giving birth in health facilities.¹
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On the 15th of May we celebrated International KMC awareness day. We hope you all held special events at your hospital or took the KMC challenge?
Click the link below to access resources to support implementation of KMC in your facility.
As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. Find a link below for the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.
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