Pandemic may hinder success in preventing newborn deaths

Many mothers have not been able to get proper antenatal care due to the Covid-19 pandemic, which has increased the risk of newborn deaths, medical experts said at a discussion on Wednesday.

"Kangaroo Mother Care [KMC], which is effective in preventing premature death, is considered an easy and low-cost intervention," said Dr Ahmed Ehsanur Rahman, associate scientist at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b).

"But it involves times and effort from families and the health system to provide KMC to a child as it requires a mother and baby's skin-to-skin contact for extensive hours and follow ups," he said in a keynote presentation at an evidence-sharing session with journalists at the icddr,b in Dhaka. 

The keynote paper mentioned that over the past few decades, Bangladesh has made significant strides in reducing the number of newborn deaths. 

However, the infant mortality rate is still high in the country. Per 1,000 live births, 30 newborn children die in Bangladesh. Of this number, a staggering 19% account for premature births and low birth weight (LBW) combined, it added. 

Professor Mohammad Shahidullah, chairman of the National Technical Working Committee for Neonatal Health, and Dr Sayed Rubayet, country director of Ipas Bangladesh, attended the session as technical experts. 

The session was chaired by Dr Shams El Arifeen, senior director of the Maternal and Child Health Division at the icddr,b. 

The experts also stressed that in an ongoing pandemic like Covid-19, the World Health Organization (WHO) stated that with specific precautions, KMCs do not put babies at additional risk of contracting infections. 

Hence, it is very important to give proper attention to make KMCs and other interventions available and to ensure their use by promoting their benefits to families to increase their care-seeking behaviour, they added.

The experts also discussed the prematurity and LBW burden in Bangladesh, innovations and interventions to reduce the burden as well as the importance of bringing positive changes to the mindset of the care seekers. 

They said that premature birth entails pre-term children born before completing 37 weeks in the mother's womb. Children born weighing below 2,500 grammes are considered LBW. 

In Bangladesh, every year, 573,000 babies are born premature and 834,000 with a birth weight of less than 2,500 grammes – among which 192,000 are born with birth weight of less than 2,000 grammes. 

It is unfortunate that about 17,100 newborns die every year – from these two reasons combined – in Bangladesh, of which 72% die even before completing the first day of their lives, the experts further said.

Of these 17,100 cases, 40% of the families do not seek healthcare at health facilities, while 43% of the deaths occur in health facilities. 

Lifesaving interventions – such as antenatal corticosteroid, kangaroo mother care and the special care newborn unit – are already proven to be very effective in preventing such untimely deaths. In 2020, only 5,731 babies received the KMC service – that is, about 1% of the babies requiring the service.

It is imperative that Bangladesh strengthens its efforts in reducing newborn deaths to be on track to achieve Sustainable Development Goal (SDG) 3.2, which requires ending all preventable under-five deaths by 2030.

The session was organised by the USAID-supported Research for Decision Makers activity of icddr,b and Data for Impact (D4I) as part of an advocacy effort to sensitise and encourage journalists to report on ways to reduce preventable deaths among children.