JAYNE AUGOYE

In a new report, the World Health Organisation says deaths of newborns in Nigeria is still alarming, writes JAYNE AUGOYE


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A new study by the World Health Organisation reveals that there is a decline in deaths of newborns around the world - but Africa and Nigeria in particular has recorded the highest death rates for infants. The study, which spanned 20 years, was published in the medical journal, PLoS Medicine Today on August 31, 2011.

It involved all the 193 WHO member states and was conducted by researchers from the organisation, Save the Children's Saving Newborn Lives Programme and the London School of Hygiene and Tropical Medicine.

Deaths of newborn refer to the ones that occur in the first four weeks of life (neonatal period). It accounts for 41 per cent of all child deaths before the age of five.

In past researches, the United Nations had hinted that 53,000 women in Nigeria die annually of pregnancy-related illnesses, making the maternal mortality rate one of the highest in the world. Doctors and youth counsellors in Nigeria are also quick to say that teenage mothers are more at risk because of poverty, lack of access to health care and a culture that does not permit discussing sex education freely.

But findings of the new study also show that 99 per cent of new born deaths occur in developing countries partly as a result of their large population. Emphatically, it says that more than half of these deaths occur in India, Nigeria, Pakistan, China and the Democratic Republic of Congo.

As a result, Nigeria, the world's seventh most populous country, now ranks second in newborn deaths up from the fifth position it occupied in 1990. This report says this is due to an increase in the total number of births.

Africa has also had the slowest progress of any region in the world with a reduction of one per cent per year.

The first week of life is known to be the riskiest for new borns and yet WHO says many countries are just introducing postnatal care programmes to reach mothers and babies at this critical period.

Shedding light on causes of neonatal deaths, WHO Assistant Director for Family, Women's and Children's Health, Dr Flavia Bustreo, says, "Newborn survival is being left behind despite well-documented, cost effective solutions to prevent these deaths. Neonatal mortality has declined in all world regions. Progress has been slowest in the regions with high NMRs. Global health programmes need to address neonatal deaths more effectively if Millennium Development Goal 4 (two-thirds reduction in child mortality) is to be achieved."

Of the 15 countries with more than 39 neonatal deaths per 1000 live births, 12 were from Africa-Angola, Burundi, Chad, Central African Republic, Democratic Republic of Congo, Equatorial Guinea, Guinea, Guinea-Bissau, Mali, Mauritania, Mozambique, and Sierra Leone). Afghanistan, Pakistan and Somalia also had high neonatal death rates, according to report.

WHO says going by the current progress rate, it would take Africa more than 150 years to meet up with the U.S or U.K newborn survival rates.

The estimated figures in the study are based on more data than ever, as well as extensive consultations with relevant institutions in the sampled countries.

"This study shows in stark terms that where babies are born dramatically influences their chances of survival, and that especially in Africa too many mothers experience the heartbreak of losing their baby. Millions of babies should not be dying when there are proven, cost effective interventions to prevent the leading causes of newborn death," says the co-author of the study Dr.Joy Lawn.

The research findings also show that newborn deaths decreased from 4.6 million in 1990 to 3.3 million in 2009 and fell at a slightly faster rate since 2000. WHO attributes these declining rates to investment in healthcare and children in the last decade when the United Nations Millennium Development Goals (MDGs) were set.

They also addd that this proactive action contributed to more rapid progress for the survival of mothers(2.3 per cent per year) and children under the age of five (2.1 per cent per year) than newborns'(1.7% per year).

In 2000, world leaders set a target of reducing child mortality to one-third of its 1990 level by 2015 as Millennium Development Goal 4 (MDG4). This goal, together with seven others, is designed to help improve the social, economic, and health conditions in the world's poorest countries. In recent years, progress towards reducing child mortality has accelerated but remains insufficient to achieve MDG4.

Included in the MDGs targets are reducing by two-thirds, between 1990 and 2015, the under-five mortality rate, reducing by three quarters the maternal mortality ratio and achieving universal access to reproductive health.

The international health body lists the major causes of neonatal deaths in the world as follows: preterm delivery (29%), asphyxia (23%) and severe infections, such as sepsis and pneumonia (25%).

Simple interventions such as improved hygiene at birth and advice on breastfeeding can substantially reduce neonatal deaths while existing interventions can prevent two-thirds or more of these deaths if they reach those in need.

Every year, more than eight million children die before their fifth birthday. Most of these deaths occur in developing countries and most are caused by preventable or treatable diseases.

WHO notes that in many developed countries, child mortality rates can be calculated directly from vital civil registration data i.e. records of all births and deaths. But many developing countries still lack vital registration systems; hence, child mortality is estimated using data collected in household surveys such as the Demographic and Health Surveys (a project that helps developing countries collect data on health and population trends).

In this study, however, the researchers estimate annual national NMRs (the number of neonatal deaths per 1,000 live births) and numbers of neonatal deaths for the past 20 years using the available data.

The researchers employed civil registration systems, household surveys, and other sources to compile a database of deaths among neonates and children under five years old for 193 countries between 1990 and 2009. They estimated NMRs for 38 countries from reliable vital registration data and developed a statistical model to estimate NMRs for the remaining 155 countries (in which 92% of global live births occurred). http://odili.net/news/source/2011/sep/8/816.html

Well that is the result of no free health service

Those rubbish hospital are not close to world standards at all.

Although we keep saying the government should do this and that but in reality it is really there job to do it. The money paid to HORs alone is enough to provide this.

The only world class Nigeria hospital I have seen is st'nicolas lagos apart from this the rest are all not up to scratched

We have doctors in Nigeria earning 60 k while a cashier is earning 120 k this is wrong. Our health service would keep going down at this rate.

Poverty and illetracy especially in de north could be responsible 4 these stark differences btw ours and de west.But our govt no de try at all bearin in mind their wives can attend 2wkly antenatal care in usa and start residin there 4rm there 36wks GA.anyhow us wey don pass de neonatal age suppose begin de dance alanta

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The people that rob Nigeria and steal from the government, all these deaths are on their hands. No matter how much you steal your destiny is to die and thieves will squander your ill gotten wealth. Then you will face God for the 10's of thousands you have killed. This is a very avoidable and common occurrence. Survival in Nigeria is only by God's grace, very big risk.