Each year, on the 17th of November, World Prematurity Day is observed to raise awareness about the challenges faced by preterm babies and their families worldwide. The theme for this year’s World Prematurity Day is “Small Actions, BIG IMPACT.” It underscores the significance of every small step we take to improve the care and support of premature babies and their families.

Today, I celebrate the resilience and strength of families raising preterm babies and to extend an arm of hope, love, empathy, and support to them. Babies born too soon face numerous challenges in many aspects of life while growing up and require special assistance to help them grow safely.

Premature birth is defined as a birth that occurs before 37 weeks of pregnancy; it is a global concern. It affects millions of families and has significant implications for the health and well-being of new-borns. In many cases, the causes of premature birth are complex and not entirely understood, making prevention a challenging task. However, the care and support provided to premature babies and their families can make a world of difference.

According to the World Health Organization, an estimated 15 million babies are born preterm each year, accounting for about one in 10 of all births worldwide. The National Institute of Health recorded that preterm babies accounts for 40 – 60% of all perinatal deaths in Nigeria, 11 by gestational age. 5.2% of preterm births occur at less than 28weeks gestation (extremely preterm), 10.4% at 28-<32 weeks (very preterm) and 85.3% at 32 – 36 weeks (moderate – late preterm).

Preterm delivery could be spontaneous or induced. Clinical and socio-demographic variables which are usually not apparent have been associated with spontaneous preterm delivery. Preterm neonates are more likely to have difficulty with feeding, blood glucose control, jaundice, temperature instability, apnoea, respiratory distress, sepsis, wide spectrum of neuro-developmental disabilities, as well as growth and health problems either singly or in combination compared to neonates delivered at term. Consequent upon these complications, the birth of a preterm neonate can bring with it considerable emotional and economic costs to families with its attendant implications for public-sector services. The survival of preterm infants is a function of both their biological maturity and technological advancement in any given setting. While technological advancement has continued to show marked improvement in developed countries with increasing survival of extremely preterm babies, the same cannot be said of the developing countries. especially in Africa, –particularly Nigeria, where there is poor health infrastructure, poverty, mass illiteracy, gross gender inequality, numerous conflicts, and a lack of equipment, manpower, and support services necessary to float a functioning neonatal intensive care service.

In light of this, the plausible way of reducing the burden of preterm birth in our health sector is by reducing its incidence, starting with a proper understanding of the factors associated with these births. An urgent improvement in prenatal and newborn care is therefore needed in the study centre to improve the capacity to prevent or abate preterm labour, and preterm premature rupture of membranes, and to reduce avoidable stillbirths. Further upgrading of personnel and facilities in the newborn special care unit is also required to minimize early neonatal deaths. The onus therefore lies on us all to start making conscious efforts in the little ways we can, to curb this issue as much as possible.

Small Actions, BIG IMPACT:
As healthcare practitioners, I urge us all today to continually through our care to give hope to babies born too soon and their families as our actions goes a long way in creating a big impact for the newborns. The small actions that create a big impact are as follows:

1. Kangaroo Care: One of the simplest yet most effective interventions for premature babies is Kangaroo Care. This method involves skin-to-skin contact between the baby and the parent, typically the mother but when the mother is not available the father can suffice. It helps regulate the baby’s temperature, heart rate, and breathing, and promotes bonding.

2. Breast Milk: Providing premature babies with breast milk, even in small amounts, can have a significant impact on their health and development. It helps protect them from infections and provides essential nutrients.

3. Immediate care at birth: There is a significant advantage in the survival of premature babies depending on the immediate care rendered at birth and during the first few days of life especially preterm with breathing difficulties. This helps to prevent mortality and lifetime neurological impairment. Immediate care includes mechanical ventilation, Continuous positive airway pressure (CPAP), temperature regulation, blood sugar control and medicine such as caffeine citrate, surfactant etc.

4. Infection control measures: Hospital- acquired (nosocomial) infection is primarily a problem for premature infants requiring prolonged hospitalization, the lower the birth weight, the higher the risk of infection. Therefore active monitoring and adherence to infection control measures is essential e.g. Hand hygiene, sterilisation and disinfection of equipment, NICU protocol PPE (cap,facemask,gown and footwear), infection surveillance and antibiotics.

5. Supportive Environment: Creating a nurturing and supportive environment in neonatal intensive care units (NICUs) is crucial. Simple gestures like soft lighting, quiet surroundings, and gentle handling can reduce stress and improve the baby’s development.

6. Parental Involvement: Engaging parents in the care of their premature babies is vital. Parents can learn to feed, change diapers, and comfort their babies, playing an active role in their child’s care.

7. Follow-up / home Care: The health care team may let baby go home if certain requirements are met e.g., free from major health problem, can breathe without support, has stable body temperature and is gaining weight overtime. Parents are taught how to care for baby at home and precautionary measures to prevent re- hospitalisation.

8. Education and Awareness: Raising awareness about premature birth and the challenges it poses is a small action with a big impact. It helps reduce stigma, encourages early prenatal care, and fosters community support.

9. Research and Innovation: Scientific research and innovations in neonatal care have led to remarkable improvements in the survival and long-term outcomes of premature babies.



The Role of Communities:
Communities play a vital role in supporting families with premature babies. Neighbours, friends, and extended family can provide emotional support, offer assistance with daily tasks, and help create a network of care around the family.

Advocacy for Change:
On World Prematurity Day, advocacy for policy changes and increased funding for neonatal care is essential. Small actions like providing insurance scheme, signing petitions, contacting legislators, or supporting organizations focused on premature birth can collectively lead to significant change in how we address this global health issue.

Conclusion:
Every small action taken to improve the care and support of premature babies and their families can have a big impact. World Prematurity Day reminds us that together, we can make a difference in the lives of these vulnerable new-borns and their families. From Kangaroo Care to community support, education, and advocacy, every action counts in the effort to ensure that premature babies have the best possible start in life.
So, this World Prematurity Day, let’s celebrate the small actions that have a BIG IMPACT and recommit to supporting premature babies and their families in health and happiness.