Based on official statistics released recently, over the past 25 years or so, the world has made commendable progress in saving young children’s lives; but there is still a far way to go in terms of drastically reducing newborn and child deaths. The rate of child mortality fell 62 per cent from 1990 – 2016, with under-five deaths dropping from 12.7 million to 5.6 million. However, it is also quite clear that this progress has not been universal, as some countries, including Guyana, are still lagging behind.
A new report from UNICEF and its partners in the Inter-Agency Group for Child Mortality Estimation (IGME), Levels and Trends in Child Mortality: Report 2017, shows the full scope of child and newborn mortality across the world. The data reveal that the rate of newborn deaths is not decreasing as quickly as that of children aged one to five. As a result, newborns account for a growing proportion of child deaths with each passing year. For example, according to UNICEF, in 2016 alone, 7,000 newborn babies died every day.
Newborn deaths made up 46 per cent of all child deaths, an increase from 41 per cent in 2000. According to the report, most of these deaths are entirely preventable. WHO has noted that prematurity; complications during labour and birth; and infections like sepsis, pneumonia, tetanus and diarrhoea are among the leading causes – all of which can be treated, or prevented with simple, affordable solutions.
It must be mentioned, too, that these children are dying because of who they are and the environment they were born into – whether it be an impoverished family, a marginalised community, or a country consumed by conflict. Children in the poorest households are nearly twice as likely to die before the age of five than those from the richest households.
It must be noted that the vast majority of newborn deaths take place in developing countries, where access to health care is low. Most of these newborns die at home, without skilled care that could greatly increase their chances of survival.
According to the World Health Organisation (WHO), skilled health care during pregnancy, childbirth, and in the postnatal (immediately following birth) period prevents complications for mother and newborn, and allows for early detection and management of problems. WHO and UNICEF now recommend home visits by a skilled health worker during a baby’s first week of life, to improve newborn survival. Newborns in special circumstances, such as low-birth-weight babies, babies born to HIV-positive mothers, or sick babies, require additional care, and should be referred to a hospital.
The WHO has suggested that with an increasing share of under-5 deaths occurring within the neonatal period, accelerated change for child survival requires a greater focus on building strong health services, ensuring that every birth is attended by skilled personnel, and making hospital care available in an emergency.
Here, in Guyana, despite progress achieved during the last decade, this country continues to experience one of the highest maternal and infant mortality rates in Latin America and the Caribbean, with a maternal mortality rate estimated at 121 per 1,000 live births and an infant mortality rate at 22 per 1,000 live births.
In 2016, the Inter-American Development Bank (IDB) had approved an US million loan for a programme to help reduce maternal, perinatal and neonatal deaths in Guyana. The focus of the programme is to improve the quality of care at 140 health facilities and in 88 communities, benefitting at least 140,000 women and 9,000 newborns per year.
The initiative was designed with the aim of supporting and improving maternal and child health care geared towards improving access to quality neonatal health services and providing a better path to, and quality of, reproductive and maternal health services. Efforts such as these must be commended.
That said, the most recent report by UNICEF has made some useful recommendations, which the Government here should seriously consider. Diligent efforts must be made to continue reducing newborn and child deaths. We believe that once there is a concerted, coordinated effort among policymakers, businesses, healthcare workers, communities and families, we can achieve the desired results as those relate to reducing child mortality rates.
