Newborn mortality and care

According to health experts, 15.4 percent of all under-five deaths occur due to preterm birth-related complications, making it the leading cause of under-five mortality.

However, in Bhutan, we do not even have a reliable preterm birth rate or data concerning outcome of preterm babies. Morbidity and mortality patterns of preterm babies have not been studied even in Jigme Dorji Wangchuck National Referral Hospital in Thimphu.

It is about time we conducted a comprehensive study to highlight deficiencies and suggest improvements in the care package for preterm babies. If our hospitals and health centres continue to not have preterm morbidity and mortality database, identifying root causes and preventing preterm deaths could remain a major health challenge for the country.

Simply put, research and quality improvement projects in the health centres will be difficult without baseline data to refer to.

While we must applaud the dedication with which some of our health professionals are working, even without clear baseline data, to change the practice to improve the quality of care for the newborns, we must urge the ministry, agencies and organisations concerned to develop database for at least major health issues facing the country.

Leaving it to the hard work and special dedication of individual health professional or caregiver is not the right way. As if this is already not an issue among the people, service delivery in the health sector stands to earn a bad name otherwise.

Simple professional practices like keeping the babies warm, maintaining clean cord care, and nutrition and infection prevention can be wonderfully effective measures of care to both preterm and full-term babies. But we can certainly do more because we ought to. And that will include creating awareness about care before baby is conceived and critical cautionary measures through birth and after-birth experiences.

There are changes in the offing. Hospitals and caregivers have already made some positive changes in the practice like drying the baby and stimulating breathing immediately after birth. Change of culture of separation after delivery to non-separation through EENC and KMC has reportedly delivered appreciable results. Hygiene and infection control interventions have also been strengthened.

All these are good. But we still have a major problem – of not understanding the root causes.

The news that reduction of newborn mortality will be one of the priorities of the health ministry in the 12th Plan is reassuring.

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