If there is one thing Carolyn Miles knows, it’s that mothers — no matter if they’re in the United States, Pakistan or Nigeria — are fundamentally the same. “Every night, millions of mothers around the world lean over their sleeping newborns and pray that they will be safe, happy and healthy. It is what we all want for our children,” Miles, President and CEO of Save the Children USA, said.
But the likelihood that a mother will see these dreams realized depends largely on where she lives. Every year, 3 million babies die within the first month of life, according to the 14th annual State of the World’s Mothers released this week by Save the Children, an international nonprofit organization dedicated to supporting children in developing nations. Almost all, 98 percent, of newborn deaths occur in developing countries where access to basic health is limited.
While these statistics are sobering, there is a silver lining, according to Miles. In looking at the causes of newborn deaths, Save the Children found that increasing access to a few basic devices and medications could reduce infant mortality in the developing world by 75 percent.
Mortality rates: moms, kids and newborns
Maternal and child mortality rates have declined considerably in the last 20 years, according to Save the Children’s report. Since the 1990s, the annual number of children who die before the age of five has decreased from 12 million to 6.9 million, a 40 percent decrease. Improvements in the maternal mortality rates are even more impressive, with deaths declining from 543,000 to 287,000, nearly a 50 percent decrease.
But improvements to newborn mortality rates have been much slower, according to Miles. Since the 1990s, newborn mortality rates have only decreased by about 30 percent globally, according to UNICEF Global Databases. The progress has been uneven with some regions, for example East Asia and the Pacific, decreasing infant mortality by more than 60 percent. However, in other regions of the world, progress has been much less impressive. During the last 20 years, the newborn mortality rate in sub-Saharan Africa actually increased by 10 percent.
While nearly all of newborn deaths occur in developing countries, Carolyn Miles of Save the Children pointed out that the bulk of these deaths are concentrated in just a handful of countries. Her researchers note that 65 percent of newborn deaths occur in just 10 countries: India, Nigeria, Pakistan, China, DR Congo, Ethiopia, Bangladesh, Indonesia, Afghanistan and Tanzania.
Keeping newborns alive
Part of the reason there hasn’t been as much improvement in newborn death rates is because for a “long time everyone thought that nothing could be done to save the lives of newborns in the poorest countries,” according to Save the Children’s report. In the United States, neonatal and perinatal care is extremely high tech with monitors used to track baby's breathing and the incubators to keep them warm, said Danielle Ehret, a resident specializing in neonatal-perinatal medicine at Boston Children’s Hospital. In this context, she explained, it is easy to lose sight of the fact that some of the best tools for saving newborns are simple, affordable and easy to use. In other words: simple technology saves lives.
Save the Children found that 35 percent of newborn deaths are related to complications associated with preterm birth such as under-formed organs. They also found that 23 percent of deaths are the result of infection and another 23 percent are related to birth complications such as difficulty breathing. Save the Children estimates that at least 75 percent of these deaths could be prevented with simple lifesaving technology.
Steroid injections, for example, can be given to women to delay labor, giving their babies more time to develop thereby increasing the likelihood they will be born healthy. Simple resuscitation devices, which look and function similarly to the nasal aspirators parents in the United States use to clean their babies stuffy noses, make it possible for little ones in distress to breathe.
Babies are most susceptible to infection through their umbilical cord. The foundation finds that in many instances, infection can be prevented by applying an antibiotic cream (think Neosporin) to the cord after it is cut. In cases where the baby develops an infection, antibiotics often cure them.
All these innovations are affordable, ranging from 13 cents to $6 per treatment, and require minimal training to use, said Miles. “That is the good news in this report,” she said, “a mother can put antibiotic cream on her baby’s umbilical cord, (and) a community health care worker can be trained to administer antibiotics and resuscitate a baby who isn’t breathing.”