baby elephant
In one of the largest countries in Africa, a new program is working to change the outcome of premature births with a simple footprint.  Tanzania is home to an estimated 46,218,000 people who earn an average of $570 per year.  With about one third of its people living below the national poverty line, Tanzania is regarded as a ‘developing country.’  The term ‘developing country’ is described by Princeton as “a nation with a low level of material well-being.”  A common reality in developing countries is the limited or complete lack of access to medical assistance, whether a hospital, pharmaceuticals or a birth attendant.

The latter is an issue that can have devastating consequences.  In low-income countries, about 40% of births are unattended by a trained, medical professional.  Whether or not they are equipped with modern tools and resources, a trained professional is better able to determine the dangers and necessary steps to take before, during, and after birth, especially regarding premature babies.  Of the approximately 10% of infants worldwide born prematurely each year, about one million die, with over 80% of those deaths occurring in South Asia and Sub-Saharan Africa.

At present, Dr. Joanna Schellenberg and a team at Ifakara Health Institute (IHI) in Tanzania are researching a strategy with the potential to have a global impact.  The research began by attempting to solve how to reduce premature infant deaths without requiring entire health systems to be constructed (and funded) first. This is especially important since one of the greatest obstacles facing health care in rural areas is the absence of equipment.  However, the World Health Organization (WHO) estimates that 75% of preterm infant deaths could be prevented without the use of intensive care and modern resources.  Premature infant weights are under 5lb 5oz, yet since scales cannot be assumed to be available, the IHI team came up with another measurement: the size of a baby’s footprint.

Volunteer health workers visit villages with a laminated card picturing two footprints.  The health workers measure infants’ feet against the pictures and determine how to proceed based on their size.  If the infant’s footprint is the same size or larger than the bigger footprint, then the child is not premature.  If the footprint is between the two sizes, it may be premature but not necessarily in danger.

Health workers then proceed with suggestions on how to promote infant health such as holding the child skin-to-skin for warmth, or how to breastfeed effectively.  Finally, if the footprint is smaller than both samples, about 67mm or less, the mother is directed to the nearest health center where the infant can receive potentially life-saving care.

The strategy just described is called “Mtunze Mtoto Mchanga” which translates to “Protect the newborn baby,” a concept that local women have been quick to support.  With the persistent visits and encouragement by the project’s health workers, support has grown into a greater compliance by the public. Though the project will continue for another six months before clear results are available, the team is already poised to implement it throughout Tanzania.

The laminated-card system is not only relatively simple to duplicate, it also demonstrates potential self-sufficiency amongst rural women.  Moreover, once the procedure and subsequent actions are ingrained, the individuals could monitor their babies themselves without the need for health workers help with premature birth testing.

The versatility of the project only heightens anticipation for the results of the study.  If successful, the IHI project could mean saving up to three-quarters of a million infants each year with just a footprint.

Katey Baker-Smith

Sources: World Health Organization, Princeton University, United Nations Data, The World Bank, BBC