Women’s Health in IndiaWomen’s health in India is still vulnerable to several risks such as high maternal mortality rates, lack of preventative care and misinformation about family planning and contraception. Despite this, India has proven itself a pioneer in technological innovation among developing countries and it is putting its new innovations towards improving women’s healthcare. 

Maternal Health and Newborn Development

Although maternal mortality rates in India have declined substantially in the last decade, the number of recorded deaths related to pregnancy complications in the country is still remarkably high. A report by UNICEF estimates that 44,000 women die due to preventable pregnancy-complications in India yearly. These complications often stem from a lack of knowledge and inherently the inability to understand that their baby isn’t developing correctly. This lack of knowledge results in fewer women seeking treatment that could save their lives. To combat this, organizations are developing innovative mobile apps to help women stay proactive and educated about the health of their babies and the status of their pregnancies. 

For example, in 2014, MAMA (Mobile Alliance for Maternal Action), an organization dedicated to women’s maternal health in developing countries, developed a digital service called mMitra. The service sends recordings and SMS messages to new and expectant mothers with crucial information about the early stages of pregnancy and child development within the first year of life. The app, which collected 50,000 subscribers within months of its launch, sends educational content to women in their native languages and at times of their choosing. The app,  mMitra ultimately aims to help women pick up on pregnancy and child development issues early and seek treatment before symptoms escalate or endanger the mother and child. 

Breast Exams and Preventative Care

Mammograms are an essential part of preventative care for women globally. Despite this, it is estimated that over 90 percent of women in the developing world go without this essential screening examination. Particularly, in India, high-costs, unsustainable electricity and lack of properly trained radiologists are major causes for the inaccessibility to mammograms and other procedures like it. More women die of breast cancer in the country than anywhere else in the world (around 70,000 women annually). While these high death rates due to inaccessibility to preventive care are tragic, they’ve inspired innovative medical devices that have revolutionized women’s health in India. 

One such device, known as iBreastExam was invented by computer engineer Mihir Shah. Shah invented the device to ensure that women in even the most rural parts of India could get affordable, accurate breast exams and seek treatments as needed. The battery-operated wireless machine is designed to record variations in breast elasticity and performs full examinations in five minutes, posting and recording results through a mobile app. Not only that, the exams are painless, radiation-free and are extremely affordable at $1 to $4 per exam.

Family Planning and Contraceptive Options

Lack of family planning and knowledge of contraceptive options is another challenge in improving women’s health in India. Many Indian women shy away from modern family planning and contraception due to things like familial expectations, cultural influence and a general fear stemming from misinformation from disreputable resources. Family planning and the use of contraception could reduce India’s high maternal mortality rates. However, without proper education on these matters, it is difficult for young Indian women to make informed decisions about what options are best for them. But, in the midst of India’s technological revolution, an increase in accessibility to mobile devices is steadily transforming the way women are gaining health awareness in India. 

There is a particular mobile app that is playing a huge role in improving women’s health awareness in India. Known as Gyan Jyoti, the mobile app provides credible information through educational films, TV advertisements and expert testimonials from doctors. It also acts as a counseling tool for ASHAS (appointed health counselors). The app allows ASHAS to expand their knowledge of family planning through an e-learning feature, customize their counseling plan according to the needs of clients and monitor and store client activity in order to provide the best information possible. 

Overall, while there are still many challenges in improving women’s health in India, the country has proven itself to be a pioneer in technological innovation. Just as well, it’s proven that transformation is possible by putting its innovations towards women’s health awareness through mobile apps, life-saving hand-held devices, and educational platforms that can be accessed at the click of a button. 

Ashlyn Jensen
Photo: Flickr

 

ChlorhexidineAn estimated 390,000 babies die within their first months of life annually due to severe infections. For the past decade or so, USAID has been combating this number with a low-cost yet highly effective antiseptic called Chlorhexidine. The chemical is typically used in hospitals to either disinfect the skin before a surgery or to sterilize surgical equipment, but USAID says that the antiseptic “can also be used to protect the umbilical stumps of newborns to prevent life-threatening complications from an infection.” These infections, USAID explains, can in part be a regular consequence of the traditional home birthing practices found in poorer countries. After conducting multiple studies, it has been shown that even a “one-time chlorhexidine treatment can lower the risk of severe infection [in infants] by 68 percent and infant death by 23 percent.”

Countries Adopting Chlorhexidine

Because it is relatively cheap, easy to manufacture and proven to be effective, around 30 nations throughout Africa and Asia either expressed interest in the antiseptic or have begun working with USAID to integrate the antiseptic into their healthcare system over the past several years.

Case Study: Nepal

Nepal was the first nation to implement the treatment back in 2011. It has since reduced the likelihood of infant illness and mortality by 34 percent. The success in Nepal is what inspired a chain-reaction that lead to the antiseptic being adopted into a variety of different countries—but the success of the disinfectant did not come without its challenges.

Before Chlorhexidine was initiated into their health system, the World Health Organization (WHO) recommended that the nation adopt a dry care system to treat the umbilical cord; this system required that the mother keep her child’s umbilical stump clean and dry until the stump fell off on its own while she kept an eye out for any signs of infection.

Due to cultural barriers, this suggestion was not followed. USAID said that mothers in Nepal had been used to routinely applying unsanitary substances such as turmeric, ash, cow dung or a mercury-based red cosmetic powder used by Hindu women to the umbilical stump by hand. Thankfully Nepal has been impressed with the results Chlorhexidine has supplied but the earlier setbacks in treatment shed an important light for USAID and its partners on how complex assimilating a scientifically safe treatment into impoverished nation’s culture can actually be.

Today, both single-dose tubes of the antiseptic are freely distributed to all expecting mothers in their eighth month of pregnancy and a one-on-one training session explaining how to safely apply the gel after cutting the umbilical cord.

Case Study: Pakistan

Pakistan implemented the treatment in 2014. Pakistan reportedly has the third-highest newborn mortality rate in the world, with umbilical cord infections serving as the second leading cause of death to Pakistani newborns. Seeing as Pakistan is a much larger and complex country, it faced a different set of challenges than Nepal when it came to making the antiseptic widespread.

There were some cultural barriers to overcome in Pakistan as well—many Pakistani women used to treat umbilical cords with surma, a lead-based concoction)—but the main challenge the nation had to overcome was to bring together all the government and private offices working towards a Chlorhexidine treatment program independently. To convene all of these health offices together and collaborate on an implementation plan was no small feat and took around a full year, and then the plans were formally adopted another year later, in 2016.

Of course, Chlorhexidine comes with its own set of risks. Although it has been found to reduce infections, it has also been discovered to cause rashes and burns on some skin types. Even so, the use of Chlorhexidine in both Nepal and Pakistan shows that although the process of assimilating treatment is not always easy or quick, it yields hopeful results that encourage nations in the surrounding areas to adopt the life-saving drug as well.

– Haley Hiday
Photo: Flickr

Maternal health in Guinea

Guinea, officially known as the Republic of Guinea, is a country in West Africa with a significant amount of natural resources, such as bauxite and iron ore as well as gold and diamond mines that could bring the country immense wealth. However, due to its reliance on agriculture and the Ebola outbreak of 2014, the country remains in poverty and has some of the lowest health rates in the world. The philanthropic focus on eradicating Ebola has shifted funds from maternal health to ending the Ebola crisis, endangering the lives of women and children. Improving maternal health in Guinea needs to become a priority.

Maternal Health in Guinea

Of the numerous social problems facing Guinea, maternal health is one of the most detrimental to the country. The neonatal mortality rate in Guinea is 25 deaths per 1,000 live births. The maternal mortality rate is 679 women out of 100,000 live births. This compared to a global neonatal mortality rate of 18 deaths per 1,000 live births depicts a country struggling with maternal health development. Throughout the country, only 36.1 percent of children are vaccinated and approximately 31 babies die each day while 21 babies are stillborn.

One aspect of maternal health that could use improvement is prenatal care and scheduled doctor visits. In rural areas, fewer than 40 percent of women receive prenatal treatment while 71 percent of women in urban areas attend doctor visits before the birth of their child. These low percentages of prenatal care correspond to equally low rates of women who give birth in facilities with trained personnel. The main reason women do not want to give birth in facilities is the mixed-gender wings. Women feel uncomfortable giving birth where men are present.

Global Funding to Reduce Maternal Mortality

To combat these statistics, the government of Guinea and various non-profit organizations are implementing programs to help improve the health and mortality of infants and mothers. In 2018, the World Bank approved $55 million in funding for the two poorest regions of Guinea, Kindia and Kankan. This money will go to improving reproductive, maternal, newborn and child health.

The grant was distributed to two different associations. The International Development Association will receive $45 million to provide low to zero-interest rates for programs that improve economic growth and reduce poverty. The Global Financing Facility will receive $10 million to prioritize underinvested areas of maternal and infant health.

In 2015, the USAID began the Maternal and Child Survival Program in Guinea, which improves the quality and availability of maternal and infant services. The goal of this program is to empower district-level lawmakers to strengthen local centers through a bottom-up approach. Through this initiative, MCSP has established seven healthcare facilities with 42 healthcare providers and 125 healthcare educators.

Focusing on Maternal Health

In 2015, the IDA approved a grant to implement the Primary Health Services Improvement Plan as part of a five-year plan to improve maternal health, child health and nutrition in Guinea. The grant specifically targets health centers by increasing the number of health centers and the availability of equipment and supplies in these centers.

Due to many centers focusing on fighting Ebola, this plan improves the availability of medicines in health centers, restores drug funds within health facilities, supports training in financial drug fund management and covers any financial gap to produce medicines in subsequent years. Additionally, the grant provides three-year training and continuous mentoring for nurse assistants. Furthermore, it recruits unemployed nurse assistants to work at these health centers.

Improvements Made

Since these initiatives began, there has been a significant improvement in developing maternal health in Guinea. The number of births attended by trained health professionals between 2016 and 2018 improved from approximately 27,000 personnel to 44,000. There were also 8 percent more women who received prenatal care by attending at least four doctor visits before the birth of their babies.

Similarly, the Ebola Response Project, although meant to target people affected by the Ebola breakout, has positively affected maternal health development in Guinea by helping fund a new maternity center in Koba. This center helps women attain the privacy they desperately desire by providing two separate wings for men and women. At this center, specifically, a program was initiated to distribute clothes, mosquito nets and soap to expecting mothers to encourage visiting the center.

Maternal health development in Guinea has been steadily improving through programs and governmental plans; however, there is still much work to be done. Although infant and maternal mortality rates are dropping due to an increase in health centers and personnel, a continued increase in funding and a restructuring of fund management is necessary to continue to improve maternal health in Guinea.

Hayley Jellison
Photo: Flickr

Breastfeeding
The first week of August was World Breastfeeding Week, a week that, among other things, aims to inform the public something often overlooked: increasing the number of moms who breastfeed could significantly help decrease infant mortality and boost survival in extreme poverty. A healthy and low-cost practice, breastfeeding helps alleviate poverty.

Essential Health Benefits and Survival Booster

Breast milk has all the nutrition that a baby needs in its first six months of life and is a natural way of warding off diseases. Studies show that breastfeeding could decrease the risk of diabetes, allergies and other health hazards that may come in the baby’s later life. It is recommended that mothers feed their babies with breast milk exclusively for six months, and then breastfeed up to two years while introducing nutritional solid food.

Breastfeeding is not only beneficial but also necessary. A baby’s survival rate is boosted if it takes in breast milk within the first hour after birth. Failure to give a baby breast milk within a short period of time after birth could increase the possibility of infant death by as much as 80 percent.

The effects of breastfeeding on a global scale are striking. If all mothers across the world exclusively breastfeed their babies for six months and then feed their babies with breast milk along with other solid food for another year, 13 percent of global child deaths under five could be averted. Other recommended methods to increase child survival, such as hygienic delivery, Hib vaccine and tetanus toxoid, could each avert only up to 5 percent of child deaths under five.

“Breastfeeding is the best gift a mother, rich or poor, can give her child, as well as herself,” UNICEF’s Deputy Executive Director Shahida Azfar said on Mother’s Day.

Why Breastfeeding Helps Alleviate Poverty?

Breastfeeding is important everywhere in the world, and an essential way to help mothers in poverty or wealth. But poor regions with unclean water and insufficient hygiene should especially embrace breastfeeding because in these places this issue has a higher stake: artificial milk or infant formulas could become poisonous if contaminated, resulting in illnesses, or even death. Breast milk also provides sufficient water for babies in their first six months.

Breastfeeding is low-cost yet easily meets the nutritional needs of young babies. In other words, breastfeeding promises food security for babies and takes off some of the households’ financial burdens.

In a joint message released during the 2016 Breastfeeding Week, UNICEF and WHO stated: “breastfeeding is not only the cornerstone of a child’s healthy development; it is also the foundation of a country’s development. In fact, supporting breastfeeding is one of the smartest investments countries can make in the well-being of their citizens–and thus, in their own long-term strength.”

Why Aren’t More Mothers Breastfeeding?

It might be counter-intuitive that many mothers do not breastfeed their babies even though breastfeeding is ultimately the most cost-efficient practice. But breastfeeding may not be as easy as it appears: female workers often cannot afford sustained breastfeeding because their working environment or work routine do not provide them with the time and space for the practice.

UNICEF calls for support of national legislation and policies that provide women with paid maternity leave, breastfeeding breaks and other deserved benefits after birth.

UNICEF and WHO also launched the Baby-Friendly Hospital Initiative (BFHI) in 1991. This initiative essentially does not allow feeding bottles and cheap breast milk substitutes. The initiative proved highly successful. Cuba, for example, saw a three-fold increase in exclusive breastfeeding for four months in the stretch of only six years after making 49 of 56 hospitals or maternity facilities baby-friendly.

Countries also need more informed, supportive health-workers who encourage and assist with breastfeeding. Advocacy for breastfeeding like the World Breastfeeding Week also helps raise awareness.

“Now, as governments around the world develop budgets and action plans to achieve the Sustainable Development Goals, breastfeeding must be a policy, programming, and public spending priority,” WHO and UNICEF stated in 2016.

– Feng Ye
Photo: Flickr

Saving Premature Babies Globally with Scientific Research
Globally, an estimated 15 million babies are born prematurely, meaning they have completed less than 37 weeks of gestation. Scientific research throughout the years has been successful in saving premature babies on a global scale. For instance, India is a developing country whose focus is on saving the lives of preterm babies.

Achievements of Scientific Research Regarding Premature Babies

In 1953, researcher Dr. John Clements discovered that there was a way to save millions of premature babies around the world through his understanding of lung functionality. He found that a slippery substance, a surfactant, can help lessen the surface tension in the alveolar membranes. Therefore, scientists discovered that a lack of surfactant connects to human lung disease.

Another researcher, Dr. Mary Ellen Avery, in 1959, used Dr. Clements’ research to find that the lungs of premature babies cannot produce surfactant. Since then, saving premature babies globally has been made more possible through the FDA approval of five synthetic surfactants, which helps prevent respiratory distress syndrome in premature babies.

A recent innovative, surfaxin, was approved in 2012 and is a method to help with stopping the disease in premature babies. Dr. Clements say: “When we began this work back in the 1950s, the mortality from RDS was above 90 percent. Today, that mortality is 5 percent or less.” The original findings of Dr. Clements helped lead to a solution of saving the lives of preterm babies all over the world.

Premature Babies in India

Due to having the most significant number of premature babies in the world, the vast size and population of India can find hope through these scientific discoveries. In addition to this prevalence, one should also consider gestational age.

Usually, ultrasound imaging is completed in the first trimester. One thing that makes this hard is that ultrasound calls for training to receive the images accurately. This can be hard to do because ultrasound imaging is not practiced regularly; instead, the mothers are asked the date of the last period, which results in inaccurate assessments of the time of conception.

Increasing Affordability and Impact

Moving forward, a more affordable and recent hardware-software can be made possible through positive changes in the ultrasound hardware, such as modifications to the core technology.

An issue in this field is that there is consistently a lack of trained healthcare workers. Machine learning and development of software technologies have improved to combat this deficiency and reduce the need for trained healthcare personnel overall.

Recent discoveries have shown that a deficiency of selenium could be related to more preterm babies’ births. The researchers performed a genome-wide association study in an extensive database and combined it with independent data to acquire results.

Future Discoveries on the Horizon

Research is being done in Africa and Asia to see if such processes actually work. These areas are predominantly where selenium deficiency is present, but these tests could prove crucial to saving premature babies globally as selenium contains proteins present in body functions.

Preterm births are traced back to inflammation, and the body function of producing antioxidants prevents inflammation. This is one example of how scientific research can greatly impact studies on premature births.

In fact, scientific research has made it possible for successful progress to be achieved in India and all around the world when it comes to saving the lives of premature babies. All of these recent discoveries create a positive sense of hope around the world in the quest of ending the problem of premature babies. The world is getting closer day by day to having more babies born healthy.

– Kelly Kipfer
Photo: Flickr

Cost of Giving BirthFor something as common and essential as the creation of life, delivering a child can come at quite the cost. Though the United States holds some of the steepest delivery-related costs in the world, many countries around the globe offer maternal healthcare at astronomical prices. These services cater to wealthier families and leave the poor and uninsured to struggle. In rural and low-income communities especially, the high cost of giving birth is very risky for women and newborns.

In many countries, there is a large quality gap between public and private hospitals. Even though there are public hospitals in South Africa, for example, that offer free healthcare services, these facilities often lack adequate equipment and accommodations for mothers and their newborns. One hospital outside of Johannesburg lost six infants around three years ago because it had run out of antiseptic soaps.

Private health facilities typically offer higher-quality healthcare services but at much steeper prices. On average, it costs a woman $2,000 to give birth at a private healthcare facility in South Africa. This is a cost that less than half of South Africa’s population can afford due to large income inequality problem and a widespread lack of health insurance coverage. Families instead settle for menial care or, in some cases, forgo care altogether.

As an alternative to formal care, women commonly hire traditional birth attendants (TBAs) to help with deliveries in rural areas of developing countries like Ethiopia. TBAs lack official training but are more affordable than midwives, who can cost upwards of 2,000 Ethiopian birr, about $90, or even more if a Caesarean-section is necessary. The result is a population that is underserved when it comes to delivery-side medical attention. Only 2 percent of deliveries in rural Ethiopia are administered by a health professional.

Tadelech Kesale, a 32-year-old mother from Ethiopia’s Wolayta province, has suffered due to insufficient care and the exorbitant cost of giving birth. Kesale had her first baby when she was 18 and has since lost three of her six children, one of whom was stillborn. Kesale typically earns two to three birr, equivalent to a tenth of a dollar, each week and was unable to hire a qualified professional for any of her deliveries.

“I gave birth at home with a traditional birth attendant,” Kesale said. “If I could afford it, I would go into a clinic. One of my friends, Zenebexh, died in labor – she just started bleeding after breakfast and fell down dead. A healer came but couldn’t do anything.”

The cost of giving birth in private hospitals in India is similarly prohibitive. Although government facilities hospitalize women and assist with delivery for free, many expecting mothers opt for private facilities for the higher quality of care. These facilities typically charge around $1,165 for basic delivery services $3,100 for Caesarean-section deliveries.

The costliness of Caesarean-sections and other procedures can be deterrents for poorer mothers who are faced with complications during labor or pregnancy. The Guttmacher Institute estimates that only 35 percent of women in developing countries receive the care they need when faced with complications. When such needs go unmet, both mothers and their babies face life-threatening medical risks.

The costs of transport to and from health centers can also be discouraging for expecting mothers, forcing them to deliver at home or in other unsterilized spaces. In rural areas especially, transportation is necessary to travel the long distances to health centers, though it is not always readily available. Aside from being expensive, it can also be scarce; as a result, many women deliver in their houses. When complications arise during delivery, this can be especially perilous.

Though there is no one way to remedy the astronomical cost of giving birth in countries around the globe, organizations like Oxfam are calling on the U.S. and other developed nations to send increased aid to countries with high rates of maternal and infant mortality. This aid can serve mothers and their babies in a myriad of ways, from covering basic health care costs to making it more possible for new moms to take time off from work after delivery. Ultimately, it will mitigate the steep costs many families must meet during and after pregnancy, providing mothers with the assistance they need to have safe, successful deliveries.

Sabine Poux

Photo: Flickr


Many people falsely believe that increasing healthcare in the least Developed Countries (LDCs) will exacerbate the global population growth problem. In reality, the exact opposite is true.

Statistics show that as healthcare increases around the world, families have fewer children, driving down infant mortality rates as well as population growth. On average, birth rates in More Developed Countries (MDCs) are 1.7 children per family while in LDCs, birth rates average to 4.3 children per family. In LDCs families are having more children to compensate for high infant mortality rates. Parents plan to have around 5 children as an insurance policy, to offset the children that are lost. The World Health Organization, with the help of the Bill and Melinda Gates Foundation (BMGF), has been working to reshape this ideology since 1990. By increasing planned parenthood facilities, healthcare infrastructure, and vaccinations, families are able to have fewer, healthier children. In Lesser Developed Countries birthrates dropped to 2.6 children per family. Roughly 122 million children’s lives have been saved since 1990.

BMGF has found that the best management practice for raising global health is vaccination. Vaccination rates have gone from under 10 percent in 1980 to 80 percent in 2015 in LDCs saving countless lives from preventable diseases. This has been possible through the creation of Gavi, the Vaccine Alliance. Gavi is an international non-government organization that serves as the middleman between pharmaceutical companies and governments willing to fund vaccinations programs. According to Bill Gates, “Since 2000, Gavi has helped immunize 580 million children around the world. The US is a major donor to Gavi —with bipartisan support—along with the U.K., Norway, Germany, France and Canada. It’s one of the great things the rich world does for the rest of the world.”

While vaccinations are a great first step towards ending poverty, they have their limits. Malnutrition is another key barrier as it is linked to 45 percent of all child deaths. Children missing key nutrients experience both cognitive and physical growth stunting. This is a much harder problem in terms of economic efficacy. It costs one dollar to administer the pentavalent vaccine, which protects against five deadly infections.

Nutrition, on the other hand, is a much more costly and nuanced problem that will require considerable economic growth within the affected countries to truly fix. The Bill and Melinda Gates Foundation philanthropic work has been indispensable to halving global extreme poverty since 1990.

Josh Ward

Photo: Flickr

Nepalese Newborns and Chlorhexidine: Match Made in Heaven
Every year, thousands of Nepalese newborns die due to various life-threatening infections contracted early on that go unaddressed. Currently, one in 19 Nepalese children dies before they reach the age of five and half of that number die before reaching even 28 days of life.

Finding successful ways to nurse newborns to health in Nepal has been a challenge for decades. Navel Glazers, a simple topical application of chlorhexidine digluconate (CHX), are helping to pave the way to a brighter future for Nepalese children.

The application of CHX has been used in health care settings to reduce the development and transmission of infections for a number of years now. However, due to limited support regarding its effectiveness in reducing newborn umbilical cord infections, it is not a widely known practice.

Per the recommendation of the World Health Organization (WHO) more studies have been done to assess the navel-glazing strategy, specifically in high-risk environments like Nepal.

Country-wide clinical trials of CHX application post-birth were rolled out in Nepal through the support of the National Institutes of Health, the Bill and Melinda Gates Foundation and USAID.

It was found that applying a 4 percent chlorhexidine solution to the umbilical cord after birth significantly reduced neonatal mortality.

“This is very important because, after its implementation, the number of infected umbilical cord cases in my facility declined,” explains Birendra Ghale, a health worker in charge of this peripheral-level health facility in Banke, Nepal. “I have also seen that fewer babies are dying in my VDC [village development committee].”

For a long time, cultural barriers kept the implementation of the newly-found, life-saving technique from being used. Nepalese mothers are accustomed to applying substances like turmeric, ash, cow dung or vermilion to their child’s umbilical cord post-birth.

Now, single-dose tubes are freely distributed to all expectant mothers in their eighth month of pregnancy. They also receive a one-on-one educational session to explain how to apply the gel after cutting the cord as well.

Chlorhexidine has rolled out to 26 of 75 districts in Nepal as of July 2012. The country’s government has committed to incurring the full expense of buying the commodity as well as other program costs from its own resources. They are even using a local manufacturer to help with a production of a high-quality product, and distribution continues to rapidly expand — mainly through community health workers.

Delegates from more than 20 countries learned from Nepal and its implementation of the program. At least five of those countries have implemented similar interventions.

According to the Healthy Newborn Network (HNN), the application of CHX is recognized as being successful, acceptable, feasible and cost-effective newborn care intervention. The widespread practice of CHX cord cleansing, or navel glazing, could prevent more than 200,000 newborn deaths each year in South Asia.

Keaton McCalla

Photo: Flickr

Reduce Neonatal Deaths
The United Nations World Health Organization (WHO) has recently released three new publications that will help strengthen knowledge on how to prevent stillbirth and neonatal deaths. These publications are aimed to assist countries as they develop their classification, analysis and investigation processes on unreported deaths.

Over 2.7 million babies die within the first month of life, according to the U.N. health agency. Another 2.6 million are stillborn, and over 300,000 women die during childbirth. Most of these deaths are preventable if paired with the appropriate health care.

“By reviewing the causes of maternal and infant deaths, countries can improve quality of health care, take corrective actions and prevent millions of families from enduring the pain of losing their infants or mothers,” stated the Director of Health and Research at WHO, Ian Askew.

When a baby is stillborn, they are not recorded in either a death or birth certificate. Therefore, many of the above numbers are an underestimate of the true amount of stillborn and newborn deaths. Countries are unable to truly investigate these deaths and find out appropriate prevention methods for future cases. This is why WHO decided to improve education efforts for countries by releasing these three new publications:

  1.  “WHO Application of the International Classification of Disease-10 to deaths during the perinatal period.” This publication aims to help countries link certain stillbirths to relevant causes. Such causes could be conditions like diabetes or hypertension in the mother. Before this recent publication, there was no classification system that would help countries record this information.
  2. “Making Every Baby Count: Audit and Review of Stillbirths and Neonatal Deaths.” This will be a guide to assist countries’ investigation of deaths, allowing them to develop solutions for future cases. It will incorporate the above classification system to publish a basic review of every stillbirth death. According to Anthony Costello — WHO’s director of maternal, children’s and adolescent’s health — every death review gives valuable information about what can be done in the future to prevent a child’s life from being lost.
  3. “Time to Respond: A Report on the Global Implementation of Maternal Death Surveillance and Response.” This will help strengthen countries review process of deaths in hospitals and clinics. It also details guidelines for hospitals to better improve their quality of care. WHO recommends hospital committees to meet at least twice a year. They also suggest conducting mortality audits and reviews of their past patients.

To strengthen other countries’ health information systems, WHO is partnering with more than 30 other global health organizations in hope of developing a more easily understood package of guidance and tools for countries to prevent neonatal deaths.

Katie Grovatt

Photo: Flickr

AIRBreathing problems are at the root of 1.8 million stillbirths and neonatal deaths that occur every year. Many of these deaths could have been prevented if health facilities had adequate equipment and proper training programs available.

Having worked with over 1,000 healthcare providers in Uganda’s Helping Babies Breathe (HBB) program, Dr. Data Santorino is intimately familiar with this issue. Alongside Kevin Cedrone, Craig Mielcarz and Dr. Kristian Olson, Dr. Santorino developed the Augmented Infant Resuscitator (AIR) as an inexpensive and effective solution.

AIR is an add-on to already existing emergency ventilation equipment that provides real-time feedback to birth attendants. The feedback incorporates both an assessment of the quality of emergency ventilation administration and “actionable cues” for users to take up.

These cues are vital to the babies under neonatal care. They not only help users improve their performance but also build their confidence in the abilities that they have to care for the newborn.

Because the feedback also helps to improve skills, AIR alleviates former inadequacies in neonatal resuscitation training. With the device, users can put their skills to use while also learning and maintaining proper practices.

AIR may prove especially helpful in developing countries where proper equipment is often too costly or inaccessible and training of healthcare professionals remains seriously insufficient.

Currently, birth attendants administering emergency assisted ventilation will periodically stop the process in order to manually check and monitor the baby’s heart rate. This interruption within the first “golden minute” after a baby is born could prove detrimental, according to Santorino, as the lack of oxygen could either kill the baby or cause other health issues such as brain damage.

As the first place winner for the best pitch at the Boston Children’s Hospital Innovation Tank, AIR continues to be developed and improved. Its first deployment is projected for January 2017.

Jocelyn Lim

Sources: Elsevier, Augmented Infant Resuscitator, Boston Children’s Hospital, MIT Ideas Global Challenge
Photo: Flickr