Although the neonatal mortality rate across the globe has been consistently decreasing, neonatal death is still common in many regions. According to the World Health Organization (WHO), annual infant deaths were at an all-time low of 4.1 million deaths in 2017, decreasing from 8.8 million in 1990. However, the death rate in Africa is over six times higher than it is in Europe, illustrating a severe disparity. As such, there is still much more that people can do to lower neonatal mortality rates. One potential solution is chlorhexidine, which reduces neonatal mortality.
How Chlorhexidine Reduces Neonatal Mortality
To combat mortality rates, Save the Children and governments in Nepal and Nigeria have implemented chlorhexidine, an antiseptic found in mouthwash. When used to clean the umbilical cord as soon as possible after birth, chlorhexidine reduces neonatal mortality by preventing infection in newborns, which is among the top drivers of neonatal deaths across the globe. Save the Children and pharmaceutical company GlaxoSmithKline (GSK) partnered to create a chlorhexidine gel to distribute in wrapped pouches. Save the Children noted that this gel “was developed to be suitable for use in high temperatures, useful in sub-Saharan Africa and [South] Asia where the risk of newborn infections is high and temperatures are hot.”
Chlorhexidine gel has become wildly popular in Nepal, where USAID created the Chlorhexidine “Navi” Care Program to distribute chlorhexidine gel. In Nepal, around half of deliveries happen at home, making newborns even more exposed to infection if they are not delivered in a clean environment. In fact, a large majority of deaths in Nepal occur within the first month of life. Moreover, infections cause half of those deaths. In Nepal, chlorhexidine has reduced neonatal mortality by 24% and decreased the rate of infections in newborns by 68%. The Chlorhexidine “Navi” Care program’s objective aims to distribute chlorhexidine gel to all 75 districts of Nepal.
The Lifesaving Effects of Chlorhexidine
Nepal is not the only country to see chlorhexidine reduce neonatal mortality rates. Nigeria, one of the most populous countries in Africa, has also seen success. Its neonatal mortality rate has dropped from 48 deaths per 1,000 births in 2003 to 37 deaths per 1,000 live births in 2013. According to many estimates, infections cause at least one-third of newborn mortalities in Nigeria. In March 2016, Nigeria created a plan to scale-up the use of chlorhexidine to lower neonatal mortality rates. If this program succeeds, it will save 55,000 infants. Although this scaling up program started slowly, the Nigerian government has committed to continuing the use of chlorhexidine to prevent infection and fatalities. To do so, it has a plan in place to help local governments achieve their goals.
Across the globe, there are large imbalances in neonatal mortality rates. Countries like Pakistan, Afghanistan and Somalia have a much higher neonatal death rate than countries such as Australia, Canada or China. In developing countries where poverty rates are higher, neonatal death skyrockets due to a lack of resources. This simple, cheap and over-the-counter chlorhexidine gel is saving lives across the globe. As chlorhexidine becomes even more accessible to every community, it is hopeful that neonatal deaths will continue to decrease.
– Hannah Kaufman