World Prematurity Day 2019 on Sunday
Bangladesh has managed to curb the premature deaths in recent years, according to the United Nations (UN).
Although the deaths caused by communicable diseases have decreased over the past years, the death of premature babies is still a concern for the authorities.
Even a few years ago, Bangladesh was a country where communicable diseases were responsible for the death of many newborn babies. But with the recent awareness programs by different organizations, about how to take care of neonates, mortality rate of infants from communicable diseases have decreased noticeably.
When asked, DGHS officials said more than 3 million children are born every year in Bangladesh, and very few die of communicable diseases
Though, death from premature birth now tops the list. Out of 3 million children born every year in Bangladesh some 0.6 million are born premature, and out of that 0.6 million premature births 20,000 infants die, said UN.
According to 2018 UN estimation, the newborn mortality rate in Bangladesh is 18 per 1000 infants.
Dr Shamim Jahan, director of Health, Nutrition & HIV/AIDS, Save the Children, said the number has decreased in comparison to 2016 as 23620 infants died due to premature birth that year.
The UN estimation said that complications of premature birth is the cause for it to top the list of infant deaths.
Experts opined that this situation has not been addressed for a long time, resulting in such number of deaths in the country.
Though, experts themselves are still unaware of the real reason as to why premature birth tops the list for infant mortality.
Professor Dr Begum Sharifun Nahar, head of Neonatology department of Sir Salimullah Medical College and Mitford Hospital, said “A premature child do not live for long, as most of the time the infant’s vital organs are not completely developed, and they suffer from lung problems, which leads to breathing issues. In conjunction with low birth weight, feeding disorders and hypothermia causes the death of premature infants. “
But she added that many of these issues can be avoided if people are more aware of the procedure, and the baby is taken care of by proper doctors, and nurses who have good knowledge about premature birth related issues, she added.
A miracle touch keeps child breathing without stress
When Popy (25) became pregnant for the second time, her family became very cautious, as she went through a miscarriage two years back.
She was married at the age of 20 and when she first conceived at 22. In her second pregnancy she was supposed to give birth to twins.
But her joy turned into tears, as the low birth weight caused death to one of her children ten days after their birth on October 29, following their premature birth weight of only 1500 grams. The babies had breathing difficulties along with other health hazards.
Her child was given treatment at NICU of Mitford Hospital, and later given to her as part of KMC.
“You can’t explain the feelings of its breath, when it takes its food from you. It seems like the world started living on my chest,” Popy told the reporter.
Professor Dr Begum Sharifun Nahar said KMC, a method of contacting a skin–to–skin contact between a mother and her newborn facilitating frequent or exclusive breastfeeding, and early discharge from the hospital has been effective in reducing the risk of mortality among preterm, and low birth weight infants.
“KMC helps the children to be stress free, and easiest breast feeding process. We have witnessed that the child going through KMC treatment have good growth, more sleep, less infections, and control temperature lessening chances of hypothermia,” she said.
Dr Shamim Jahan director - Health, Nutrition & HIV/AIDS, Save the Children said: “As part of their objectives to make Bangladesh controlling deaths from premature birth, Save the Children is providing assistance in capacity building, establishing a monitoring system, and by providing technical assistance to the government for effective implement of KMC.”
Government initiatives to end premature birth
Dr Shamim Jahan said Bangladesh is at the seventh position among the top 10 countries with the largest numbers of preterm births, and deaths.
In the course of changing paradigm of diseases that are causing neonatal deaths, without controlling premature deaths, achieving SDGs new global target to end preventable newborn, and child deaths by 2030 (SDG 3.2) would never be possible, he said, adding that the theme for World Prematurity Day 2019 has put forth our course of action rightly -- ‘’Born Too Soon: Providing the right care, at the right time, in the right place.”
Recognizing premature birth and death as a matter of concern, Dr Shamsul Haque, line director of Mother Neonatal Care and Adolescent Health (MNC&AH) under Directorate General of Health Services (DGHS) said, under the fourth sectoral program DGHS has established some 42 Special Care Newborn Units (SCANU) in tertiary, and district level hospitals.
Besides, as part of keeping the child alive, government has taken KMC as a trusted way, and have already established 132 centres in tertiary, district, and upazila level government hospitals. Besides, the private hospitals have also been asked to use the method.
The government started the programme (January 2017-June 2022) with an aim to reduce the newborn mortality rate to under 12 per 1,000 live births by 2030.
Directorate General of Family Planning (DGFP) and Directorate General of Health Services (DGHS) under the Ministry of Health and Family Welfare are implementing the programme at a cost of around Tk 422 crore.
To meet the manpower problem, necessary training are being provided to pediatric specialists, and nurses in the hospitals, as many as they can. So that, wherever the doctors are transferred, they could continue the process.
“The government has planned to establish SCANU in every district, and all the upazila would have the facility of KMC treatment within 2022,” the line director stressing the need for creating awareness among rural people regarding premature births.
About KMC he said it is a very low cost treatment, and costs almost nothing. Besides, it takes only Tk 85,000 to set up a two bed unit.
The early result of KMC methods has made them hopeful of the fact that it would play a key role in preventing premature birth, and infant death in the country within the timeline they targeted, he added.