The lives of more than a million babies a year could be saved in the developing world if mothers had access to simple, inexpensive health measures such as vitamins, antimalarials and aspirin, according to a new report. analysis.
The study, centered on the ‘silent public health disaster’ of babies born ‘too small or too soon’, comes as the United Nations warns that progress in reducing newborn deaths and stillbirths has stalled since 2015, and that unequal and underfunded antenatal care is partly to blame.
The authors of the analysis, published in The Lancet, estimate that 476,000 newborn deaths and 566,000 stillbirths could be averted each year if a handful of predominantly prenatal measures were fully implemented in 81 low-income or intermediate.
Globally, the number of neonatal deaths – babies who die within 28 days – has more than halved in the three decades between 1990 and 2020, from 5 million to 2.4 million. But in the developing world, particularly in sub-Saharan Africa and South Asia, the numbers remain high.
A UN report released this week shows that the pace of progress has stalled since 2015 due to dwindling investment, with each year since leading to more than 2 million newborn deaths and 1.9 million stillbirths (ranked by the World Health Organization as babies who die after 28 weeks of pregnancy).
“If we want to see different results, we have to do things differently,” said Dr Anshu Banerjee, WHO director for maternal, newborn, child and child health and aging. the teenager. “Bigger and smarter investments in primary health care are needed now to ensure that every woman and baby, wherever they live, has the best chance of health and survival.”
Many, if not all, of the measures recommended in the Lancet series are already being used in high-income countries, from helping pregnant women quit smoking to giving them aspirin when at risk. high for pre-eclampsia. But they are not used routinely in many places, especially in countries where health systems are under enormous strain from humanitarian emergencies, such as Afghanistan or South Sudan.
The UN report found that less than 60% of women in the worst-affected countries received even four of the eight WHO-recommended prenatal checks.
Despite the scale of the challenge, the cost of rolling out the measures across the 81 countries would be around $1.1bn (£870m), the authors say, an amount described by one as “a fraction ” what other health programs receive. Yet the impact could be enormous, they say, potentially preventing 5.2 million babies a year from being born preterm, small for gestational age or with low birth weight (defined as less than 5.5 lbs. ).
The authors – a group of professors specializing in various aspects of infant or maternal health – create a new umbrella term for these babies: vulnerable small newborns, or SVN. They calculate that, of the 135 million babies born alive in 2020, one in four (35.3 million) would have met the criteria to be SVN.
“Our very first estimates on this subject show that the problem of vulnerable newborn babies is larger than previously thought and is a silent public health disaster affecting the entire life cycle. life, reducing human capital and hampering national economies,” said Joy Lawn, co-lead. author and Professor of Maternal, Reproductive and Child Health at the London School of Hygiene & Tropical Medicine.
Lead author Per Ashorn, professor of pediatrics at the University of Tampere in Finland, called on national governments, as well as partners and donors, to act and invest urgently. “Despite several global commitments and targets to reduce SVN outcomes since 1990, one in four babies worldwide is ‘born too small’ or ‘born too early,'” he said.
“Our series suggests we already have the knowledge to reverse the current trend and save the lives of thousands of babies a year at a cost of $1.1 billion, a fraction of what other health programs receive. We need national actors, with global partners, to urgently prioritize action, advocacy and investment.
In 2020, the authors calculate that more than half of all neonatal deaths worldwide were attributable to babies being NVS. “By failing to address this priority, we are jeopardizing our collective future,” they write.