Saving newborn lives

Better services and awareness can end preventable deaths

Ayedatujannah Tahiat at the Special Care Newborn Units (SCANU) of the Institute of Child and Mother Health in Dhaka, Bangladesh
UNICEF/UN0188860/Njiokiktjien VII Photo

The challenge

Bangladesh has one of the highest rates of newborn death in the world

Bangladesh has emerged as a development icon after reducing deaths of children below the age of five, meeting the global target four years ahead of time.

But the number of newborns dying in Bangladesh is still very high at 62,000 every year.

This is one of the highest in the world. All these occur in the first month of life and half within the first day of life.

The main causes of newborn deaths in Bangladesh are prematurity, sepsis and conditions arising from complications around delivery, like asphyxia.

Stillbirth rates are also alarmingly high, with nearly 230 cases every day. But many cases are never recorded and many conditions behind such loss of life remain unknown.

In addition, about 5,200 women in Bangladesh die every year due to complications during pregnancy, delivery and the period following birth.

Most of these deaths happen due to mothers delivering babies at home by unskilled birth attendants. Mothers also die because there is a lack of proper and round-the-clock emergency obstetric care at hospitals, clinics and health centres.

প্রতিবছর জন্মের পর মারা যায় ৬২ হাজার নবজাতক  

62,000 newborns die every year  

প্রতিবছর বাংলাদেশে প্রায় পাঁচ হাজার ২০০ নারীর মৃত্যু হয় গর্ভকালীন, প্রসবকালীন এবং সন্তান জন্মের পর সৃষ্ট জটিলতায়

5,200 mothers die over giving birth every year 

প্রতিদিনি মৃতসন্তান প্রসব হারও উদ্বেগজনক, প্রায় ২৩০টি ঘটনা ঘটে এ ধরনের

230 stillbirths take place every day 

Poor nutritional status of pregnant mothers and early pregnancies lead to low birth weight of infants. Low-birth-weight babies, who comprise 13.2 per cent of all births, have less chances of survival and development. When they do survive, they are more prone to disease, growth retardation and impaired mental growth.

The risks may apply more to adolescent mothers, because 29 per cent of all Bangladeshi girls are malnourished and severely lack essential elements for proper body functioning. Twice as many newborn deaths occur among very young pregnant women.

Because child marriage is still common, Bangladesh has one of the highest adolescent birth rates in the world, that is 113 per 1,000 live births.

The children of mothers who are less educated are more vulnerable, have less access to health care and evidence shows that they are more prone to life-threatening diseases.

Of three pregnant women, only one seeks essential care in the hands of professionals.
Of three pregnant women, only one seeks essential care in the hands of professionals.

Mothers must see a doctor at least four times during pregnancy and four times after giving birth. But only 1 in 3 mothers complete the four vital visits before delivery

Mothers of children in urban slums have even less access to health care. Because these women are mostly occupied with poor-paid jobs that make access to basic services difficult.

Health challenges in urban slums are particularly acute because knowledge and use of essential newborn care practices there remain very low.

Despite the barriers, Bangladesh now has a new global target to reach. By 2030, the number of newborn deaths must be reduced to at least 12 per 1,000 live births. The current newborn mortality rate is 20 per 1,000 live births.

Saving newborns require more efficient and round-the-clock delivery of essential health services, more skilled professionals and significant community engagement for adapting good hygiene and health practices.         

A greater focus is also needed for reducing disparities to eliminate geographic, gender, social and economic divides.

The highest child mortality rate is found among mothers with no education. The child mortality figure traced back to uneducated mothers is double compared to mothers with secondary education or higher.

The solution

Eighty-eight per cent of these deaths are preventable

UNICEF recognises that the leading causes of newborn deaths are largely preventable.

To keep every child alive, UNICEF focuses on providing the ‘newborn bundle’, which contains four essential elements.

People, meaning health workers with adequate skills for maternal and newborn care, available round the clock.

Place, meaning facilities that are clean and safe for giving birth.

Products, meaning Special Care Newborn units with life-saving equipment and commodities.

Power, meaning communities that are empowered to take the right action for newborns and mothers.

Care during labour, delivery and the first week of life have the greatest impact on ending preventable neonatal deaths and stillbirths. Special care for small and sick newborn is also highly essential for saving lives.

UNICEF interventions are designed to be highly effective, low-cost, scalable and inclusive for serving the most deprived.

Universal coverage of such high-quality interventions can save over 55,000 newborn lives, prevent over 5,000 maternal deaths and prevent over 80,000 stillbirths every year.

In health facilities, UNICEF promotes handwashing with soap by mothers and professionals because good hygiene practices can reduce neonatal deaths by 44 per cent and Acute Respiratory Infections by 25 per cent.

In 2013, the Bangladesh government pledged to end preventable child deaths by 2035 under the international initiative on child survival -- A Promise Renewed.

It has since renewed its commitment by developing the Bangladesh Every Newborn Action Plan and is implementing the plan through the National Newborn Health Programme.

Establishing SCANUs in 36 districts and in four regional medical college hospitals has demonstrated an effective model for managing sick newborns with serious complications and needs to be scaled up in all 64 districts

UNICEF provides technical support to the government’s plans by strengthening services, focusing on optimum coverage, emergency obstetric care and increasing the number and capacity of Special Newborn-care Units or SCANUs.

UNICEF is introducing Kangaroo Mother Care for sick and low-birth weight babies in medical colleges, district hospitals and Upazila health complexes. 

UNICEF also supports the government’s National Newborn Campaign to empower communities to take action for essential newborn care. 

UNICEF also works to strengthen services for the prevention of mother-to-child transmission of HIV and for early infant diagnosis and treatment of HIV.

In immunisation, UNICEF supports the extension of the cold chain system, improving effective management of vaccines and reaching deprived communities in urban slums and hard-to-reach areas.

Immunisation contributed to the substantial reduction of U-5 child mortality, and is now being strengthened further by UNICEF for securing more young lives.

UNICEF believes reducing the risk to newborns provides the basis for Early Childhood Care and Development, as well as for child health as a whole.