In Ghana, reducing newborn deaths is key to achieving MDG 4
By Madeleine Logan
SAVELUGU, Ghana, 9 October 2013 - Maybe Baby Suale should have been called ‘Lucky’ at the customary naming ceremony, held seven days after her birth.
She was underweight when she was delivered by cesarean section in Savelugu-Nanton Municipal Hospital on August 26. Her low birth weight put her at risk of hypothermia, infection and difficulty in breathing.
If she was born a few days earlier, her family’s only choice would have been to travel to the northern capital, Tamale, for intensive care. But she was lucky she was born the day before a Newborn Intensive Care Unit (NICU) was set up at Savelugu-Nanton Municipal Hospital – one of six new units in Northern Ghana. Thanks to the new unit, she was able to be treated in a baby warmer at the NICU of the hospital where she was born.
On August 28, the Ambassador of Japan travelled to Savelugu-Nanton Municipal Hospital to launch one of six newborn intensive care units, which will bring specialist care closer to sick babies in the Upper East and Northern regions. The units include resuscitation tables, phototherapy machines, baby warmers and suction machines, oxygen concentrators and infusion pumps which equip hospital staff to treat the three main killers of newborns - prematurity, birth asphyxia and infections.
Before the newborn intensive care units were launched, the Northern and Upper East regions (total land area of nearly 80,000 sq kilometres) relied on just one newborn intensive care unit at Tamale Teaching Hospital.
No child should die in their first month of life. But in Northern Ghana that is exactly what is happening. Out of every 100 babies who are born in the Northern Region, four die before they are 30 days old. Sixty per cent of infant deaths in Ghana happen in the first month of life, and the country will not meet the Millennium Development Goal for reducing child mortality if the country doesn’t reduce newborn deaths.
The $2 million Japan-UNICEF Partnership for reducing maternal and child deaths in Northern Ghana provides the equipment and training necessary to give all babies the chance of life.
“These newborn intensive care units will improve the quality of newborn care at hospital level, and complement improvements to newborn care in communities,” His Excellency the ambassador Naoto Nikai said.
Community approaches to newborn care
The Newborn Intensive Care Units complete the strengthened referral pathways from houses, to clinics, to hospitals.
Last year, the EMBRACE partnership trained nurses and health volunteers in communities to identify babies with early danger signs and refer them to the closest clinic or hospital. With basic newborn care kits in hand, they visit newborns in their homes at least three times during their first month of life. In the first half of 2013, community health nurses carried out 3,129 home visits in the Northern Region. They identified and referred 113 sick babies.
The Ambassador of Japan and the team from UNICEF travelled to Moglaa clinic to see the impact of this work. They met Community Health Nurse Christiana Aduku, who last month conducted 10 home visits. She referred two cases to Savelugu-Nanton Municipal Hospital – one of the babies had neonatal jaundice and the other had difficulty breathing.
Sadia Abdul Rachman delivered her baby Falira at the Moglaa Clinic two weeks before the visit. Since then, baby Falira had been visited twice at her home by nurses and taken once to post-natal care at the clinic.
“This is my fourth delivery, and I never had this level of care before for my baby. I feel important when the nurse visits me,” she said.
This community-level intervention was introduced after a study by the Kintampo Health Research Centre found only 20% of mothers of neonates who died at home sought care from a health care provider during their baby’s illness. Health workers and volunteers need to actively seek out sick newborns if they are going to reduce these invisible deaths.
Having an impact on newborn deaths
UNICEF Representative Susan Namondo Ngongi said that UNICEF would continue its work to make sure that newborns not only survived, but that they grow up in communities with good sanitation and safe water; they are well-nourished, they go to school, and they are protected from abuse and exploitation.
“We are confident we will see a significant reduction in newborn deaths in the next 3-5 years, thanks to this program,” Ms Ngongi said.
“Babies deserve every chance to survive. Now they have it.”