Monthly Archives: September 2011

More Education and Training Needed to Save Newborns

The Guardian

Sarah Boseley; August 31, 2011

Newborn deaths put millennium development goal under threat

As more older children survive, slower progress in cutting death rates among babies in the first weeks of life is putting the goal of reducing child deaths by two-thirds in jeopardy

Children under the age of five are increasingly likely to survive in poor countries, as efforts to reach millennium development goal 4 (reducing child deaths by two-thirds) pay off. But newborns are still at high risk – and a new study shows that the slower progress in cutting death rates among babies in the first weeks of life is putting the goal in jeopardy.

More than 8 million children die before they reach the age of five, but as more older children survive an increasing proportion of those deaths – now 41% – are among neonates (babies less than four weeks old).

Tiny babies are very vulnerable. They die because they are small and frail after premature delivery (29%), from asphyxia during birth, or from severe infections such as blood poisoning and pneumonia. Many would survive if they were delivered by a trained midwife, but these are in short supply.

“The global health worker crisis is the biggest factor in the deaths of mothers and children, and particularly the 3.3 million newborns dying needlessly each year. Training more midwives and more community health workers will allow many more lives to be saved,” says Dr Joy Lawn of Save the Children’s Saving Newborn Lives programme, a co-author of the report that SCF has produced with the World Health Organisation and the London School of Hygiene and Tropical Medicine.

The report, published on the open access website PLoS Medicine, is the most comprehensive estimate yet of the death toll among newborns worldwide over a 20 year period, from 1990 to 2009. The researchers find that newborn mortality dropped by 28% – but that was much slower than the drop in maternal mortality (34%) and the deaths of older children under five (37%).

“Newborn survival is being left behind despite well-documented, cost-effective solutions to prevent these deaths,” says Dr Flavia Bustreo, WHO assistant director general for family, women’s and children’s health. “With four years to achieve the millennium development goals, more attention and action for newborns is critical.”

“We know that solutions as simple as keeping newborns warm, clean and properly breastfed can keep them alive, but many countries are in desperate need of more and better-trained frontline health workers to teach these basic lifesaving practices.”

The study authors urge more focus on newborn survival. “National governments, international organisations, non-governmental organisations, and other international health bodies must increase investment in care at birth and the first few weeks of life within existing health programmes, adding targeted interventions especially at the time of birth. The majority of neonatal deaths could be prevented with existing interventions, including some that can be delivered at community level with potential to reduce neonatal deaths by one-third, such as improved hygiene at birth, breastfeeding, and simple approaches to keeping babies warm,” they write.

“Maternal health programmes and child health programmes are beginning to place greater emphasis on newborn survival, but major missed opportunities remain even in existing programmes – for example, midwives who are not trained and equipped for simple newborn care and neonatal resuscitation. Many of the 79 million babies who died in the neonatal period since 1990 were born with little or no access to health
services and in settings with little health information to drive health system improvement.

“If MDG 4 is to be achieved, and this needless loss of life prevented, it is essential that national governments, international agencies and civil society increase attention to systematically preventing and tracking neonatal deaths.”

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September 13th, 2011||0 Comments

Ongoing Need for Cholera Education in Haiti

Press Release from the Center for Economic and Policy Research
Date:  August 18, 2011
Contact:  Dan Beeton, 202-239-1460
Web address:  http://www.cepr.net/index.php/press-center/

Thousands of Lives Could Be Saved, and Haiti’s Cholera Epidemic Managed, With Greater Treatment and Prevention Efforts, CEPR Paper Finds

Recent Cholera Spike Was “Entirely Predictable,” Yet Treatment Efforts Fell Off

Washington, D.C.  A new paper from the Center for Economic and Policy Research argues that cholera treatment and prevention efforts in Haiti have fallen woefully behind, leading to thousands of preventable deaths, even though the dramatic rise in new cases this spring and summer was entirely predictable. The paper, “Not Doing Enough: Unnecessary Sickness and Death from Cholera in Haiti”, by researchers Jake Johnston and Keane Bhatt, argues that it is not too late to bring the 10-month old cholera epidemic under control and save thousands of lives by ramping up treatment and prevention efforts.

“Haiti’s cholera epidemic has been much worse than it could have been, and thousands more people have died, due to an inadequate response from the international community, going back to when the outbreak began,” CEPR Co-Director Mark Weisbrot said. “It’s time to reverse course and get serious about controlling and eventually eliminating cholera from Haiti.”

“In July 2011, one person was infected with cholera almost every minute, and at least 375 died over the course of the month due to an easily preventable and curable illness,” the paper notes. A March 2011 article in the medical journal The Lancet predicted that cholera infections would spike with the onset of the rainy season following a drop-off during the drier months of late 2010 and early 2011. Yet overall cholera efforts were scaled back just as infections were increasing: only 48 nongovernmental organizations (NGOs) were addressing cholera in July, down from 128 in January.

As predicted, new cholera infections increased with the onset of the rainy season this year, reaching an average of 1800 new infections per day in June — almost twice as many as in May and three times as many as in March and April, the paper notes.

The paper also notes that NGO’s and international agencies have targeted urban centers over rural areas, despite the anticipated spread of the disease to all corners of Haiti, and significantly higher case fatality rates in some rural areas. The department of Sud Est, for example, currently has the highest fatality rate, at 5.4%, but no Cholera Treatment Centers.

The authors recommend several ways in which the cholera epidemic could be brought under control — and thousands of lives saved — including expanding the reach of inpatient facilities in the hardest-hit areas, scaling up antibiotic and supplement treatment efforts, prevention and care through education campaigns, and a vaccination strategy. International donors also have fallen far behind on their pledges for cholera assistance.

The paper outlines a number of other factors that contributed to the severity of the epidemic, one of the most important being the relative scarcity of potable water in Haiti. The authors describe various ways in which public water systems have been under-funded and implementation delayed by the international community, while some donors have pushed instead for “cost recovery” water systems in camps for internally displaced persons (IDP’s) and elsewhere. These would require residents to pay for potable water, and likely lead to an increase in cholera infections as potable water would be put out of reach of IDP’s and other low-income Haitians.

“Safe, clean drinking water for all Haitians should be a top priority for international donors,” Weisbrot said. “And if it had not been so neglected years ago, when loans for this purpose were blocked by the United States, the severity of this outbreak might have been drastically reduced.”

The paper’s lead author, Jake Johnston, added: “The money is there: the U.S. Congress appropriated $1.14 billion for Haiti a year ago, and most of that money has not been spent; and a lot of the $1.4 billion that Americans gave to private charities after the earthquake — including the biggest organizations such as the American Red Cross — also remains unspent. And there are also hundreds of millions of dollars of
international aid that were pledged by governments but not yet delivered. These funds can be used to expand treatment and prevention of cholera in Haiti, and to build the necessary water infrastructure.”

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September 1st, 2011||0 Comments
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