DHAKA, June 24, 2018 (BSS/UNICEF FEATURE) – A child’s risk of dying is the
highest in the first 28 days of life while improving the quality of antenatal
care at the time of birth and postnatal care for mothers and their newborns
are very essential to prevent these untimely demise.
Globally, 2.6 million children died in the first month of life in 2016.
There are approximately 7, 000 newborn deaths every day, amounting to 46% of
all child deaths under the age of 5-years, said the World Health Organization
(WHO) in a report.
The priority that most low-income countries give to neonatal mortality, now
constitutes more than 40% of deaths to children younger than 5 years, is a
stumbling block to the world achieving the child survival Millennium
Development Goals (MDGs). Bangladesh is an exception to this attention
proving itself able enough to bring down the rate of infant mortality.
In Bangladesh, the infant mortality rate went down by 73% in the past 2.5
decades, a UNICEF report said. During this period, the world has made a
significant progress in saving the young children’s lives. Bangladesh has
experienced a significant reduction of child mortality over this period,
which has helped achieve the Millennium Development Goal 4 (MDG 4) target.
But the mortality among the under-5 children must be further reduced for a
substantial effort to achieve the Sustainable Development Goals (SDGs)
target, reads the report suggesting, at this stage it is hence important to
explore the trend and determinants of under-5 mortality to reduce the
vulnerability of child’s survival.
The frailty models revealed that the combined effect of birth order and
preceding birth interval length, sex of the child, maternal age at birth,
mother’s working status and parental education were the important
determinants associated with the risk of child mortality. The risk of
mortality also varied across divisions with Sylhet being the most vulnerable
one.
Generating more Political Priority for Neonatal Mortality Reduction in
Bangladesh is earnestly necessary as the political scientists have a long-
standing interest in how and why some issues come to attract the attention
and resources of the policymakers.
The social scientists who investigate health policymaking in low-income
countries like Bangladesh also have considered agenda-setting processes in
this important field.
According to WHO, Bangladesh has registered a substantive acceleration,
experiencing a remarkable change in child mortality rates over the last few
decades. Although, WHO says, child mortality rate is decreasing over time,
Bangladesh has to further reduce child’s death to obtain the Sustainable
Development Goals (SDGs).
Within the first month, up to half of all deaths occur within the first 24
hours of life, and 75% occur in the first week. The 48 hours immediately
following birth is the most crucial period for newborn survival. This is when
the mother and child should receive quality follow-up care to prevent and
treat illness.
The report said preterm birth, birth asphyxia or lack of breathing at
birth, and infections cause most neonatal deaths. From the end of the
neonatal period and through the first 5 years of life, the main causes of
death are pneumonia, diarrhoea and malaria. Malnutrition is the underlying
contributing factor, making children more vulnerable to severe diseases.
At the time of birth, a baby’s chance of survival increases significantly
with delivery in a health facility in the presence of a skilled birth
attendant. Identifying and caring for illnesses in a newborn is very
important, as a baby can become very ill and die quickly if an illness is not
recognized and treated appropriately.
In the report, the WHO essentially stressed upon providing warmth for the
newborns as they are wet from the amniotic fluid and can easily become cold.
Drying the baby and using warm blankets and heat lamps can help prevent heat
loss.
Placing a baby skin-to-skin on the mother’s chest or abdomen also helps to
keep the baby warm. This early skin-to-skin contact also reduces crying,
improves mother-infant interaction, and helps mothers to breastfeed
successfully.
According to another UNICEF report, the Every Newborn Action Plan (ENAP)
calls for an increased focus on the time around birth with targeted high
impact interventions as a strategy for reducing not only newborn deaths but
also maternal deaths and stillbirths, generating a triple return in
investment.
Care for small and sick newborns could avert 30 per cent of neonatal
deaths. In this respect, key interventions include kangaroo mother care,
prevention or management of neonatal sepsis, addressing neonatal jaundice and
preventing brain damage after birth-related oxygen deprivation.
The world has made substantial progress in child survival with the global
under-5 mortality rate dropping by 56 per cent from 93 deaths per 1000 live
births in 1990 to 41 in 2016. Nonetheless, accelerated progress will be
needed in more than a quarter of all countries including Bangladesh to
achieve the Sustainable Development Goal (SDG) target (1) on under-five
mortality by 2030.
Meeting the SDGs target would reduce the number of under-5 deaths by 10
million between 2017 and 2030, observed the report adding; globally the
number of neonatal deaths declined from 5.1 million in 1990 to 2.6 million in
2016. However, the decline in neonatal mortality from 1990 to 2016 was slower
than that of post-neonatal under-5 mortality: 49% compared with 62% globally.