Inequalities in care a contributor to high numbers of preterm births

At least 60 per cent of all preterm births occur in Sub-Saharan Africa and South Asia. [iStockphoto]

A global action report titled ‘born too soon’ released in May revealed that at least nine in 10 preterm babies survive in high-income countries, against one in every 10 born in low-income countries.

According to the report, at least 152 million children were born too soon between 2010 and 2020, globally.

In 2020, an estimated 13.4 million children were born preterm globally, a slight decrease from 13.4 million in 2010.

Cases of preterm births increased in sub-Saharan Africa, with 563, 000 more babies born preterm in 2020 than in 2010.

Data reveal that an estimated 4 million babies are born too soon every year in Africa.

The top five for preterm birth numbers were India (3,016,700) Pakistan (914,000), Nigeria (774,100), China (752,900) and Ethiopia which recorded 495,900.

“Inequalities in care between and within countries result in unacceptably large survival gaps for babies born preterm.

Laura Oyiengo, UNICEF Kenya, Health Specialist in charge of Maternal Newborn Health, notes that newborns are one of the most vulnerable populations in the world with prematurity identified as the leading cause of mortality among children under five years and a major cause of disability and chronic ill health later in life.

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At least 60 per cent of all preterm births occur in Sub-Saharan Africa and South Asia.

“In Kenya, approximately 193,000 babies are born prematurely out of which approximately 13,000 succumb to complication due to prematurity,” says Oyiengo.

The specialist advises essential care of preterm births immediately after delivery for example drying, warming, hygiene, and cord care as well as care simple interventions such as kangaroo mother care, managing breathing difficulties and infections can substantially reduce mortality in preterm and low birth weight.

She adds, “It is also imperative that the mother takes a central role in the baby’s care where unless the baby is critically ill or the mother is unavailable, the mother and baby should not be separated from each other”.

Preterm babies with moderate to severe respiratory distress and requiring breathing support are managed with Continuous Positive Airway Pressure (CPAP). This ventilatory support method is for preterm and newborn babies with respiratory conditions.

MoH, with support from multiple partners, has scaled up the availability of CPAP in country health facilities. This has been coupled with training of health staff to ensure they have the skills to diagnose and manage preterms (and newborns) with CPAP.

MoH, with support from PATH, has established a human milk bank at Pumwani Maternity referral hospital. This is a milk bank where mothers can donate breast milk. The breast milk is screened and, once safe, is used to feed small and sick babies whose mothers are either unavailable or unable to produce enough breast milk. This is one of the few human milk banks in Africa.