21 out of 1000 newborns die before 28 days, doctors say

Kenya has recorded a stagnation of neonatal deaths, with 21 out of 1,000 children dying before 28 days

Even as the country joins the globe to commemorate World Prematurity Day, today, at least a third of neonatal deaths recorded this year were as a result of prematurity complications.

Data by the Kenya Health Information System (KHIS) reveal that this year alone, 37 per cent of newborn deaths of babies aged between zero and 28 days were as a result of prematurity.

The percentage rose from 2022 and 2021, where prematurity accounted for 33 and 32.82 per cent of all neonatal deaths, respectively.

Kenya's neonatal mortality rate is 21 deaths per 1,000 live births, accounting for 51 per cent of under-five deaths.

Kenya has a target of reducing neonatal deaths from 21 for every 1,000 live births to 11 by 2030.

Neonatal death is the death of a baby, between zero and 28 days from birth, whereas a preterm is a baby born before the completion of 37 weeks of pregnancy.

Head of Division on Neonatal and Child Health Dr Janet Karimi said preterm babies suffer health complications, risking deaths.

"Preterm birth is the highest cause of all the overall under-five deaths," she said during the media engagement session. "If we have to reduce the under-five deaths, we must reduce the neonatal deaths because neonatal deaths are about half of all the under-five deaths."

Karimi added that preterm birth complications account for about 16.6 per cent of deaths of children under five globally.

Complications are attributed to a lack of fully developed body organs like the lungs, brain and respiratory system.

The largest burden of neonatal death is in Sub-Saharan Africa, where the neonatal mortality rate is 27 deaths per 1,000 live births, representing 43 per cent of global newborn deaths.

In Kenya, the under-five mortality rate is now at 41 deaths per 1,000 live births.

According to data, for every 1,000 live births, at least 21 die between the age of zero to 28 days.

"Out of the 21 deaths reported in babies, about a third is because of prematurity," said Dr Karimi.

In Kenya, there were approximately 127, 500 babies born too soon, before 37 weeks of pregnancy in 2020, representing about 12 per cent of all births.

Karimi said unfortunately a significant number of the babies died because of complications.

Three-quarters of the deaths, she said, can be prevented through interventions like Kangaroo Mother Care.

Kangaroo mother care enhances faster weight gain promotes exclusive breastfeeding and ultimately lowers infant mortality rates

"The Ministry of Health is promoting high-impact interventions to ensure the survival and thriving of preterm babies through the provision of adequate warmth for example encouraging immediate kangaroo care," said Dr Karimi.

Other interventions in managing preterm babies include feeding, infection prevention, respiratory support and frequent monitoring of the baby's vital signs including oxygen saturation, temperature, respiratory rate and pulse rate.

Kangaroo mother care is recommended by the World Health Organisation (WHO) immediately after birth.

However, Karimi said even preterm babies who survive at birth number risk developing lifetime complications.

"...their brains, lungs, the respiratory system is not fully developed and some of the treatment due to complications and lifetime disability like visual impermanent, learning advisability and hearing disability," she said.

About half of preterm birth, the cause is not known it can happen to anyone without predisposing factors.

Dr Mary Waiyego, in charge of the paediatric division in the ministry, said in Kenya, some predisposing factors include poor nutrition before and during pregnancy, smoking and drinking alcohol, chronic diseases like hypertension and diabetes, and infections like urinary tract infections.

Women with a history of pre-term delivery(before 37 completed weeks of pregnancy) also have higher chances of delivering a preterm child.

"The most common cause of preterm birth is hypertension, diabetes UTIs, and abnormal formation of the uterus," said Dr Waiyego.

Interventions for the prevention and treatment of prematurity by the ministry include equitable access to high-quality sexual reproductive health services, including family planning.

Other prevention interventions include social behavioural change and communication on nutrition and healthy lifestyle, and medical use of antenatal corticosteroids to aid in the maturation of the fetal lungs where the risk of prematurity has been identified.

Also, the ministry has supported ten counties to establish a level two newborn care unit to manage preterm babies.

Among the counties are Nairobi, Nakuru, Kiambu, Kisumu, Machakos, Nyeri, Embu, Bungoma, Kirinyaga and Kakamega.

The units are equipped with various machines for example syringe pump, bilirubinometer, hemoglobinometer, oxygen concentrators, suction machine radiant warmer, pulse oximeter and flow splitter.

"We are urging the counties to equip the units and ensure there is the supply of commodities to be able to offer preterm babies with comprehensive services," she said.

With the implementation of Universal Health Coverage, (UHC) the ministry is strengthening of community interventions on maternal and newborn health packages for community health promoters.

In addition, through the support of UNICEF, the ministry has established regional maternal and newborn learning centres for in-service and preservice skills in Pumwani Maternity Hospital, Kakamega, Lodwar, Kilifi and Garissa County Hospitals.