First day of life most risky for Newborns: new Report

Pakistan ranked 139th on the list of best places to be a mother

Pakistan among 10 countries with high newborn death rate

Sana Jamal

The day a newborn open eyes to world is the most anticipated one for the mother and a blissful moment for the whole family. But the first day of life is a delicate time for a newborn as it is often the most risky day of a child’s life, according to a report released this week by the humanitarian group, Save the Children. The 2013 State of the World's Mothers Report (SOWM) titled ‘Surviving the First Day’ reflects how risky the very first day is for many babies and mothers in almost every part of the world. 

Global state of Mothers 

More than one million babies are dying the actual day that they are born - making the baby’s day of birth the most dangerous day of their life nearly every country. The annual Report by the humanitarian organization reveals that two decades of progress on mother and child health has been too slow and uneven over the years. Released around Mother's Day, the report assesses the well-being of mothers and children in 176 countries. Finland, Sweden and Norway top the Mother's Index list (global ranking system for maternal and infant health) while Congo, Somalia and Sierra Leone rank last. This year’s Report contains first ever Birth Day Risk Index with the death rate for babies in their first day of life in 186 countries.

Key Findings of the Report:

• First day of life is the most dangerous day for mother and babies (First day death rates are highest in Somalia, Congo, Mali and Sierra Leone). 
• First day is also a day unequaled opportunity to save lives and set the stage for a healthy future (4 low-cost products can save lives of over 1 million babies). 
• Mothers and babies in sub-Saharan Africa face the greatest risks. 
• In South Asia, mothers and babies die in great numbers. Babies born to mothers living in greatest poverty face the greatest challenges to survival. 
• Funding for newborn survival programs does not match the need.
• United States has the highest rate of first-day deaths in babies than any other industrialized nation (11,300 newborn nannies die in US each year). 

Courtesy: Healthy Newborn Network

South Asia – second riskiest Region to be born

The region that accounts for 24 percent of world’s population is also the place where 40 percent of world’s first-day deaths occur. An estimated 420,000 babies die each year in South Asia on the day they are born. Premature birth, low birth-weight due to poor nutritional status of mothers, early marriages, little or no access to health facilities are some of the reasons contributing to high rates of first-day death, according to the Report. 

What risk Babies face in Pakistan? 

The Report was launched in Islamabad on Tuesday (May 7) to highlight its significance in Pakistan. Among the 10 countries with high newborn death rate, Pakistan ranks third with around 169,400 infants dying during their first month of life while India has the highest burden followed by Nigeria. About 60,000 babies die within the first day of life, accounting for 30 per cent of all newborn deaths, informed Dr. Qudsia Uzma, director Health and Nutrition at the Save the Children. Critical reasons for high rate were premature births, low birth weight, poor nutritional status of mothers, poor family planning, lack of health workers and early childbearing, she added reading the highlights of the Report. 

Pakistan ranked 139th on the list of best places to be a mother, based on factors such as mother’s health, education and economic status, as well as critical child indicators such as health and nutrition. Pakistan is doing comparatively better than neighbors, India and Afghanistan, but trailed behind Bangladesh, Nepal and Sri Lanka. 

“The number of newborn deaths in Pakistan is unacceptably high. About 1-in-28 babies in Pakistan do not live past the first month of life, making Pakistan one of 10 countries accounting for nearly two-thirds of the three million newborn deaths that take place globally every year,” said David Skinner, country director for Save the Children in Pakistan. 

Courtesy: Healthy Newborn Network

Haroon Rashid, a celebrity and Every One Campaign Ambassador in Pakistan said that while many mothers and kids face greatest threats on the first day of life, but there is also tremendous opportunity to save lives. Every One is Save the Children’s biggest global campaign which stresses that: No child is born to die. And no mother should die giving birth. Haroon explained that the organization is working on four fronts as part of its campaign: 

1. Increasing awareness of the challenges and solutions to maternal, newborn and child survival.
2. Encouraging action by mobilizing citizens to call for policy and political change to reduce maternal and child mortality. 
3. Working in partnerships with governments, civil society and private sector to deliver quality health services. 
4. Collaborating with partners to determine what tools and approaches work best to save lives of babies in the first month of life. 

Solution for Pakistan: Stronger Health Systems for Mother and Babies

Speakers at the Report launching said that the solutions that could work best for Pakistan could be the gleaning examples of few countries that have made remarkable progress in reducing newborn mortality in the last two decades: 

• Bangladesh has made newborn care more accessible by training community health workers to reach mothers and babies at home, reducing newborn mortality by 49 percent since 1990 – more than any other low-income country.
• Malawi – termed as a ‘rare African success story’ – has reduced newborn mortality by 44 percent since 1990 by investing in kangaroo mother care and increased training for nurses and midwives. 
• Nepal – a world leader in adopting low-cost life-saving product – has succeeded in reducing newborn mortality by 47 percent since 1990 despite high levels of poverty, poor infrastructure and conflicts.
• Brazil has reduced newborn mortality by 64 percent since 1990 by introducing a unified health system providing access to health care without user fees and through geographic targeting of the poorest areas. Brazil is also one of the few countries that have narrowed the health care equity gap between rich and poor. 

Recommendations

• When mothers are strong and stable – physically, financially and socially – their children are more likely to survive and thrive. 
• The world faces a shortage of 5 million health workers of all types - especially those working on the front line. New health workers need to be recruited and trained and those already practicing need to improve their skills. 
• Investing in low-cost, low-tech solutions can help save lives during pregnancy, at birth and immediately after birth. 
• Strengthen health systems and address demand-related barriers to access and use of health services. Increased commitments and funding to save the lives of mothers and newborns.

You can read the report in its entirety, along with an infographic that highlights salient statistics here.