{"id":15484,"date":"2016-01-01T10:06:36","date_gmt":"2016-01-01T08:06:36","guid":{"rendered":"http:\/\/www.times.mw\/?p=15484"},"modified":"2016-01-01T10:06:36","modified_gmt":"2016-01-01T08:06:36","slug":"malawi-giving-the-smallest-babies-the-best-chance-at-life","status":"publish","type":"post","link":"https:\/\/archive.times.mw\/index.php\/2016\/01\/01\/malawi-giving-the-smallest-babies-the-best-chance-at-life\/","title":{"rendered":"Malawi: Giving the smallest babies the best chance at life"},"content":{"rendered":"

W<\/strong>hen Dr Elizabeth Molyneux of the College of Medicine started treating preterm babies at Queen Elizabeth Central Hospital in Blantyre, Malawi more than 40 years ago, she did not have incubators to keep babies warm. Nor did she have phototherapy lights to prevent jaundice or specialized equipment to ensure their tiny airways stayed open.<\/p>\n

\u201cIt\u2019s been clear over the years that the smallest babies in Malawi were the most neglected,\u201d explains Dr Molyneux.<\/p>\n

This is despite the fact that Malawi has one of the highest rates of preterm birth in the world. Nearly 1 in 5 babies are born before 37 weeks of gestation. Globally, complications of prematurity, such as difficulty in feeding, breathing and regulating body temperature, are the single largest cause of neonatal death. In order to survive, these babies need specialized care and equipment \u2014 resources most developing countries do not have.<\/p>\n

Malawi is no exception. <\/strong><\/p>\n

Determined to help, Dr Molyneux helped to set up the hospital\u2019s neonatal care unit, which today admits more than 3 000 babies a year. At first, she introduced warm cots and kangaroo mother care, a method which encourages skin-to-skin contact, but found she also needed a way to help babies whose lungs were not fully developed to breathe.<\/p>\n

A low -cost solution <\/strong><\/p>\n

Engineering students at Rice University in Texas, USA, were able to design the solution\u2014a low-cost bubble continuous positive airway pressure (CPAP) device called Pumani, which means \u201cbreathe\u201d in the Malawian language of Chichewa. And it\u2019s working. Since 2006, more than 1000 babies\u2019 lives have been saved.<\/p>\n

\u201cBefore CPAP we found that, if we couldn\u2019t give any breathing support, mortality was high. By giving CPAP to babies who needed the support, survival rates improved in premature babies with breathing difficulties from 24% to 67%,\u201d says Norman Lufesi, Head of the Acute Respiratory Infection Unit, Malawi Ministry of Health.<\/p>\n

This is good news in a country where 1 out of 43 new borns die within the first 4 weeks of life.<\/p>\n

\u201cWhile CPAP has made a big difference for babies with respiratory distress syndrome, we still have a long way to go to reduce neonatal mortality,\u201d says Dr Molyneux. \u201cWe still need a package of care that can be sustained in all of our hospitals.\u201d<\/p>\n

Preterm birth guidelines <\/strong><\/p>\n

Worldwide, complications of prematurity are the leading cause of deaths among children under the age of 5. In order to reduce neonatal and child mortality, WHO recommends evidence-based interventions be given to women at imminent risk for preterm birth or to preterm babies after birth.<\/p>\n

CPAP, kangaroo mother care, surfactant and oxygen therapy are all new born interventions outlined in, \u201cWHO recommendations on interventions to improve preterm birth outcomes,\u201d a new guideline published this month. Recommended maternal interventions to improve preterm babies\u2019 chances of survival include antenatal corticosteroids, when gestation is confirmed to be between 24 and 34 weeks, antibiotics when the fetal membranes are ruptured, and magnesium sulfate for protecting the infant against serious neurological complications.<\/p>\n

While Malawi has implemented CPAP, kangaroo mother care and oxygen therapy at Queen Elizabeth Central Hospital, which is the country\u2019s largest health facility, the designated neonatal rooms in most of the district hospitals are without specialized equipment or trained staff. Over the past 2 years CPAP has been introduced into 28 district hospitals and will soon be in 8 non-profit hospitals.<\/p>\n

Focused on every newborn <\/strong><\/p>\n

Through early adoption of global policies and programmes to increase access to life-saving newborn and child health interventions, Malawi is one of a few countries in sub-Saharan Africa to achieve Millennium Development Goal 4, which aims to reduce under-5 mortality by two-thirds by the end of this year. In 1990, 1 in 4 Malawian children died before the age of five. Today, the rate is 1 in 14.<\/p>\n

\u201cWe have done a good job at reducing under-5 child mortality in Malawi, but 44% of the deaths continue to be babies within their first month of life,\u201d says Fannie Kachale, Director of Reproductive Health, Malawi Ministry of Health. \u201cWe realize we could have done even better if we had focused more on newborn health.\u201d<\/p>\n

To improve the situation, the country recently launched an adaptation of WHO and UNICEF\u2019s Every Newborn Action Plan, with the goal of reducing neonatal mortality to 17 per 1 000 births by 2030. As part of the plan, Malawi is increasing the number of skilled birth attendants, giving antenatal corticosteroids and antibiotics to women with preterm labour using stringent criteria as defined by WHO, and strengthening newborn care during the first 4 weeks of life.<\/p>\n

The country is also renovating 10 neonatal care units in the district hospitals and expanding Queen Elizabeth Central Hospital\u2019s kangaroo mother care unit to 40 beds. \u201cThrough CPAP, babies who wouldn\u2019t otherwise have survived are now surviving,\u201d says Lufesi. \u201cHopefully by adding good neonatal care units in our hospitals we\u2019ll be able to save even more babies and reduce our neonatal mortality rates.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

When Dr Elizabeth Molyneux of the College of Medicine started treating preterm babies at Queen Elizabeth Central Hospital in Blantyre, Malawi more than 40 years ago, she did not have incubators to keep babies warm. Nor did she have phototherapy lights to prevent jaundice or specialized equipment to ensure their tiny airways stayed open. \u201cIt\u2019s […]<\/p>\n","protected":false},"author":3,"featured_media":15488,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-15484","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/posts\/15484","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/comments?post=15484"}],"version-history":[{"count":1,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/posts\/15484\/revisions"}],"predecessor-version":[{"id":15489,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/posts\/15484\/revisions\/15489"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/media\/15488"}],"wp:attachment":[{"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/media?parent=15484"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/categories?post=15484"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/archive.times.mw\/index.php\/wp-json\/wp\/v2\/tags?post=15484"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}