Tuesday
February 25, 2014
Save the Children releases new report on ending
newborn deaths as well as ensuring every baby
survives. It is a crucial report which puts the
spotlight on maternal and child health picture
throughout the world. The report is not only
critical of health delivery systems, but offers
a way out for governments that have fared badly
on the scales as Save the Children reveals that
"One
Million Babies Die Globally on the First Day of
Their Life".
The Children's Advocacy
group, Save the Children has issued
a report
that clearly puts the spotlight on why, for
example, Africa has scored so badly with
specific examples that should guide governments
on how best they should go about saving the
lives of mothers as well as the newborn on a
continent beset by many problems.
In a statement issued by
Save the Children, the organisation notes
-
"The new report,
"Ending Newborn Deaths," shows one
half of first day deaths around the world could
be prevented if the mother and baby had access
to free health care and a skilled midwife. The
children's aid agency says the deaths happen
because of premature birth and complications
during birth, such as prolonged labour, pre-eclampsia
and infection, which can be avoided if quality
health experts are present. The research also
found an additional 1.2 million babies are
stillborn each year, their heartbeats stopping
during labour because of childbirth
complications, maternal infections and
hypertension.
In a bid to save millions of
newborn lives, Save the Children has
called on world leaders to commit in 2014 to a
blueprint for change – The Five Point Newborn
Promise – which focuses on training and
equipping enough skilled health workers to make
sure no baby is born without proper help, and
removing fees for all pregnancy and birth
services.
The world has made amazing progress in reducing
child mortality during the past decade – nearly
halved from 12 million to 6.6 million – thanks
to global political action on immunisation,
treatment of pneumonia, diarrhoea, and malaria,
family planning and nutrition. But this progress
could stall without urgent action to tackle
scandalously high numbers of newborns dying.
This report warns that newborn deaths now
account for nearly half of all under-five
deaths.
Carolyn Miles, President and CEO of Save the
Children, said: "The first day of a child's life
is the most dangerous, and too many mothers give
birth alone on the floor of their home or in the
bush without any life-saving help. We hear
horror stories of mothers walking for hours
during labour to find trained help, all too
often ending in tragedy.
"It's criminal that many of these deaths could
be averted simply if there was someone on hand
to make sure the birth took place safely and who
knew what to do in a crisis."
Each year, 40 million women give birth without
trained help.
In a part of
the report titled -
"Ten countries with the highest rates of
first-day deaths and stillbirths during labour"
Sierra Leone has been ranked near the
top of this group after Pakistan and Nigeria - a
clear indication that more needs to be done in
this direction by backing words and intentions
with real action on the ground. Statistics from
some countries are disappointing as pointed out
in a couple of examples -
"In
Ethiopia, only 10 percent of births have skilled
help whereas in some areas of rural Afghanistan
there is just one midwife for 10,000 people. In
countries such as the Democratic Republic of
Congo (DRC) or the Central African Republic
(CAR), some mothers have to pay for emergency
maternal care, often costing as much as their
monthly food bill.
There have even been reports of mothers being
kept under jail-like conditions for months until
they have been able to pay for their emergency
caesarean. Carolyn Miles added: "These new
statistics reveal – for the first time ever –
the true scale of the newborn crisis. The
solutions are well-known but need greater
political will to give babies a fighting chance
of reaching their second day of life. Without
targeted action now, progress made in cutting
child mortality through vaccines and tackling
malnutrition will stall." Save the Children is
calling on world leaders, philanthropists and
the private sector to meet and commit to the
Five Point Newborn Promise in 2014:
These range
from issuing a defining and accountable
declaration to end all preventable newborn
mortality, saving 2 million newborn lives a year
and stopping the 1.2 million stillbirths during
labour to paying for the training, equipping and
the support of health workers as well as
removing user fees for all maternal, newborn and
child health services, including emergency
obstetric care.
In Sierra
Leone's country report was this -
As Sierra Leone emerged from civil war,
health outcomes were atrocious and coverage
of health services was extremely low. In
2008, the neonatal mortality rate was the
fourth highest in the world, with 49 babies
in every 1,000 dying within their first
month of life. That year, just one in four
of the poorest mothers had skilled
attendance during birth. 149
Overcoming such a challenge
is not easy. The health system was weak,
underfunded and reliant on user fees from
the population, which deterred the majority
from seeking care.
A crucial step towards better maternal
and child health outcomes has been the Free
Health Care Initiative (FHCI), launched in
April 2010 to remove user fees for pregnant
and lactating women, and children under
five. This was led by the President, Ernest
Koroma, who acknowledged the scale of the
crisis and thus made maternal and child
health a key priority. The FHCI has been
implemented with increased public financing
and wider system reforms to strengthen the
quality of care provided, by increasing the
numbers of health workers and improving the
drug supply.
In 2014, Sierra Leone will finalise and
implement its Every Newborn Plan, which must
be closely situated within the health sector
plan to ensure an integrated approach is
taken to scale up coverage of essential
services. A focus on newborns, within the
consolidation of the FHCI, has huge
potential to accelerate progress on child
survival in Sierra Leone.
We were
impressed to hear today's BBC radio report from
Freetown, Sierra Leone's capital that things
appear to be improving as narrated by the BBC's
Umaru Fofana when he visited the Ola During
Children's Hospital where mothers says they were
not being charged or harassed for fees and other
needed support services. We hope that this was
not a show for the BBC reporter and that the
same could now be said of the many health
delivery systems in the country, thereby making
it unnecessary for those who have the right
connections to fly overseas for care and
delivery of their babies.
We hope that
it was not just a show - given reports that the
present Health Minister was rude to medical
staff who did not jump up and start cleaning the
floor because one Mr Tony Blair was to make a
visit and hence the need to give the impression
that Connaught Hospital has always been spick
and span as you would find in any hospital in
the so-called developed countries.
So why should
the Health Minister get so jittery because of
the Tony Blair visit? If she wants to be
believed that she is on top of her job, she has
the right to take upon herself spot visits,
unannounced to see the situation for herself and
thus would get a true picture of what obtains.
But back to
the Ola During Hospital - this was the
observation contained in the recent Audit Report
and we do hope that all the points raised have
been addressed.
8.24.3. Review of the Free Health Care System
The following were observed:
Due to the presence of the Free Health
Care Programme, the wards were congested;
There were instances where more than
two patients of diverse diseases were clustered on a single bed;
There was a serious shortage of
medical doctors at the Hospital;
There were only three doctors
attending to an overwhelming number of patients;
Interviews with key personnel revealed
that doctors were usually not on duty at night; and
Several patients of
diverse ailments were using one oxygen cylinder at the same time.
It was therefore recommended that the responsible officers at the Ministry of
Health and Sanitation should ensure that the other health centres were equipped
to handle referred cases in order to avoid the clustering of patients. In
addition, the Ministry of Health and Sanitation were urged to put mechanisms in
place to address the chronic shortage of doctors at the Hospital. Furthermore,
it further recommended that the relevant authorities should put mechanisms in
place for the procurement of more oxygen cylinders, so as to ameliorate the
situation.
Then we saw this too in that Audit 2012
report
Even though several recommendations had been made in the past for the
Hospital Management to institute written guidelines regarding the management of
medical waste, no such action was taken. It was also noted with dismay that in
some instances medical waste (Including sharp object and used needles) were not
separated from the general waste that was eventually transported to a general
dumping site. Furthermore, there was a garbage dumping spot closer to the
Hospital premises designated for the transfer of rubbish, even though, the
Hospital through the Freetown City Council, was paying the Freetown Waste
Management Company, a total amount of Le 3,000,000 per month for the clearing
and transfer of rubbish to the general dumping site. In order to prevent the
spread of communicable diseases and to mitigate the risk associated with medical
waste, it was recommended that the Hospital Management should make every effort
to develop an internal Medical Waste Management Policy. Such a policy would
address issues relating to the identification of the various forms of waste, the
storage, transporting and the risks associated with medical waste which would
will have the benefit of ensuring that all the concerned parties
were aware of the cause of action to take when dealing with waste.
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