I will go on clearing the debris
with all my strength
From the face of this earth.
I will make this world habitable for this child;
This is my firm pledge to the newborn.
— Sukanta Bhattacharya, The Testimonial Poet (Translated by Rini Bhattacharya Mehta)
As a foreigner, I was inspired to read the works of a few great poets of Bengal by the festivities of Bangladesh. For a while, these lines were playing in my mind. Once again, I realised every child's birth is special, be it for the parents or anyone in the family. From the initial feeling of gaiety, I suddenly started to ponder realistically like any development professional and to contemplate whether we are doing enough to keep these little bundles of joy alive. Are we ensuring safe birth for every newborn and handling them well enough in the aftermath to sustain their lives, even if they are from the under privileged segments of society?
When it comes to newborn deaths, the global trends are alarmingly high, particularly among the world's poorest countries. Global data indicates that 2.6 million newborn babies die every year and the average newborn mortality rate in low-income countries are way higher compared to high-income countries. Newborns from low-income countries are 50 times more likely to die.
Compared to any other low-income countries, no doubt, Bangladesh has done quite well in relation to many development indicators, including its progress in neonatal mortality. A sharp decline is evident from the data: 241,000 newborns were dying in 1990 and then this data went down to 62,000 in 2016.
But the question is whether this progress has been made in all the regions of country. Has its impact reached out to every newborn? A recent UNICEF report reveals that despite well-performing public health programmes, Bangladesh is still among the 10 countries with the highest number of newborn deaths in 2016, and newborn mortality rates. While the number of stillbirth (a baby born with no signs of life at or after 28 weeks' gestation) is even more catastrophic at 83,000 every year (The Lancet, 2015).
Looking deeper into the causes, what does it take to prevent neonatal deaths? The answer is simple—affordable, quality care for every baby and mother. Eighty-eight percent of neonatal deaths in Bangladesh stem from highly preventable causes and the fact is, simple solutions like access to well-trained midwives, clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact, immediate drying, delayed bathing and good nutrition cannot be done without.
But the reality on the ground shows that many places in Bangladesh still lack these basic solutions, leading to the tragic death of many newborns and their mothers. Readiness of the facilities and Essential Newborn Care (ENC) that is vital for newborn survival has low coverage. The facility deliveries have increased, but mostly in the private sector. Often, financial and other socio-economic barriers pose challenges for the poorest of the poor to access essential maternal and newborn care.
Eyeing this situation, UNICEF is launching the new global campaign “Every Child Alive,” demanding and delivering solutions on behalf of the world's newborns. The campaign will seek attention of and take on board all the governments, healthcare providers, donors, the private sector, families and businesses to keep every child alive. And most positively, Bangladesh too joins this global call to contain all preventable child and neonatal deaths by 2030.
It is now time to agree and ensure that affordable, quality healthcare, reaches every mother and every baby so that no baby dies of preventable causes. This will only be ensured if we can provide every baby and every mother with a package of four P's: Place (a clean, well-equipped health facility), People (skilled health workers), Products (facilities, drugs and equipment for treating premature and sick newborns) and Power (necessary awareness and skills within communities, women and adolescent girls).
Bangladesh is indeed on the right track, with commitment and strong footing on the ground. To this end, the National Newborn Campaign launched last year promotes affordable interventions at community and household levels, to provide essential care, to all newborns. The government is also prioritising effective interventions for maternal and newborn health, of which UNICEF is a proud partner.
Another major breakthrough and a one-stop-solution to ending newborn deaths in Bangladesh are the existing Special Newborn Care Units (SCANUs) in the public hospitals of 44 districts. SCANUs have positive impact on newborn survival, providing specialised care to newborns suffering from various forms of sicknesses. We hope, the “Every Child Alive Campaign” will expedite the goal of expanding these SCANUs and many more initiatives in the remaining districts in future to reach out to every baby and every mother.
To reinforce our commitment, we must carry on the good work until the figure of preventable newborn death reaches zero. To reach this objective, we must all unite and take the necessary measures required to keep this pledge.
Edouard Beigbeder is UNICEF Representative in Bangladesh.