By Duncan Mlanjira
The Ministry of Health (MoH) is today (November 22) commemorating the World Prematurity Day under the global theme ‘Born too soon; Providing the Right Care; at the Right Time and in the Right Place’.
Secretary for Health and Population, Dr. Dan Namarika, says in a press statement that the theme resonates well with the global report on ‘Survive and Thrive; transforming care for every small and sick newborn’ which was launched at the World Health Assembly in Geneva that calls for provision of quality care, affordable services to mothers and newborns.
“The theme also calls upon all stakeholders, including health institutions, health care providers, development partners and the general public to take holistic actions to ensure the survival and welfare of children who are born prematurely or with low birth weight.
“The ministry, therefore, appeals to all stakeholders and the general public to find and implement means for reducing morbidity and mortality associated with prematurity and low birth weight.
“As Malawi commemorates the World Prematurity Day, The Ministry of Health and Population wishes to remind the general public that ‘everyone’ has a role to play in ensuring survival and wellbeing of premature and low birth weight babies.
“Premature and low birth weight babies have the potential to grow healthy and become productive citizens,” says Dr. Namarika.
World Prematurity Day is commemorated every 17th of November but Malawi shifted it to November 17.
According to a world survey, Malawi tops the list of 10 countries with the highest rates of premature births per 100 live births, followed by:
*Comoros: 16.7 preterm births per 100 births
*Equatorial Guinea: 16.5
World Prematurity Day is a global reminder that preterm birth is a serious health problem and a major cause of infant morbidity and mortality worldwide.
Malawi is rated at 18.1 preterm births per 100 births as confirmed by Dr. Grace Chiudzu, a specialist in Obstetrics and Gynecology in an earlier Maravi Express report.
About 1 in 10 babies is born premature every year, out of a total 15 million preterm births.
The first international awareness day for preterm birth on 17 November was created by European parent organizations in 2008. It has been celebrated worldwide since 2011.
According to the World Health Organisation (WHO), ‘Preterm’ is defined as babies born alive before 37 weeks of pregnancy are completed.
There are sub-categories of preterm birth, based on gestational age:
*extremely preterm (less than 28 weeks)
*very preterm (28 to 32 weeks)
*moderate to late preterm (32 to 37 weeks).
A determined effort is needed to save the preterm babies. If sufficient efforts are made, more than three quarters of premature babies can be saved with feasible, cost-effective care.
Dr. Chiudzu acknowledges that preterm birth is a complex issue and that currently she is pursuing a PhD on association of preterm birth and nutrition.
“I am trying to see if the risk of preterm birth is associated with micronutrients defiency prevalent in the country.”
She said there are two broad groups: spontaneous preterm birth whereby the birth occur on its own as well provider initiated preterm birth whereby the labour is induced or the Caesarian section is done to save the mothers life or the baby him/herself.
“The commonest cause is Hypertensive diseases in pregnancy. To date there is no definite cause of spontaneous birth.
“Various theories have been advanced. So considering that we don’t know the cause, it’s difficult to prevent it.”
She said MoH is doing everything possible as solutions to the preterm babies such as:
*Use of steroids before they are born
*Use of antibiotics before they are born
*Transfer of risk mother to a center where the baby could be looked after
*antibiotics to treat newborn infections
*Kangaroo baby care, which a natural system that the baby is carried by the mother with skin-to-skin contact and frequent breastfeeding.
She also observed that young mothers are prone to significant obstetrics complications especially hypertension (Preeclampsia), which is the commonest cause of induced preterm birth in Malawian setting.
She advises mothers to seriously attend antenatal care help to identify the early warning signs of preterm birth so that the mother can be given steroids and transferred to a facility with neonatal facilities, if necessary.
“Government hospitals also encourage men to join their wives for antenatal care but not many of them do for obvious reasons,” she said.