Clean delivery stressed to control high newborn mortality

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ISLAMABAD: Speakers on Wednesday urged to take effective steps to control the high rate of newborn mortality in the country. They said that one of 19 newborn children die in the first month of their life and the biggest cause of the death is infection. Both prevention and treatment efforts are required to address the high burden of newborn sepsis, they said.To prevent deaths due to infection, access to clean delivery by skilled birth attendants is needed, they said while addressing a seminar entitled “Simplified Antibiotic Treatment Trial” (SATT) organised by the Advocacy and Advisory Network for Newborns (AANN). They said that according to PDHS 2006-07, newborn sepsis constitutes 30% of newborn mortality. Under PBHF 2006-07 the newborn mortality rate was 54 per one thousands live births, while according to PDHF, in 2013, it rose to 55 per one thousand live births, they said.Speakers said that currently in Pakistan, high proportion of deliveries occur at home, sometimes in unhygienic conditions. This may lead to development of newborn sepsis, they added. Child Health Adviser Anita Zaidi, Child Health Adviser at the World Health Organisation (WHO) Assad Hafeez, and dean of the Health Services Academy were also present on the occasion.Save the Children in collaboration with the Agha Khan University Karachi, and the WHO conducted the Simplified Antibiotic Treatment Trial. The results were disseminated from the platform of ‘AANN’. They said that globally, and in Pakistan, newborn mortality rate is very high and constitutes around two-thirds of under-five child deaths in Pakistan. Major causes of newborn mortality in Pakistan are newborn sepsis, birth asphyxia and low birth weight, they noted.Speakers said that the current WHO guideline for the management of newborn infection is injectable antibiotics in the hospital. This is not feasible for most of the families because of cost, distance to the facility, lack of child care, etc. These are the main issues due to which majority of the newborns do not get lifesaving antibiotics, they said. The speakers said that availability of simple treatment closer to the community might prevent these unnecessary deaths.In this regard, work is in progress globally and in Pakistan to develop simpler antibiotic regimens. Two large randomised controlled trials were commissioned in Africa and South Asia to evaluate simplified regimens for the treatment of infections in newborns in outpatient settings where referral is not possible or families refuse referral. Agha Khan University Professor Anita Zaidi led the study conducted in the urban settlements of Karachi.The African study conducted in Nigeria, Democratic Republic of Congo and Kenya was also supported by the BMGF. Shamim Qazi and Rajiv Bahl provided the technical support for this study from WHO. Both studies found simpler antibiotic regimens effective in treatment of newborn infections at facility level. In his concluding remarks, AANN President Tabish Hazir emphasised on education and women empowerment to be able to change the trajectory of the newborn mortality in Pakistan. The event was moderated by AANN Executive Member Jamal Raza.

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