November 22, 2006, 14:45
Africa's infant mortality rate of 1.16 million per year placed it on a par with England's figures in the early 20th century, according to a study released today.
"Opportunities for Africa's Newborns" indicated that half of these deaths occurred in Nigeria, the Democratic Republic of Congo, Ethiopia, Tanzania and Uganda. Nigeria alone had over 255 000 newborn deaths a year. Most of these children died nameless as, in Africa, babies were traditionally not named until the sixth week after birth.
"Africa's child mortality now is similar to that of England in the beginning of the 20th century or Sweden at the start of the 19th century. So we are way behind," said Francisco Songane, a director of the Partnership for Maternal, Newborn and Child Health.
Of the total infant deaths, half died on their birthday. The major causes were infections, including tetanus, pre-term birth complications and birth asphyxia. All of these were "highly preventable", said Joy Lawn, a senior researcher and policy advisor for Saving Newborn Lives/Save the Children USA.
Most of these deaths could be prevented by avoiding adolescent pregnancy, spacing births at least two years apart and ensuring clean and safe child births assisted by a skilled attendant. Breastfeeding could save 15% of babies by preventing infections. Tying babies to the mother's chest or back to keep them warm would also bring down the death rate.
No lack of policy
The report indicated that up to 800 000 babies a year could be saved if 90% of women and babies received these interventions. They came at a cost R10 per capita or R7.24 billion a year. This would also benefit the one million stillborn babies and 250 000 mothers who died each year. Lawn said Africa did not suffer from a lack of policy. "I think the risk is that we have lots of road maps and commitment, but how do we translate this into action?"
The good news, however, was that six countries including Malawi, Tanzania, Uganda, Eritrea and Burkina Faso had managed an average reduction of 29% over the last 10 years in newborn mortality rates. In Malawi this was attributed to "presidential-level commitment" to newborn and child health. In Tanzania district health managers set local budget priorities based on deaths in each district, which led to increased government spending. While, in Uganda the performance of district health services was ranked annually and published in the national newspaper.
Lawn said South Africa's neonatal mortality rate of 21 deaths per 1 000 births about half the average for Africa hid a lot of inequities as the rate was high in some, particularly rural, areas of the country and low in others.
No progress in reducing newborn death rate
According to the report, "there has been virtually no progress in reducing (South Africa's) newborn death rate in the last 10 years. This lack of progress is an important barrier to meeting child survival targets, especially for the Millennium Development Goals".
Lawn commented: "I think in a country with such resources there should be progress, but it does not seem to be on the agenda".
Gertrude Mongella, the Pan African Parliament president, said in a statement on the release of the study that cost-effective interventions already existed in the policies of most countries, but did not reach the poor. "In the past, newborns died unseen and uncounted, but now donors are beginning to recognise newborn health as a priority," she wrote. - Sapa
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