4 million neonatal deaths: When? Where? Why?

Lawn, Joy E; Cousens, Simon; Zupan, Jelka

doi:10.1016/s0140-6736(05)71048-5

Cited by 3,143 publications

(2,709 citation statements)

References 38 publications

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“…Previous studies have shown that BCG has beneficial non-specific or heterologous effects, providing protection also against many non-tuberculosis causes of death: in randomized trials of early BCG to low-birth-weight children, BCG at birth versus delayed BCG, as is normal practice, decreased neonatal mortality by 38% (17–54%) [37–39]. With most infant deaths occurring during the neonatal period [40] and with less than half of children vaccinated during the first two weeks of life, most children do not benefit from BCG when they are most at risk.…”

Section: Discussionmentioning

confidence: 99%

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Kagoné

Yé

Nebié

et al. 2017

Global Health Action

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Background: Vaccination is an important tool for reducing infectious disease morbidity and mortality. In the past, less than 80% of children 12–23 months of age were fully immunized in Burkina Faso. Objectives: To describe coverage and assess factors associated with adherence to the vaccination schedule in rural area Burkina Faso. Methods: The study population was extracted from the Nouna Health and Demographic surveillance system cohort. Data from four rounds of interviews conducted between November 2012 and June 2014 were considered. This study included 4016 children aged 12–23 months. We assessed the effects of several background factors, including sex, factors reflecting access to health care (residence, place of birth), and maternal factors (age, education, marital status), on being fully immunized defined as having received Bacillus Calmette–Guérin (BCG), three doses of diphtheria–tetanus–pertussis and oral polio vaccine, and measles vaccine by 12 months of age. The associations were studied using binomial regression to derive prevalence ratios (PRs) in univariate and multivariate regression models. Results: The full vaccination coverage increased significantly over time (72% in 2012, 79% in 2013, and 81% in 2014, p = 0.003), and the coverage was significantly lower in urban than in rural areas (PR 0.84; 0.80–0.89). Vaccination coverage was neither influenced by sex nor influenced by place of birth or by maternal factors. Conclusion: The study documented a further improvement in full vaccination coverage in Burkina Faso in recent years and better vaccination coverage in rural than in urban areas. The organization of healthcare systems with systematic outreach activities in the rural areas may explain the difference between rural and urban areas.

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Section: Discussionmentioning

confidence: 99%

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Kagoné

Yé

Nebié

et al. 2017

Global Health Action

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“…The burden of neonatal mortality rests almost entirely on poor countries with an estimated one million newborn deaths occurring in Sub-Saharan Africa each year. Intrapartum-related hypoxia accounts for more than a quarter of these deaths, and contributes to an unknown number of disabilities [1,2]. …”

Section: Introductionmentioning

confidence: 99%

Factors affecting effective ventilation during newborn resuscitation: a qualitative study among midwives in rural Tanzania

Moshiro

Ersdal

Mdoe

et al. 2018

Global Health Action

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Background: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. Objective: This study aimed at exploring barriers and facilitators to effective bag mask ventilation, an essential component of the HBB algorithm, during actual newborn resuscitation in rural Tanzania. Methods: Eight midwives, each with more than one year’s working experience in the labour ward, were interviewed individually at Haydom Lutheran Hospital, Tanzania. The audio recordings were transcribed and translated into English and analysed using qualitative content analysis. Results: Midwives reported the ability to monitor labour properly, preparing resuscitation equipment before delivery, teamwork and frequent ventilation training as the most effective factors in improving actual ventilation practices and promoting the survival of newborns. They thought that their anxiety and fear due to stress of ventilating a non-breathing baby often led to poor resuscitation performance. Additionally, they experienced difficulties assessing the baby’s condition and providing appropriate clinical responses to initial interventions at birth; hence, further necessary actions and timely initiation of ventilation were delayed. Conclusions: Efforts should be focused on improving labour monitoring, birth preparedness and accurate assessment immediately after birth, to decrease intrapartum-related hypoxia. Midwives should be well prepared to treat a non-breathing baby through high-quality and frequent simulation training with an emphasis on teamwork training.

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“…These recorded deaths during the first 28 days of life have frequently been invisible in official statistics in low‐income settings 8, 9. The Millennium Development Goal agenda did not include a neonatal mortality target from the start 10. Births are often not officially counted until it is evident that the newborn child is surviving.…”

Section: Child Survival Patternsmentioning

confidence: 99%

“…The global research and advocacy for improved child survival that took place after the Millennium shift was mainly giving priority to postneonatal and child health problems 34 and the potential for change by a series of cost‐effective, evidence‐based interventions 35. Later, more emphasis was given to neonatal deaths 10 and the strategies to prevent these by establishing a continuum of maternal and newborn care 36. The huge problem of preventable fresh stillbirths in low‐income settings has now been added to the agenda 37.…”

Section: Future Challengesmentioning

confidence: 99%

Child survival revolutions revisited – lessons learned from Bangladesh, Nicaragua, Rwanda and Vietnam

et al. 2017

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Analysing child mortality may enhance our perspective on global achievements in child survival. We used data from surveillance sites in Bangladesh, Nicaragua and Vietnam and Demographic Health Surveys in Rwanda to explore the development of neonatal and under‐five mortality. The mortality curves showed dramatic reductions over time, but child mortality in the four countries peaked during wars and catastrophes and was rapidly reduced by targeted interventions, multisectorial development efforts and community engagement. Conclusion: Lessons learned from these countries may be useful when tackling future challenges, including persistent neonatal deaths, survival inequalities and the consequences of climate change and migration.

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4 million neonatal deaths: When? Where? Why?

Cited by 3,143 publications

References 38 publications

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Factors affecting effective ventilation during newborn resuscitation: a qualitative study among midwives in rural Tanzania

Child survival revolutions revisited – lessons learned from Bangladesh, Nicaragua, Rwanda and Vietnam

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