I had been thinking about our class discussion on the lack of priority given to the Safe Motherhood Initiative, and in particular, how difficult it is to show the burden of infant and maternal mortality. Interestingly enough, when looking at recent articles on birth and global health, I came across several articles on a report in The Lancet on the toll of prematurity. Researchers from the World Health Organization, the Johns Hopkins Bloomberg School of Public Health and the London School of Hygiene and Tropical Medicine looked at the causes of child mortality in 194 countries from 2000 to 2013, and found that premature birth was the single greatest cause of death among babies and young children.
For the first time, an infectious disease is not the leading killer of children under five. This could drastically shift the focus of most international health organizations from solely targeting infectious diseases to broader and longer-term health solutions that would combat infectious diseases and the underlying causes of preterm birth. As an NPR article noted, “Babies born premature are more fragile, more susceptible to infection. This may not happen at the time of birth but can happen soon after, during the first month of life. They may get pneumonia, sepsis, a systemic infection.”
In looking at preventions for preterm births and deaths, the NPR article discusses many of the same maternal health interventions we looked at in our class, such as improving nutrition, reducing infections (especially syphilis), and reducing smoking. On the newborn side, thermal care is imperative, such as keeping preterm babies warm by wrapping them in a blanket. These ideas are central to many of the programs implemented by the Safe Motherhood Initiative, with an educational focus. With reports like this, do other students think there might be a greater international focus on maternal and newborn health programs? Does this reflect a greater epidemiological shift in developing countries that require deeper and overarching health systems?