There are moments in life that most people think of as moments of unalloyed joy. The birth of a child, for example. It is idealized in our literature, art and popular culture. It would have been long anticipated by a loving family. In some cultures, rooms and spaces are prepared for the new addition; grandmothers and aunts and friends have baby showers, and, when the day arrives, proud fathers hand out cigars.
Unfortunately for millions of mothers and families throughout the world the experience is far different. An astounding 2.9 million babies die every year. In fact the day of birth is the most dangerous – more than four out of 10 children who die before their fifth birthday die in the first day of life.
For millions, therefore, the day of birth is a day of death. Not a day of celebration, but of mourning. Very often for the child, and almost as often for the mother – half of maternal deaths also occur during the first 24 hours.
How can the world not even notice this tragedy, you may ask? This is clearly something we should be rallying, agitating, moving mountains to stop, isn’t it?
But in fact we have tacitly accepted that babies die. So common is the expectation that many babies will not live that in many cultures children are not even given a name until they have passed the first critical days. Essentially they are not regarded as persons until they survive the dangers that are seen as inevitable. They are not even registered, and so enter and leave the world as if they had not existed.
UNICEF is determined to be part of the solution to this massive, unheeded daily disaster.
This week I am in Johannesburg for one of the most exciting events I can imagine for newborns. It is the global launch of the Every Newborn Action Plan, with the help of former South Africa First Lady Graça Machel and the Government of South Africa. The launch takes place at the Partners Forum on Maternal, Newborn and Child Health.
The Every Newborn Action Plan, conceived by UNICEF and the World Health Organization, provides a clear roadmap to end preventable newborn deaths. After nearly two years of working with governments, health professionals, civil society and others, it was finally endorsed by the World Health Assembly in May of this year.
The Action Plan essentially intends to guide governments and the health sector to put into practice the preventative measures which we know will work to save newborns. Many of these are quite simple: immediate and exclusive breastfeeding; newborn resuscitation; ‘kangaroo care’ for premature babies – that is, prolonged skin-to-skin contact with the mother; and preventing and treating infections.
Governments are essential in turning around the situation of newborns. It will take more funding and adequate equipment in hospitals and health care centres. We need more skilled birth attendants – which doesn’t only mean more doctors and nurses, but also more trained midwives and community health workers.
The endorsement of the Action Plan shows that the will is there – and where there is a will, there is a way. With buy-in from the governments and the health sector, especially of the most affected countries, we have no doubt that we will see the end of preventable newborn deaths within a generation.
This is why this event is so exciting to me and to UNICEF.
We know what to do. We now have to do it.
Dr Kim Eva Dickson is the senior adviser for maternal and newborn health at UNICEF, New York, and a public health physician. Dr Dickson is a co-author of the recent Every Newborn Series from The Lancet.