World Prematurity Day: Investing in health starts at pregnancy & birth
By: Naoko Kozuki
Tags: Newborn, Maternal Health, Humanitarian, Health, Research

Throughout our careers in public health, we have both maintained a strong passion for furthering the global agenda on improving maternal and newborn health. If we can’t protect women who are bringing life into this world and their vulnerable babies, our community is failing.

We know a person is most at risk of dying at the time of birth. We also know that good maternal and newborn health is linked to childhood health and nutrition outcomes and can have lifelong implications on physical and cognitive development. For those reasons, maternal and newborn health also impacts the work of our colleagues outside the health sector, like education and economic recovery and development. Therefore, if we are truly going to improve the health and wellbeing of the people we work with, we have to start with pregnancy, delivery, and the first days after birth.

Despite this reality, maternal and newborn health remains a severely neglected issue in humanitarian and conflict-affected settings where the burden is highest.

Every year 2.6 million babies die before turning one month old and 45% of all of those deaths occur in humanitarian and fragile contexts. We have to do better.

Today is World Prematurity Day — an important opportunity to reflect on the fact that preterm birth causes almost 40% of all newborn deaths. Today, we call on all of our colleagues to take a moment to better understand the burden, the barriers to quality neonatal care, and the solutions that exist but are not yet reaching those who need them most.

Consider these staggering statistics:

15 million babies are born premature every year.

More than 1 million babies die annually as a result of complications from premature birth — more than 80% of whom are born in South Asia and Sub-Saharan Africa.

The risk of a neonatal death due to complications of preterm birth is at least 12 times higher for an African baby than for a European baby.

Fortunately, over 75% of deaths of preterm births can be prevented without intensive care and up to 58% of premature babies could be saved through the provision of cost-effective care for mothers and babies that can be feasibly delivered in low-resource settings. The challenge is making sure the solutions that exist reach the people who need it most — including those living in crisis affected communities where health systems are weak and access is limited.

The International Rescue Committee (IRC) is stepping up to address that.

Last year, the IRC announced three Global Research and Innovation Priorities to focus our energy over the coming years in order to generate a set of breakthrough solutions that improve client outcomes across the humanitarian sector. Maternal and newborn health (alongside other areas of sexual and reproductive health) was selected as part of an organization-wide commitment to identify and scale the most effective approaches for delivering services to our clients. We believe that by introducing innovative approaches to give women and newborns more options for quality care before, during and after pregnancy, we have the potential to drive sector wide change and accelerate progress to end preventable maternal and newborn deaths — including caused by pre-term birth — in crisis-affected communities.

Specifically, we are looking to use research and innovation in a number of key areas including:

Supporting women to engage in life-saving behaviors for labor, delivery, and immediate postpartum, such as breastfeeding, identification of clinical danger signs, and thermal care to prevent newborn hypothermia.

Equipping low-literate community health workers with the tools and training to deliver high-quality sexual, reproductive, and maternal and newborn services tailored to women’s and girls’ needs.

Engaging other community agents, such as pharmacists, traditional healers, and teachers to increase access to health knowledge and services.

We are also excited that the IRC was chosen as the host of the Interagency Working Group for Reproductive Health in Crises (IAWG) Newborn Initiative — an initiative that seeks to accelerate progress on a global, five-year strategic plan to protect every newborn in humanitarian settings.

The need for this type of work has become more urgent in the face of the COVID-19 pandemic as mobility restrictions and fear of transmission prevent women and newborns from accessing care at health facilities.

While the full impact of COVID on pregnancy is still largely unknown, a new study released by the CDC indicates that pregnant women with COVID-19 are at increased risk for severe illness and may be at higher risk for preterm birth. Among 3,912 lives birth from women with confirmed COVID-19 between March and October 2020, 12.9% were pre-term — higher than the 10.2% among the US general population.

This follows other reports estimating that a 10% decline in the provision of maternal and newborn healthcare due to COVID-19 could result in 28,000 excess maternal deaths and 168,000 excess newborn deaths across low- and middle-income countries — including those where we work.

With so many lives on the line, we have to do better

With greater investment, the right political commitment, and the research and innovation needed to tackle outstanding operational questions, we can transform maternal and newborn health services in humanitarian and fragile settings and reduce preventable deaths, including those caused by complications from preterm births.

Co-authored by Naoko Kozuki, Research & Innovation Lead — Sexual, Reproductive, Maternal and Neonatal Health; and Alicia Adler, Health Policy and Communication Specialist