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Thursday, November 21, 2013

Pre-Mature births in Nigeria A Burden

THE burden of infant deaths in Nigeria was again brought to the fore recently as experts’ findings revealed that no fewer than 700,000 pre-mature babies are lost every year in the country.



    The deaths, due to pre-mature related complications, places Nigeria second after India on the global neonatal mortality ratio of babies that die within 0 – 28 days of birth.

    At a walk and lecture, in commemoration of World Pre-maturity Day (WPD) 2013 in Lagos recently, paediatricians noted that the pre-mature birth complications is the leading cause of newborn deaths in Nigeria, because of poor awareness, lack of specialised care and unaffordable cost of managing a preterm baby for most families.

    Pre-maturity or pre-term is the birth of a baby of less than 36 weeks gestational age. The cause of preterm birth is in many situations unknown. About 35 per cent (15 million) of babies born worldwide are pre-mature, out of which about two million are lost yearly, due to complications.

    A specialist in the study and management of newborn babies, Dr Elizabeth Disu noted that neonatal mortality ratio in Nigeria is 40/1,000 live births, for reasons not unconnected with cases of pre-mature births, birth asphyxia and infections.

    Disu, who teaches at Lagos State College of Medicine (LASUCOM), said the burden was huge, partly because of the country’s high population, but largely because the necessary awareness have not yet been created about pre-maturity among the public.

     Pre-term babies, she noted, have a lot of problems - both immediate and long-term problems - hence the need to create awareness.

    According to Disu, “what you’d first note is that, because they are born too early, too soon and have immature organs, they are unable to maintain breathing. Their lungs are immature. The brain that controls breathing and temperature are also immature. So, they suffer from cold. You have to keep them in incubator and have them insulated.

    “They are also highly prone to infections, because their immune system has not developed. Once, they are cold, they are prone to a lot of problems and need extra glucose to keep breathing, stay awake and alive,” she said.

     Disu, who spoke at the commemoration, organised by Tiny Beating Hearts Initiatives (TBHI) at Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, observed that pre-term babies were often brought to the centre cold and when there is nothing specialists could to resuscitate.
     Continuing, she said, “some pre-terms are brought to LASUTH on okada!

A father, right from Ajegunle, brought a pre-term who was delivered at home, down to LASUTH on okada. The baby was in a cartoon. They first went to Massey Street Children Hospital and Lagos University Teach Hospital (LUTH) but there was no incubator. By the time they got here, the baby was stone dead.

     “Whereas, all they would have done is to have the mother place the baby to her chest, skin-to-skin, to maintain her temperature, cover the head with wool and legs with stockings; the baby would still be alive. But this is part of the reason about 700 of them die daily in this country. Several of them during home deliveries,” she said.

     It would be recalled that a recent ‘State of The World Mothers 2013’ report stated that Nigeria has the second highest burden (after India) of children that die on their first day of birth. The report had estimated that nearly 90,000 die, constituting nine per cent of the global total.

     Peadiatricians said the more pre-term babies are, the more their problems and lesser their chances of surviving. Besides their problem with feeding, they also, on the long term, often have issues with their sight, blindness, inability to hear, learning disabilities and motor functions of the limbs.

     “Their problems are indeed enormous and extremely costly to manage, hence the need to raise awareness on preventive measures like effectively planning pregnancy, attending Antenatal Care (ANC), seeking specialist’s help once a problem is suspected during pregnancy.

  “We don’t only want the babies to survive, but to survive well without disabilities. We need to let everyone know about pre-term problems and prove cost effective measures and intervention,” she said.

     Founder of TBHI, Petra Onyegbule, added that the problems of a pregnant woman are indeed enormous, and any of them could cause pre-mature delivery.

    Sharing her experience with pre-mature birth, Onyegbule advised that ANC services are better sought at public hospitals, in a pregnant woman’s neighbourhood, “because of their high likelihood of having skilled personnel and requisite equipment.”

      She said, “we really need to spread the news that with effective care at the right place and right time, pre-term babies can survive. More so, our doctors in public hospitals are not all bad after all.

By my experience, there is a lot they can do, far better than the so-called private hospitals, but we need to raise awareness for people to be aware of the problem and what they need do,” she said.

       World Prematurity Day, November 17 2013, is a global movement to raise awareness about prematurity highlighting the burden of preterm birth, informing on simple, proven cost-effective solutions, and evoking compassion for families who have experienced preterm birth.

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