Life cut at the beginning

HARARE - Neo-natal deaths are fast becoming Zimbabwe’s new headache.

Beating HIV/Aids as the number one killer, they are accounting for most of the deaths of children under the age of five.

According to UN agency, Unicef’s health specialist Ranganai Mathema, about 80 percent of deaths among children under five are caused by four mostly preventable causes.

“Neo-natal is the highest at 29 percent followed by Aids at 21 percent. Pneumonia and diarrhoea are at 13 percent and nine percent respectively. Measles has resurfaced with an 8 percent contribution to mortality,” said Mathema.

“Malnutrition is an underlying cause for most of these conditions.

Most of these deaths can be prevented by providing universal coverage with proven high impact low-cost interventions,” said Mathema.

She said over 65 percent of these deaths occurred within the first year of life, as estimated by an infant mortality of 60 per 1 000 live births.

“Within the first month, 24 neonates out of 1 000 live births die each year. This represents about 40 percent of the infant mortality and 28 percent of the under five mortality,” said the health specialist.

She said neo-natal deaths comprised preterm birth complications, birth asphyxia and neo-natal sepsis.

“Most deaths of under-fives occur in the neo-natal period. At least 39 percent of neo-natal deaths are caused by preterm birth complications followed by birth asphyxia which account for 27 percent, and neonatal sepsis 14 percent,”  said Mathema adding that 75 percent of the neo-natal deaths occurred within the first week of life. Of these, 50 percent occur within the first 24 hours of life,” said Mathema.

Mathema said the causes of these neo-natal deaths are mostly preventable.

“Risk factors of neo-natal mortality include unsafe and unhygienic delivery environments, delays in seeking skilled medical care, home deliveries, poor antenatal surveillance and poor postnatal care,” she said.

“Whereas causes of under-five morbidity are respiratory conditions, diarrhoea, malaria and skin conditions rank among the top five causes of morbidity in children under-5 years in Zimbabwe. Acute respiratory infections account for most outpatient attendances. A significant proportion of children are affected by pneumonia, often of the severe form,” she said.

Last year, reports stated that Zimbabwe is one of the 58 countries in the world facing a critical shortage of midwives and this has contributed to an increase in maternal mortality and child mortality rates in the country.

This was revealed in a global report on the state of midwifery, under which service providers offer care to women during pregnancy, labour and birth.

According to The State of The World’s Midwifery 2011 report, since 1990 the maternity mortality rate has doubled, newly-born deaths has risen due to the lack of midwifery workforce which equals
8 244 midwives inclusive of the nurse-midwives and nurses with midwifery competencies in Zimbabwe.

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