Around 15 million (1.5 crore) infants are born prematurely every year around the world. And 1 million (10 lakh) of them die. In Bangladesh, every year 438,800 infants are born premature. Premature infants face a lot of complications. It is possible to reduce the rate of premature births by curbing child marriage, ensuring proper nutrition for the mothers and providing proper training and skills to the health workers.
These observations were made on Tuesday at a virtual roundtable on ‘Working together towards saving the lives of premature infants.’ The discussion was organised by Bangladesh Neonatal Forum, with support from Save the Children, UNICEF and Prothom Alo.
Presenting the keynote at the event, chairman of the neonatal department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Mohammad Shahidullah said 15 million (1.5 crore) infants are born prematurely every year around the world. And 1 million (10 lakh) of them die. One in every 10 infant dies due to being premature. Of the total number of infants born, 35 per cent die with complications, having been prematurely born.
He said, in Bangladesh every year 438,800 infants (19 per cent) are born premature. The resulting complications lead 23,600 infants to die every year before they can reach 5 years of age. And 11,200 of the premature infants survive with various complications.
Mohammad Shahidullah said that there are Kangaroo Mother Care (KMC) services in 192 health complexes around the country to protect premature infants. By 2022, this service will be provided in 270 complexes. Steps must be taken for this service to be provided in all hospitals and health complexes of the country.
Line director of the family planning directorate (MCRAH) and director (Mother and Child Health), Mohammad Sharif, said child marriage was a major cause of the rise in the number of premature births. KMC was an excellent initiative to keep premature infants healthy. When a child is born prematurely, it not necessarily must be rushed to ICU. Efforts are being made to lessen this.
KMC services are relatively new in Bangladesh. It is possible to provide this service within the existing system. There are excellent guidelines, workers and commitment. All that is required is implementation and monitoring. Then it will be possible to prevent neonatal deaths
Directorate General of Health Services line director (MNCAH) Md Shamsul Haque said two types of measures must be taken to reduce premature births. One is preventive and the other is antenatal medical treatment. Further awareness must be mobilised among the health workers and the public in this regard. The population problem is the biggest challenge. Necessary facilities have been increased at an upazila and district level.
Nurses and health workers were given training in the care of premature infants. But often when they are needed, they are assigned to other wards. This is a serious challenge
BNF president Tahmina Begum said that a mother suffering from malnutrition gives birth to an undernourished child. Care must first be given to mothers’ nutrition. The family and the community must take responsibility for this.
Health manager of UNICEF, Ziaul Matin, said accurate data of the number of premature infants is not coming in. There is a lack of data about this at a union, upazila and district level. This shortcoming must be addressed.
Dr. Umme Salma Jahan Meena, Chief of Party, USAID’s MaMoni MNCSP, Save the Children, said that a study indicated that follow-ups at a community level proved to be effective in survival of premature infants. KMC services are relatively new in Bangladesh. It is possible to provide this service within the existing system. There are excellent guidelines, workers and commitment. All that is required is implementation and monitoring. Then it will be possible to prevent neonatal deaths.
USAID project manager specialist (maternal health), Farhana Akhter, said retinopathy or ROP was a major complication of premature infants. If the blood does not flow to a premature infant’s retina, this may result in retinopathy. It is necessary for a premature infant to undergo retina screening. Oxygen is also essential for a premature infant but this must be administered with care or else the infant’s eye may be harmed.
Senior director of icddr’b’s mother and child health department, Shams L Arefin, felt the need for strategic discussions and planning to prevent the rate of premature births. He said, these programmes must be taken in proper time. Just 270 KMC service facilities for over 400,000 premature births were inadequate. This had to be increased manifold.
DGHS programme manager (NNHP) Shariful Islam said nurses and health workers were given training in the care of premature infants. But often when they are needed, they are assigned to other wards. This is a serious challenge. Midwives have been assigned to many healthcare centres. It will be beneficial if they are trained in premature infant care.
President of the Obstetrical and Gynaecological Society of Bangladesh (OGSB), Samina Chowdhury, said that the quality of neonatal care in the country is questionable. But it is possible to tackle the challenges. Public awareness is also necessary. The media’s cooperation is also required.
Momena Khatun, health technical specialist of Global Affairs Canada, said that the government has the major role in reducing the rate of premature births. The projects of donor agencies come to an end. It is necessary for these initiatives to then be taken up in government projects. The 270 KMCs is just a number. It is essential to spread to service all over the country.
In his opening address at the event, Prothom Alo associate editor Abdul Quayum said that the major challenge is to ensure that infants are not born before 37 weeks. That calls for the mother to be taken care of properly and for the concerted efforts of all concerned.
Prothom Alo assistant editor Firoz Choudhury moderated the roundtable.