News / Health

Q&A with Ishtiaq Mannan: Preventing Newborn Deaths

FILE - Monowara holds her 22-day-old grandson Arafat, as she walks through a mustard field on the outskirts of Dhaka.
FILE - Monowara holds her 22-day-old grandson Arafat, as she walks through a mustard field on the outskirts of Dhaka.
Frances Alonzo
Save the Children says that over a million babies die each year on their birthday. These are preventable deaths. However, some Asian countries are bright spots in this sad reality. In its newest report, Ending Newborn Deaths, Bangladesh figures prominently. It's the region's greatest success at making successful strides in reining in this statistic.
Ishtiaq Mannan told VOA's Frances Alonzo that the deaths happen because of premature birth and complications during birth.
MANNAN: These newborn deaths happen on the first day of life, actually, [they] can be attributed to intra-partum complications, which is mostly known as birth asphyxia, then prematurity is one of the leading causes of the first day deaths and also infection. So these are the three major causes that contribute to the first day deaths. 
ALONZO: In this report, Bangladesh figures prominently. Tell me why.
MANNAN: There are two sides of Bangladesh being featured in this report as one of the focus countries. Bangladesh has made tremendous progress over the last several decades in terms of reducing child mortality. Now, when I say child mortality, that means we consider “under five mortality,” children under five. So, over the last two decades child mortality has come down significantly to a level of 41 per 1,000 live births. And Bangladesh is one of the very rare countries which are on track for achieving Millennium Development Goal 4 (MDG 4) [which is to reduce child mortality.]
So that is a big success story, I would say, and can be attributed towards Bangladesh’s effort to get very good coverage, almost universal coverage of immunization, treatment of diarrhea, treatment of pneumonia. And also on the maternal health side, Bangladesh has been able to reduce the maternal mortality by 40% over the last one decade.  So that is the success side of it, and the attributing factor like skilled attendants at delivery has almost doubled over the last eight years.
But on the other hand, if we look at the levels now… mothers who are delivering at facilities with skilled attendants are really only one third of the total mothers. That means two thirds of Bangladeshi mothers that are still delivering at home at the hand of unskilled providers. So, these mothers are at a risk, both the mothers and the newborn babies that are being born to these mothers. On the other hand, there is an issue of quality of care, the care that is being given to the mothers that are of questionable quality in many cases. 
The other aspect is the inequity part of it. Though Bangladesh is a small homogenous country, it has a huge population of 160 million. The last challenge that Bangladesh is facing is strengthening of the health systems. So the health systems like human resource problems, health workforce issues, then the availability of acceptable and usable quality of information, supervision system, mentoring support, logistic supply. These are the overarching issues that are actually resulting into poor coverage and quality.
ALONZO: Earlier, you spoke of the strides that are happening in Bangladesh. Tell me about how other countries in Asia are faring.
MANNAN: Nepal, I would say, is just like Bangladesh, who is very much on track on achieving Millennium Development Goal 4 and 5 [which is to improve maternal health.]  So, Nepal has shown and demonstrated that use of community based volunteers, community based approaches and continuous commitment from the government can make a big difference. 
Some parts of India are making very good progress and you know India is a very big country. And there are still inequity issues.  But in the recent past [the] Indian government has recruited over a million of health workers and this health workforce is now acting as a vehicle to the rural communities to get the newborn health care services in their households. 
And also there are Pakistan and Afghanistan, who are making significant progress.  
ALONZO: Tell me about how this report, from the regular person right off the street, how can it help them?
MANNAN: A report cannot change the world. But then, the report brings people to focus their attention and to identify the right problem and where we need to focus. So the good thing about this report, what I like as a reader, I would say, that this points [a] finger, that we should really look at who are most vulnerable, who are dying and where we should focus our support towards.

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