Safeguarding The Most Vulnerable Children In Africa, Asia, Others

On World Children’s Day, 2024, UNICEF published a new ‘State of the World’s Children’ report, warning countries that, “the fu­ture of childhood hangs in the balance if urgent action is not taken to safeguard chil­dren’s rights in a changing world.”

Indeed, 2024 World Children’s Day and World Prematurity Day reiterated the crucial need to protect the world’s children in line with the United Nations Children Fund (UNICEF) 2024 ‘State of the World’s Children’ report.

World Prematurity Day highlighted the fact that preterm birth complications remain the leading cause of death in children under five years of age, accounting for approximately one million deaths, or 35 percent of all newborn deaths, each year. It is estimated that three-quar­ters of these deaths can be prevented with ex­isting, cost-effective interventions.

Scaling these interventions for premature and small and sick newborns, however, has been challenging, the AlignMNH Collective Action for Maternal Newborn Health wrote in its Newsletter. Provision of level-2 small and sick newborn care often requires specialised knowledge and skills and continued invest­ments. Provisioning of the needed financial and human resources in national plans and budgets is critical to achieving sustainable scale-up. Providing respiratory support to pre­mature newborns requires safe oxygen, which can be difficult to source in last-mile locations. Detection and management of infection in vulnerable newborns is complicated by rising rates of antimicrobial resistance and limited diagnostics and laboratory capacity. Finally, how this care is delivered puts families at the center, protects the mother-baby bond, and fa­cilitates newborn neurodevelopment – adds to the challenge of caring for these vulnerable ba­bies. A greater focus on quality of care around birth and care of small and sick newborns will shift the world beyond survival to a thriving agenda.

Governments, key stakeholders, and part­ners rose to these challenges at the West and Central Africa Regional Consultation for Every Woman Every Newborn Everywhere (EWENE) and Child Survival Action (CSA) held in Da­kar, Senegal. Indeed, governments, key stake­holders, and partners from 24 countries in the region came together to prioritise actions for effective implementation to reduce maternal, newborn, and child mortality, including focused efforts on small and sick newborn care at the EWENE according to AlignMNH Collective Ac­tion for Maternal Newborn Health Newsletter.

Similarly, the first biennial International Maternal Newborn Health Conference (IMN­HC2023) in Cape Town, South Africa also called for emergency intervention to improve mater­nal and newborn survival worldwide, espe­cially in African countries, including Nigeria, for them to achieve Sustainable Development Goals.

According to IMNHC2023, Nigeria is among 60 countries that are at risk of not meeting the maternal, newborn, and stillborn targets of the Sustainable Development Goals (SDGs) without urgent intervention.

The World Health Organisation noted that infant deaths continued to make up about half of the under-five mortality, especially in Central and Southern Asia and Sub-Saharan African countries, such as Nigeria. For instance, Nige­ria accounts for the second-highest number of maternal and child deaths globally, the United Nations reported at the conference.

Indeed, Dr. Tedros Adhanom Ghebreyesus, bemoaned Africa’s high maternal and newborn deaths at the IMNHC2023.

He said, “Africa is where seven out of 10 women die due to pregnancy-related issues. Every year, 4.5 million mothers, newborns, and stillborns die from preventable causes.”

According to Ghebreyesus, “Where a child is born or how much money its family has should not determine whether it lives or dies. But this is still the reality for many women and babies worldwide.”

Also, Matamela Cyril Ramaphosa, President of the Republic of South Africa said, “Our continent’s future is being born again – we are called upon to start a new chapter by investing in women and newborns, where our actions have the greatest impact.”

Worried about the trend, Ramaphosa wrote in an opinion that heralded the IMNHC2023 ple­nary in Thomson Reuters Foundation seeking emergency action to curb Africa’s maternal and newborn deaths.

He said, “We have made significant strides towards better health outcomes for women, newborns, children, and adolescents. Only 20 years ago, most births in Africa happened at home, where we could not monitor adverse out­comes. Today, more than half of births occur at a health facility. Yet, this is still the lowest rate of any region in the world – far below the target of 90 percent needed to reach the Sustainable Development Goals for maternal and newborn survival.

In his article, the South African president asked rhetorically, so why do seven out of 10 maternal deaths continue to take place in Afri­ca? If we truly value mothers and babies, why are we slow in preventing mortality?

Ramaphosa argued that to realise Africa’s ambitions of economic and social prosperity for all, the continent needs to focus on where it all begins, with the survival and well-being of mothers and babies.

He said, “Today, around the world, there will be 12,000 deaths resulting from complications around birth, including women, newborns, and stillborns. Half of these deaths are in Africa.

“The burden of preterm births – the leading cause of newborn death – has hardly changed in 20 years. The numbers of stillbirths, too, remain unacceptably high with two million families a year suffering preventable losses, often in si­lence or stigma.”

As Ramaphosa puts it, “This cannot be tol­erated. So, in our parliaments, in our commu­nities, and our clinics, let us speak for change, and let us invest where it matters most.

“We need to invest in the building blocks of our health system, including better data to im­prove planning, monitoring, and evaluating the health system and a well-equipped workforce, especially with more midwives.

“We must join the dots between women’s health and what underpins it, including pro­moting and protecting gender-related issues. Women’s access to sexual and reproductive health services, including family planning, is a fundamental right.

“Together, we can avert 30 million maternal and newborn deaths and stillbirths worldwide by 2030, including more than 15 million in Af­rica alone. We hear the cries of our mothers, grandmothers, and men who have lost their wives, mothers, and children”‘ Put in the words of Ramaphosa, Ghebreyesus, and other world leaders, this is the time for Asian and African countries, including, Nigeria to commit to change.