CleanBirth - Saving Mothers and Babies in Laos

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Helping Babies Breathe

I know that I have written about this organzation before but so worth checking out if you are interested in infant health and survival.  Website: http://www.helpingbabiesbreathe.org/

Objective of HBB

To ensure that all babies are born with a skilled birth attendant present.

The Curriculum

Helping Babies Breathe is a neonatal resuscitation curriculum for resource-limited circumstances. It was developed on the premise that assessment at birth and simple newborn care are things that every baby deserves. The initial steps taught in HBB can save lives and give a much better start to many babies who struggle to breathe at birth. The focus is to meet the needs of every baby born.

The Golden Minute®

Helping Babies Breathe emphasizes skilled attendance at birth, assessment of every baby, temperature support, stimulation to breathe, and assisted ventilation as needed, all within “The Golden Minute” after birth.

Preventing Under Five Mortality

When I was working on the Thai-Burma border, there was a group bringing backpacks full of medical supplies.  So when I saw this interview on under 5 mortality between Andrea Mitchell of MSNBC and USAID Administrator Raj Shah, I thought it was worth sharing.

Cheap solutions to prevent 7mn under 5 deaths, including:

Diarrhea vaccine

Sweet potatoes — has Beta Karo-tine for vitamin A

Zinc tablets — for diarrhea and used with deydration salts

Bed nets — 220,000 children saved each year — cost $6

Mask to help new babies breathe

Study Low Birth Weight Babies in Lao PDR

This study (Nagoya J. Med. Sci.  72. 51 ~ 58, 2010) shows that mother’s health and nutrition are factors in babies being born with low birth rates.

Mothers who demonstrated a good grasp of nutrition and health delivered LBW infants 10.1 less frequently than mothers who showed more limited knowledge…

While considering the health status of mothers, it was found that those in poor health had LBW infants 3.4 times more often than healthy mothers.

Other issues like family support also play a role:

…In the traditional society of Lao PDR, women have little independence to decide their own future. For a pregnant mother to get medical support, she must wait for the decision of her husband or other family members before consulting a medical doctor for a check-up of her pregnancy status. The necessity of a nutritious diet and the extent of its availability is, except in some rare situations, again dependent on the wishes of the family.

“Hypertension and proteinuria leading to pre-eclampsia” was found in the study to be the cause of 20-25% of prenatal mortalities.

Conclusions:

The results of this study showed that the maternal factors significantly associated with LBW infants included the mother’s age and occupation, her knowledge and health status, and the family’s income. It may not be possible to address all these issues at once, but early and regular antenatal visits by prospective mothers and conducting awareness programs through the mass
media focusing on proper care during pregnancy could alleviate many of these problems.

Countdown to 2015 report: Look at Laos

Countdown to 2015 released country profiles today.

The 2012 Report, Building a Future for Women and Children, highlights country progress—and obstacles to progress—towards achieving Millennium Development Goals 4 and 5 to reduce child mortality and improve maternal health.

Lao PDR is a mixed bag.  Significant progress has been made in water and sanitation, malaria prevention, and immunizations. However there is much, much more to be done. Two biggies that I see: only 26% of infants <6 are exclusively breastfed (up from 23% in 2000) and only 20% of births have a skilled attendant (up from 19% in 2000).  Antenatal care is still bleak — with 35% attended once in pregancy by a provider — up from 27% in 2000.  Density of doctors, nurses and midwives stands at 12.4 per 10,000 population.

My summary: keep funding clean birth kits, community health workers and midwifery training.

Simple Checklist to Prevent Maternal/Infant Deaths

Acording to this article from Impact, http://www.psi.org/impact-magazine/2012/05/can-simple-checklist-make-child-birth-safer, checklists have cut surgical deaths in half.  Makes alot of sense for birth.

PSI/India has joined a team led by the World Health Organization, Harvard School of Public Health, Bill & Melinda Gates Foundation and many others who are asking whether checklists can significantly reduce the nearly 5 million maternal and infant deaths a year associated with childbirth.

PSI/India and partners have assembled a 31-item list of reminders, from the simple – asking the mother’s companion to be present at the birth – to precise clinical signs of infection and hemorrhage. Their aim over the next three years is to test it in India to see whether childbirth-related harm, including death, in institutional deliveries can be significantly reduced through adherence to essential childbirth-related clinical care standards.

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