Pre­ma­ture births, big­gest killer of ba­bies in Bhutan

Bhutan Times - - Front Page - Sonam Wangmo

The Min­istry of Health in col­lab­o­ra­tion with the Fac­ulty of Nurs­ing and Pub­lic Health ob­served the World Pre­ma­ture Day on 17 Novem­ber in Thim­phu.

This year, the day was ob­served with the theme “Work­ing to­wards prevention and im­prove­ment of qual­ity care for pre­ma­ture birth in Bhutan”.

Bhutan is one of the coun­tries in South Asia that has huge bur­den of preterm birth. WHO es­ti­mates that the num­ber of preterm births for Bhutan is 1,380, which is one preterm birth per 10 live births.

Min­is­ter of health, Ly­onpo Tandin Wangchuk, said that pre­ma­ture births were the num­ber one killer of ba­bies in Bhutan. Ly­onpo added that an­nual ma­ter­nal and neona­tal death review found 37 per­cent of preterm deaths con­tribut­ing to neona­tal mor­tal­ity in the coun­try.

Ly­onpo said that the min­istry has ini­ti­ated the im­ple­men­ta­tion of Ev­ery New­born Ac­tion Plan in col­lab­o­ra­tion with Jigme Dorji Wangchuck National Re­fer­ral Hospi­tal (JDWNRH), Kh­e­sar Gyalpo Univer­sity of Med­i­cal Sciences of Bhutan, UNICEF and WHO. The plan as­pires to achieve the tar­get of re­duc­ing neona­tal mor­tal­ity rate from 21 per 1,000 live births at present to 13.2 per­cent per 1,000 live births by 2023.

Kan­ga­roo Mother Care is one of the ways to care ba­bies. It is based on skin-to-skin con­tact be­tween the baby and mother in kan­ga­roo po­si­tion.

Doc­tor Hari Prasad Ch­hetri, a pe­di­a­tri­cian of at JDWNRH, said that a kan­ga­roo mother’s care is ef­fec­tive as an in­cu­ba­tor. It pro­vides ther­mal con­trol, pro­motes bond­ing be­tween the child and her mother, and im­proves phys­i­o­log­i­cal re­cov­ery in in­fants as young as 28 weeks.

Pre­ma­ture birth is an im­por­tant pub­lic health con­cern which should be ad­dressed both at com­mu­nity and in­sti­tu­tional lev­els.

Even if the a pre­ma­turely born baby sur­vives, the child will find it dif­fi­cult to live a nor­mal life due to se­ri­ous health chal­lenges like life­long dis­abil­i­ties such as cere­bral palsy and vi­sion and hear­ing loss.

Ac­cord­ing to global es­ti­mates, in Bhutan, 10 per­cent of live births are born too soon (preterm birth).

Doc­tor Yoriko Nishizawa, a neona­tol­o­gist at JDWNRH, said, “Pre­ma­ture ba­bies can be saved now with fea­si­ble, cost­ef­fec­tive care.”

She high­lighted that lim­ited re­sources in medicines and equip­ment sup­ply, hu­man re­sources con­strains and

less ca­pac­ity de­vel­op­ment are the chal­lenges in Bhutan lead­ing to the in­crease in the num­ber of deaths.

Fam­ily plan­ning and pol­icy sup­ports, in­clud­ing smok­ing ces­sa­tion and em­ploy­ment safe­guards of preg­nant woman, will re­duce preterm births, she added.

Be­hav­ior risk fac­tor like oc­cu­pa­tional ac­tiv­i­ties, low so­cio-eco­nomic fac­tors such as stress, anx­i­ety, de­pres­sion and stress­ful live events are few of the causes of preterm birth, ac­cord­ing to Dr Pema Cho­den, a gy­ne­col­o­gist at JDWNRH

To ad­dress such chal­lenges, the min­istry of health has plans to train health­care provid- ers on Early Essen­tial New­born Care and kan­ga­roo mother care. More­over, the min­istry is also go­ing to ex­pand the phase man­ners to re­fer­ral hos­pi­tals and district hos­pi­tals to have re­duc­tion of neona­tal mor­tal­ity in the coun­try.

Tsh­er­ing Wangchuk, a father of a pre­ma­turely born baby, said many par­ents were not aware of such in­ci­dence and about the dis­eases like him. He sug­gested that it would be benefi- cial to par­ents if health­care providers could cre­ate aware­ness on this chal­lenge.

A baby is con­sid­ered born pre­ma­turely when it is less than 37 weeks old at the time of birth. A pre­ma­ture baby is usu­ally not fully de­vel­oped which means some vi­tal or­gans might not be func­tion­ing at op­ti­mal lev­els.

Of­fi­cials from UNICEF, WHO, the health min­istry, and the fac­ulty of nurs­ing and pub­lic health ob­served the day.

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