Premature births, biggest killer of babies in Bhutan
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.