EDITORIAL: No kidding matter

Good care during pregnancy, labour pains and after the birth of the baby can indeed help to reduce the fatalities
Nepal has a high neonatal mortality rate (NMR) of 38.6 per 1000 live births. Two thirds of the newborn deaths usually occur in the first week of life (early neonatal death). Newborn survival has become an important matter while seeking to improve the overall health status, as set by the Millennium Developmental Goals, of a developing country like Nepal. That this is indeed a serious health problem can be deciphered from the fact that 7,400 newborns die everyday in the South East Asian Region alone. The good news is that two-thirds of such deaths can be prevented and that too through the adoption of proven and tested cost-effective measures.

We should guarantee good quality care during childbirth and this could to a large degree ensure that there are less complications and infections in newborns. This is especially true in the case of the least developed countries like Nepal. The minimum standard of hygiene is often found lacking during the delivery of babies, particularly in remote areas which do not have convenient access to health centres. Now organizations like the WHO are gearing up to provide support to countries of this region to save newborns. They plan to do this by providing equitable access to life-saving measures through interventions for the mothers and babies, which is not the case now. We could do with more health centres well equipped and manned by adequate doctors and nurses. Midwives too play a very important role in this regard. Therefore, there is every need to provide them with the necessary training. In Nepal most of the babies are born with the assistance of midwives. The trained midwives should be mobilized in adequate numbers. They should also be funded and reach out to the unreached population. In this manner many newborn deaths could be averted. The prevention of deaths of newborns can be done by taking into consideration factors such as health, nutrition and also hygiene and sanitation. This cannot be done without empowering the women. Deaths of newborns occur in over 50 per cent of the children under five. Good care during pregnancy, labour pains and after the birth of the baby can indeed help to reduce the fatalities. Low-cost locally made equipment could be used to manage the sick newborns. Reduction of early neonatal deaths requires more intensive care.

Still, much progress has been achieved and the target has been set to reduce deaths among newborns further. We have yet to achieve the target set under the Millennium Development Goals. This should be done by giving due priority to newborn death reduction. It would go a long way in preventing the deaths of newborns that are preventable. The same goes for maternal deaths. These deaths have been reduced over time but there is little room for self-complacency. Reducing newborn deaths by two thirds is certainly not going to be easy. The goal set now is to reduce newborn mortality by as much as 12 per 1000 live births by 2030. However, it is realistic and can be achieved if due emphasis is given to preventing newborn deaths and bringing them to a halt in order to save the lives of newborns that are preventable.

Sensible idea
This year’s batch of SLC students are less lucky in the sense that their classes and studies have been seriously affected by events beyond their control. First, there came the major earthquake of April 25 and its powerful aftershocks just when the schools were about to reopen for the new academic session. This hit their education throughout the country, particularly in the earthquake-affected districts, for several weeks or even more.

To make up for lost time, the school administrations and government authorities have been taking several measures. In this context, the National Centre for Educational Development (NCED) has started using the radio and television to teach SLC candidates, particularly in eight Tarai districts. NCED has also uploaded the programmes on Facebook and Youtube, and they are planning to create a portal and mobile app to make textbook lessons available to the students. This is a sensible idea. The blockade delivered the third major blow, affecting all of them. Therefore, with special focus on the worst-hit areas, this teaching will benefit the students of all the areas.