Care of the low birthweight babies /neonatal intensive care

Abstract

While the under five childhood mortality rates have shown a somewhat decline in the developing countries in the last three decades, the neonatal mortality rates (NMR) have generally remained static (Darmstadt 2003; 224-25) Globally, there are about 4 million neonatal deaths out of the approximately 130 million live births annually and 99% of these deaths occur in the developing countries (Lawn, 2005:891-900). It is estimated that in the developing countries, 75% of the neonatal deaths occur in the first week and 50% happen at home. Low birth weight (LBW) babies account for nearly 80% of neonatal deaths. The rates for LBW babies are also highest in the developing countries. Unfortunately there is very poor documentation of these babies, and weights of newborn babies in general, in these countries (Victoria C 2003; 233-241; Adam T 2003; 407-420). Millennium development Goals (MDGs) are broad global commitment to addressing general poverty and health. MDG 4 aims to reduce the under-five mortality rate by two thirds between 1990 and 2015 (Haines 2004; 394-397). To achieve this MDG, efforts in reducing the NMRs through better care of the LBW babies have to be increased (Darmstadt 2003; 224-225). Care of the LBW, who are predominantly preterm, require a lot of resources for information and cost effective intervention measures. Paradoxically, the countries with the highest NMRs have the least of these resources (Hart JT 1971; 405-412). Any gains being made in reducing the NMRs through care of the LBW in the resource poor nations are also eroded by the HIV-AIDS scourge (Haines 2004; 394-397). The rest of this paper outlines the care of the LBW babies in terms of

Appropriate resuscitation /respiratory care • Prevention of hypothermia

Feeding

Prevention of infection which have been found to be cost effective strategies in reducing NMRs ( See Table). The place of Neonatal Intensive Care is explored.