It’s New Year 2015 - a year that represents a monumental landmark in development efforts across the world - for the last 15 years our attention has been focused on progress and priorities for achieving those all-uniting goals and targets by the end of 2015, the Millennium Development Goals.
I am sure that much attention will shift over the course of this year to the finalisation and political support of the post-2015 development goals framework. And yet it is imperative for us to ensure that unprecedented efforts and accountability for results against our MDG targets become a hallmark of 2015.
Taking up the cause for our babies survival
I am determined to make this a Newborn New Year – newborn babies represent surely our most vulnerable and dependent human life, and yet thousands upon thousands of our precious babies are born dead or die needlessly in their first few hours and days of life in Tanzania every month.
It is particularly disheartening that reversing this toll is one of the MDG targets that has seen the slowest progress, and yet this prevailing tragedy is on the most part a deafeningly silent one, despite the fact that more than 80% of these newborn deaths are preventable through timely access to medicines and simple interventions.
Just how can there be such a cloak of silence? Is it because Tanzania has made such an enormous achievement in already reaching its MDG-4 goal of reducing child deaths under-five years old by two-thirds, furthermore more than a year before the MDG deadline? True enough, we have every reason to be celebrating such a milestone, and the collective leadership and immense efforts that have succeeded in dramatically improving child survival deserve to be hailed.
However, the plight of our babies is being mostly obscured by such successes. For Tanzania to be reporting the eleventh highest number of newborn deaths in the world is an extremely sobering and serious issue.
We are losing the lives of nearly 40,000 of our newborn babies every year
Indeed, given that three-quarters of these newborn deaths happen in the first week of life – that means that 1 in 3 of all deaths to children under-five years old is now happening in their first 100 hours of life.
That is for those of our babies born alive. The silence is even louder when it comes to babies born dead.
And yet the scale of stillbirths in our country represents another huge tragedy. It is estimated that 47,000 babies are born dead every year in Tanzania, with almost half of them losing their lives during childbirth. Put in another way, 22,000 babies are alive at the point their mothers go into labour, and yet only a few hours later the joyous anticipation of mothers and families is jerked into grieving as their babies are delivered dead. It goes without saying that the vast majority of these babies’ lives absolutely should be saved.
Newborn survival – surely it is a fundamental human right?
This represents a huge development challenge for Tanzania. Given the scale of this loss of our babies lives, it is almost incomprehensible the level of ignorance and inaction to reverse this situation across our society. Just why is this the case? Why aren’t the community at large, media, politicians, leaders at all levels, and indeed health stakeholders collectively taking up the cause to save thousands of our babies’ lives?
A baby’s death is a relatively common occurrence – our society has become accepting of this reality. At a family and wider community level there remains a deep fatalism, fuelled by poverty and widespread ignorance of newborn health. In many settings, stillbirths and newborns deaths are not fully grieved by the household, rather quiet and private burials are conducted.
Furthermore, most of these deaths are not notified.Given the huge challenges we have with birth registration in Tanzania, is it of any wonder that the vast majority of stillbirth and newborn deaths are not reported, let alone reviewed?
Yet without the data it makes it very difficult for leaders and decision-makers at national and sub-national levels to take informed action, and for communities, media and stakeholder groups to persuasively advocate for newborn survival and to hold accountable the many failings that add up to this unacceptable toll.
The silence therefore pervades.
Why should a baby’s death be any different to any other death? – is this not a fundamental human rights issue?
Look at the panic and reaction recently over dengue fever, which killed around 10 Tanzanians. Just what would we do as a nation if calamity struck and the current Ebola pandemic did cross our borders, and over the next year nearly 40,000 Tanzanians succumbed to it? We know our country would change beyond unimaginable proportions. Just where is that panic and reaction about the huge loss of life of our babies which is indeed taking place?
We all need a deafening wake-up call
When we hear that there are no medicines getting to our health facilities, we can be sure that also means our babies are not receiving essential care.
When we learn that less than half of our human resources for healthcare positions are filled, we can be sure there is a lack of skilled healthcare providers to care for our newborns.
When fewer than half of our mothers report early initiation of breastfeeding, we know half of our babies are missing out on this unique first milk which is rich in protective factors.
The low use of contraceptives among our adolescent girls, despite almost a quarter of them giving birth by the age of 19, we know will result in an increase of complications during childbirth including premature babies.
When only a quarter of our delivery rooms have appropriate water and sanitation facilities, we can be sure the risk of infection increases.
With only half of our mothers giving birth in the presence of a skilled birth attendant, and furthermore two-thirds of our babies not receiving post-natal care within the critical window period around birth – then we can understand just why almost 28,000 of our babies are dying in their first week of their lives every year.
This is not a technical language that can only be understood by medical professionals. It can be very clearly communicated and understandable to us all; these are engaging issues which we can and must all take immediate concerted steps to address.
2015 – Could this be a Newborn New Year?
Calling for this New Year 2015 to be a Newborn Year, would be a fitting acknowledgement of this challenge to us, and open up more compelling opportunities to respond.
Encouragingly, there is an immediate momentum to build upon. The government and partners, with Mama Ye! Tanzania at the forefront, leveraged on marking World Prematurity Day on 17 November 2014 for the first time ever in Tanzania, to raise the profile and conduct unprecedented advocacy for newborn survival. Various efforts were made to mark this important day, including:
- The training of journalists from across all regions of Tanzania in evidence-based reporting on newborn issues; the conducting of various media activities including a joint press release and coordinated public awareness programs aired by community radio stations throughout Tanzania
- Developing various evidence-based advocacy materials; and most notably, a landmark advocacy event hosted by our National Assembly on World Prematurity Day itself, whereby national leadership and our parliamentarians came together to familiarise themselves and break the silence behind the extent of prematurity concerns in Tanzania.
- Finally, in mid-December a newborns stakeholders’ roundtable meeting was hosted by the Ministry of Health leadership, bringing together the government, development partners, professional associations, civil society organisations, and the media, to deepen awareness of the newborn context in Tanzania. We came together to improve collaboration and coordination across stakeholder groups. We took time to identify key actions to enable optimal delivery against the newborn priorities and commitments in the Sharpened One Plan – which if acted on nationally could save thousands of babies’ lives by the end of 2015. As a result we now have a movement to speak out and act for newborn survival.
We MUST take action now for our babies
I remember at the turn of the Millennium in 2000 when our President officially declared HIV/AIDS as a national disaster in Tanzania. Just look at the immense efforts, resources, and achievements recorded in addressing HIV and AIDs since then.
Now consider the newborn challenge facing us. Even a layman’s quick estimations of newborn deaths using the current relatively improved trend of an estimated 38,600 babies dying every year will tell you that since the turn of the Millennium to date we have lost possibly as many as over half a million babies...
This can be taken to an even more staggering scale if you take into account a similar even bigger toll of babies being born dead – stillbirths (with nearly half of these stillbirths happening during birth) – yet another half a million plus. Most of these deaths have not been notified; they have not been heard, but it has generally been assumed as their fate.
I wonder with a deep sense of loss just who these one million babies could have grown up to be in our society.
What a tragic development loss that demands the attention of our nation.
We cannot let this lie silently in our conscience.
We cannot say we haven’t heard them now. Undeniably we must do more. Let’s change this. Let’s be their voice. Let’s all collectively take action to turn it around and reverse this tragic toll of preventable deaths and instead save thousands and thousands of these precious lives. While disadvantaged groups in our society are many – one way or the other, they can speak out relatively for themselves.
Babies, including those born dead, totally rely on us to speak out and act on their behalf. Then they will have a voice and will be heard as they grow up.