Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
Today, on World Prematurity Day, WHO launched a new Roadmap on human resource strategies to improve newborn care in health facilities in low- and middle-income countries, aimed at improving quality of care for newborns, including small and sick babies, and supporting countries to achieve the SDG target to reduce neonatal mortality to less than 12 per 1000 live births by 2030.
As the COVID-19 pandemic overburdens already weak health systems in many countries, it is expected to increase the number of newborn deaths, particularly among babies born too soon. Disrupted essential health services, like family planning or antenatal check-ups, will leave women more at risk of preterm birth and vulnerable infants without the services they need.
“We have the power to prevent, diagnose and treat preterm birth, and save babies lives, if we invest in competent and specialized nurses and health workers to care for them,” Dr Anshu Banerjee, WHO Director for the Department of Maternal, Newborn, Child and Adolescent Health and Ageing. “As more pregnant women give birth in health facilities, we must also strengthen our health workforce to provide a positive pregnancy experience for each of them.”
Survival and health outcomes of preterm newborns can be enhanced by increasing access to interventions provided to the mother shortly before or during birth as well as interventions for the newborn baby. However, the highest burden of preterm birth, death and disability is concentrated in low- and middle-income countries, where competent and specialized health workers are in short supply.
Of the 30 million newborns who require inpatient care every year, approximately half do not have access to neonatal care services and those who have access often receive care of suboptimal quality. Skilled birth attendants, including medical doctors and midwives, are critical to the provision of high-quality newborn care and to improving newborn outcomes, not only at the time of birth and for routine postnatal care but also in health facilities to which mothers and newborns with complications are referred.
The new WHO roadmap consists of 10 strategies to guide countries in developing their policies to improve the number and competence of health workers to deliver high-quality essential care for all newborns and specialized care for small and sick newborns. It also aims to fill the gap in the numbers of health workers with specialized neonatal skills in low- and middle-income countries required to provide high-quality inpatient care for small and sick newborns.
Over the past three decades countries that have invested in their nursing and midwifery workforces have achieved sustained reductions in maternal and newborn mortality. With continued investments in universal access to high-quality newborn care an estimated 1.7 million newborns could be saved each year. Almost half of the effect would result from providing special and intensive hospital care for preterm, low-birth-weight or sick newborns.