Neonatal Care Improvements Urged to Reduce Infant Deaths in Tanzania

tanzania Grapples with Alarming Newborn Mortality Rates, Experts Demand Urgent Action

Arusha, Tanzania – A stark reality is unfolding in TanzaniaS healthcare sector as the Paediatric Association of Tanzania (PAT) reveals that over 95 percent of newborn deaths are tragically linked too a lack of oxygen during birth or labor. This critical issue was at the forefront of discussions at the 2nd National Child Health and Welfare Congress held in Arusha, highlighting an urgent need for enhanced neonatal care infrastructure and a bolstered pediatrician workforce.

Dr. Theopista Masenge, President of PAT, articulated the gravity of the situation, emphasizing that the absence of modern Neonatal Care Units (NCUs) in numerous health facilities is a primary contributor. “Establishing these units in referral, regional, and even district hospitals would be a game-changer,” Dr. Masenge stated, underscoring the vital role of well-equipped facilities with skilled personnel in safeguarding newborns. The conference, themed “Quality of care: Empowering Parents to Ensure Health across Every Child’s Journey,” gathered medical professionals to meticulously examine the trajectory of child health services, from pre-conception through to the critical moments of childbirth.

Beyond immediate survival,Dr. Masenge also pointed to the important long-term consequences of inadequate care. “If healthcare workers are equipped with the right knowledge, we can not only reduce newborn deaths but also prevent long-term complications such as cerebral palsy and premature births,” she asserted.

Compounding these challenges is an acute shortage of pediatricians nationwide. Dr. Masenge presented a sobering statistic: with over 2.3 million live births annually, Tanzania faces a dire ratio, with fewer than 350,000 doctors in total, meaning each doctor could possibly be serving over 100,000 children. To address this critical gap, PAT has urged the government to ensure a minimum of four pediatricians in every regional hospital and at least one in every district hospital, thereby improving access and the quality of care for the nation’s youngest citizens.

In response, Dr. Seif Shekalaghe, Permanent Secretary in the Ministry of Health, acknowledged the existing disparities in medical personnel distribution. “It’s true that some areas are overstaffed while others are critically underserved,” Dr. Shekalaghe commented, outlining plans for a strategic redistribution and deployment of medical personnel to alleviate the pressure on underserved regions.

The triennial congress, a collaborative effort between PAT and the ministry of Health, serves as a crucial platform for evaluating progress and refining strategies to elevate child healthcare standards across Tanzania. The urgency of the issues raised underscores the imperative for swift and decisive action to protect the health and future of the nation’s children.

What percentage of infant deaths in Tanzania occur within the neonatal period (first 28 days of life)?

The Critical First 28 Days: Understanding Neonatal health

A newborn infant, or neonate, as defined by the World Health Organization (WHO), is a baby within the first 28 days of life. this period represents the highest risk for neonatal morbidity and neonatal mortality. In Tanzania, despite progress in overall child health, infant mortality rates remain a notable concern, with a considerable proportion of deaths occurring within this crucial timeframe. Improving neonatal care is thus paramount to achieving lasting reductions in infant deaths.

Key Challenges in Tanzanian Neonatal Care

Several interconnected factors contribute to the high rate of neonatal deaths in Tanzania. These include:

Limited Access to Quality Antenatal Care: Many pregnant women lack access to regular antenatal checkups,hindering the identification and management of potential complications. This includes screening for infections, monitoring fetal well-being, and providing essential nutritional guidance.

Lack of Skilled Birth Attendance: A significant number of births still occur at home without the presence of a trained healthcare professional – a skilled birth attendant (SBA). This increases the risk of complications during labor and delivery, such as obstructed labor, postpartum hemorrhage, and birth asphyxia.

Inadequate Postnatal Care: Postnatal care for both mothers and newborns is often insufficient, leading to delayed detection and treatment of infections, feeding problems, and other health issues.

Infections: Neonatal sepsis, pneumonia, and other infections are major causes of newborn mortality in Tanzania. Poor hygiene practices and limited access to antibiotics contribute to the spread of these infections.

Preterm Birth and Low Birth Weight: Premature babies and infants with low birth weight are particularly vulnerable to complications and have a higher risk of death.

Geographical Barriers: Remote rural communities face significant challenges in accessing healthcare facilities due to distance, poor infrastructure, and limited transportation options.

Essential Interventions for Improved Neonatal Outcomes

Addressing these challenges requires a multi-faceted approach focused on strengthening the entire continuum of care:

Strengthening Antenatal Care:

Increased coverage of antenatal care services, including at least four visits during pregnancy.

Routine screening for HIV, syphilis, malaria, and other infections.

Provision of iron and folic acid supplementation.

Education on danger signs during pregnancy and the importance of seeking timely medical attention.

Promoting Skilled Birth Attendance:

Investing in training and deployment of skilled birth attendants (doctors, nurses, midwives).

Improving access to emergency obstetric care (EmOC) facilities.

Incentivizing institutional deliveries.

Enhancing Postnatal Care:

promoting early initiation of breastfeeding within the first hour of life.

Providing counseling on exclusive breastfeeding for the first six months.

Monitoring newborns for signs of infection, jaundice, and other complications.

Ensuring mothers receive adequate postnatal care, including screening for postpartum depression.

Improving Infection Prevention and Control:

Promoting hand hygiene in healthcare facilities.

Ensuring safe delivery practices.

Providing appropriate antibiotic treatment for neonatal infections.

Addressing preterm Birth and Low birth Weight:

Improving maternal nutrition.

Providing antenatal corticosteroids to women at risk of preterm labor.

Establishing neonatal intensive care units (NICUs) equipped to care for premature and low birth weight infants.

Community-Based Interventions:

Training community health workers (CHWs) to provide basic newborn care and identify danger signs.

Promoting household practices that reduce the risk of infection, such as handwashing and safe water storage.

improving access to healthcare information through community outreach programs.

The Role of Technology in neonatal Care

Innovative technologies are playing an increasingly important role in improving neonatal health in Tanzania:

mHealth Initiatives: Mobile health (mHealth) applications can be used to provide antenatal and postnatal care reminders, deliver health education messages, and facilitate communication between healthcare providers and patients.

Telemedicine: telemedicine can connect healthcare providers in remote areas with specialists in urban centers, enabling them to receive expert advice and support.

Point-of-Care Diagnostics: Portable diagnostic devices can provide rapid and accurate results for common neonatal infections, allowing for timely treatment.

Benefits of Investing in Neonatal Care

Investing in neonatal care yields significant benefits, not only for individual families but also for the broader Tanzanian society:

Reduced Infant Mortality: The most obvious benefit is a reduction in infant mortality rates, leading to healthier communities.

Improved Maternal Health: Investing in antenatal and postnatal care also benefits mothers, reducing the risk of maternal morbidity and mortality.

Increased Productivity: Healthy children are more likely