Dr Tajudeen Oyawale UNICEF representative to Zimbabwe commended doctors across the country for the quality care they offer to the people of Zimbabwe during Zimbabwe Medical Congress on Friday at Cresta Hotel.
“I am pleased to join you, my colleagues, at the Annual Congress of the Zimbabwe Medical Association.
I note with excitement the theme for this year’s congress focused on tackling emerging health issues in Zimbabwe and the opportunity to bring focus on new born health.
The Country and its people owe you a great deal of gratitude”, Dr Oyawale said.
He went on to say, “From UNICEF’s perspective, the greatest demonstration of your efforts, and that of the Government lies in the downward trend in maternal mortality ratio in Zimbabwe, which decreased from 1,068 to 362 deaths per 100,000 live births between 2002 and 2022 as reported in the 2022 Census estimates.
Such progress in maternal health does have implication for the survival and growth of children.
As we celebrate progress in maternal health, and in keeping with the theme of the Congress, let us also reflect on the persisting challenges in addressing newborn health in Zimbabwe and across many developing Countries”.
Neonatal mortality comprises the largest component of deaths in children under 5 years of age.
In Zimbabwe, neonatal mortality rate has increased from 27 to 32 deaths per 1,000 live births between 1990 and 2019.
This increase occurred despite high coverage of prevention of Mother-to-Child transmission (PMTCT) interventions at 93% (DHIS2, 2023), antenatal care uptake at 93% (ANC1) and 71% (ANC4) and, and institutional delivery with skilled birth attendants at 86% (MICS, 2019).
“As you know, the majority neonatal deaths (75%) occurs during the first week of life, associated with preterm birth, intrapartum-related complications (birth asphyxia), infections and birth defects.
From the end of the neonatal period and through the first 5 years of life, the main causes of death are pneumonia, diarrhoea, birth defects and malaria.
Malnutrition is the underlying contributing factor, making children more vulnerable to severe diseases”, said Dr Oyewale.
Proven, cost-effective, interventions exist to prevent newborn death and prevent stillbirths, but it must reach high coverage of quality antenatal care, skilled care at birth, postnatal care for mother and baby, and care of small and sick newborns.
With the increase in facility-based delivery in Zimbabwe, there is a great opportunity to provide essential newborn care and identify and manage high risk newborns.
However, few women and newborns stay in the facility for the recommended 24 hours after birth, which is the most critical time when complications can present.
In addition, too many newborns die at home because of early discharge from the hospital, barriers to access and delays in seeking care.
The four recommended postnatal care contacts delivered at health facility or through home visits play a key role to reach these newborns and their families.
Dr Oyewale said, “I am a strong advocate that every newborn should receive a package of essential newborn care, and that special focus be placed on low-birth weight and pre-term babies, sick new-born and babies born to HIV positive mothers.
To advance this comprehensive approach, allow me to refer to the two track priorities outlined in the latest publication by WHO, UNICEF, UNFPA and PMNCH – ‘Born too soon: decade of action on pre-term birth’ as these priorities are applicable to improving overall newborn heath care in Zimbabwe”.
Pre-term birth must prevented by focusing on Intersectoral interventions such as nutrition, girls’ education, mitigation of impact of climate change and emergencies on services.
Newborn care must be improved by focusing on high-quality Neonatal intensive care.
For these two to work, focus must also be placed on quality delivery care including availability of essential medicines and antibiotic for the management of preterm pre-labour rupture of the membrane.