Must adopt differential approach to reduce maternal, new-born deaths: WHO

The health officials and experts, began deliberating strategies and interventions on Tuesday, to address gaps in quality and equitable health services and further accelerate the reduction of maternal, new-born and child deaths in the WHO South-East Asia Region.

"The Region has made significant gains in mortality reduction but progress within countries has been uneven. We must adopt a differential approach to further reduce maternal, newborn, and child mortality based on their contextual priorities, available resources and new WHO guidelines and standards," said Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia.

At the four-day Regional meeting on 'Sustain, Accelerate and Innovate strategies' for reducing maternal, new-born, and child mortality, national and subnational programme managers, experts, WHO collaborating centres, partner agencies and WHO officials, besides reviewing the situation, will also contribute to the regional strategy being developed for improving newborn and child health, informed a press release by WHO SEA.

While the regional averages for evidence-based high-impact interventions across the Reproductive, Maternal, Newborn, child, and Adolescent Health (RMNCAH) life course have increased over the past decade; they are yet to reach the universal coverage levels of 90 per cent or more.

Also, some indicators have not changed over time, such as 65 per cent of women accessing post-natal contact with a health care provider within two days after birth and less than half of newborns getting breastfed within the first hours of birth.

According to the release, there is little data on the implementation of essential new-born care practices such as skin-to-skin contact in the first hour of birth, while the coverage of life-saving oral rehydration salts for children with diarrhoea continues to be low (55 per cent), and only 64 per cent of children with suspected pneumonia are taken to a health care provider.

Additionally, the high burden of diseases and deaths in children due to birth defects, disabilities, climate change, pandemics, etc. poses further challenges.

"It is important that while we sustain gains made in achieving high coverage of intervention packages such as skilled birth attendants and immunization, we must also explore innovative solutions to accelerate actions aimed at improving service delivery gaps and the quality and coverage of interventions such as intrapartum care, breastfeeding, care of preterm and low birth weight infants, and birth defect prevention," said Dr Khetrapal Singh.

Since 2014, the region has been focusing efforts to reduce maternal, newborn and child deaths, as a flagship priority, by implementing evidence-based strategies and actions.

As a result, the Region experienced a steep drop in death rates. The maternal mortality (MMR) in the Region fell by 41 per cent compared to 12 per cent globally between 2010 and 2020. Seven countries (Bangladesh, Bhutan, DPR Korea, India, Maldives, Sri Lanka, and Thailand) achieved the target of below 140 per 1,00,000 live births while four countries (Bangladesh, Myanmar, Nepal, and Timor-Leste) are likely to achieve national-level targets of a two-thirds reduction in MMR from 2010 value, the release added.

Under-5 mortality (U5MR) reduced by 45 per cent between 2010 and 2021, compared to a 26 per cent global reduction with five countries (DPR Korea, Indonesia, Maldives, Sri Lanka, and Thailand) achieving Sustainable Development Goal (SDG) target of as low as 25 per 1000 live births, another four countries (Bangladesh, Bhutan, India, Nepal) are on track for this.

The new-born mortality (NMR) has almost halved, with the Region recording a 40 per cent reduction compared to a global 22 per cent drop during the same period. Five countries (DPR Korea, Indonesia, Maldives, Sri Lanka, and Thailand) have achieved the SDG NMR target of neonatal mortality of 12 per 1000 live births while another four (Bangladesh, Bhutan, India, and Nepal) are on track to achieve this target by 2030, the release further stated.

"We must make a strategic shift to a life-course approach that goes beyond survival, to ensure that women and children thrive and achieve their full potential for health and well-being," Dr Poonam Khetrapal Singh added.

The Regional Director said that the countries can achieve this by adopting a universal health coverage approach by enhancing primary health care to encompass the full continuum of essential health services and ensuring equitable, quality, safe and affordable health care when and where it is needed without financial hardship.

Recently, WHO released new guidelines and global quality standards for newborn and child health - postnatal care, quality standards for preterm and low birth weight, Kangaroo Mother Care - aimed at strengthening national plans to improve health services at all levels of care, the release added.

"WHO remains committed to working with countries to support policies that reduce mother, child, and newborn mortality to ensure that every mother, everywhere, survives childbirth and they and their children can thrive and go on to lead healthy and productive lives," the Regional Director said.