Tuesday, May 09, 2006

Killing actual babies

A study was just released, based on World Health Organization data, tallying the rates of newborn infant mortality in countries around the world. Thirty-three countries were listed as "modern nations"; among those, the United States was in a five-way tie for second-worst.

Read more...In Latvia, still struggling to adapt to the realities of post-Soviet existence, 6 out of every 1,000 newborn infants dies. In the United States, Hungary, Malta, Poland, and Slovakia, the rate is 5 per 1,000. At the other end of the spectrum are countries like Japan (1.8) and Czech Republic, Finland, Iceland, and Norway (2.0).

  • "The United States has more neonatologists [doctors specializing in newborn infants] and neonatal intensive care beds per person than Australia, Canada, and the United Kingdom, but its newborn mortality rate is higher than that of any of those countries."

  • "In the United States, the newborn mortality rate for all races combined is 4.7 deaths per 1,000 live births, but for non-Hispanic blacks, the rate is 9.3 per 1,000."

  • The education and literacy levels of females correlate strongly with lower levels of neonatal mortality.

  • Availability and use of modern contraception correlate dramatically with lower levels of neonatal mortality.

  • Higher rates of teen pregnancies correlate strongly with higher levels of neonatal mortality.

  • High rates of obesity correlate with higher levels of neonatal mortality.
Of course, poorer nations have even higher levels of neonatal mortality, but the commitment of the government is a better predictor than per capita income. For example, Viet Nam, with a per capita income of only about USD $2,500, has made an aggressive commitment to provide prenatal and neonatal care, cutting its newborn mortality rate to the lowest in the developing world — lower than much wealthier countries such as Angola, Djibouti, Namibia, Morocco, Bolivia, South Africa, Indonesia, and China.

Indonesia, Eritrea, Nicaragua, the Philippines, and Tajikistan are also outperforming other countries with similar GDP. Malawi has embarked upon several programs to improve health care and education, with an eye to reducing infant mortality.

Some of the war-torn countries of Africa are faring much worse than their GDP would suggest. For example, 1 in 7 Angolan women dies in pregnancy or childbirth. That's about 14%. If the United States had a similar level of maternal mortality, about 2 million women would die every year. The actual rate in the U.S. is 1 in 2,500, and it is substantially lower in other industrialized nations.

The worst nations for newborn mortality are Liberia, Afghanistan, Sierra Leone, Iraq, Pakistan, Côte d'Ivoire (Ivory Coast), Mali, Angola, Ethiopia, Somalia, Nigeria, Guinea-Bissau, Democratic Republic of Congo (Zaire), Central African Republic, Gambia, Mauritania, and Guinea. With the exception of Afghanistan and Iraq, all of those countries are in sub-Saharan Africa, and almost all of them have had prolonged armed conflicts in recent years.

However, there are simple, inexpensive, low-tech measures that can cut infant mortality dramatically. Tetanus vaccinations; basic cleanliness; vitamins, minerals, and nutritional supplements; and a commitment to education and community health resources will all produce significant results. Effective family planning is also crucial: contraception helps women postpone their first childbirth and space their pregnancies farther apart, both of which will immediately reduce maternal and infant mortality. Shifting from infant formula back to natural breastfeeding greatly increases a baby's chances of survival, since breast milk contains nutrients and crucial antigens to help the newborn resist disease. Breastfeeding also improves the mother's chances of survival, since it triggers the uterus to contract, reducing post-partum blood loss.

Source: Save the Children, State of the World's Mothers 2006 report [PDF]

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