Last May, an international research team led by Professor Per Ashorn published a series of articles in the prestigious medical journal Lancet telling how every fourth baby is born prematurely, with low birth weight or is stillborn. Even if these vulnerable infants were to survive until adulthood, they would have clearly weaker preconditions for succeeding in their lives.
“In the past 20–30 years, next to nothing has happened to prevent these problems. The treatment of premature or low birth weight babies has improved, but the issue has not been regarded as a wider societal problem that should be prevented,” says Ashorn, Professor of Pediatrics at Tampere University.
A research team led by Ashorn is trying to actively change the situation. The article series presented a host of affordable and efficient means to promote the health of pregnant women and newborns. It is estimated that the measures described could reduce the proportion of babies born prematurely, with low birth weight or stillborn by about 20%.
The topic is now being discussed with local and regional decision-makers in Bangladesh, Kenya, Senegal, and Peru.
“Not everyone reads the Lancet, especially those who really have the potential to change the world. That is why information must be passed on to those who are making the decisions locally,” Ashorn points out.
Local authorities should own the issue
During the latter half of 2023, discussion events will be held in Bangladesh, Kenya, Senegal and Peru, to which health professionals, researchers, civil society actors and representatives of ministries from these and neighbouring countries will be invited.
The recommendations made in the series of articles will be presented and a discussion is conducted on what each country can do to solve the problem.
A longitudinal study on the implementation of the recommendations contained in the Lancet articles will also be started. The aim is to monitor the situation for at least two years.
Tiia Haapaniemi from Tampere University is the coordinating scientist of the study. According to her, it is vital how local actors take ownership of the problem and commit to leading the process of solving it.
Fifty-five researchers from 20 universities across the world participated in writing the articles for the Lancet. In addition, some 250 scientists and other stakeholders provided background data for the articles.
“We are lucky to have coordinated such a large group. These persons are now committed to continue the dissemination and advocacy work in their countries,” Haapaniemi says.
The aim is that the recommendations are also adopted elsewhere than in the four example counties. In this regard, the research team will collaborate with the World Health Organization (WHO) among others.
Key recommendations
1. That babies are born prematurely, with low birth weight or stillborn should be identified as a problem and its prevention should be made a priority in all countries.
2. All expectant mothers should have access to good antenatal health clinics, which promotes the health of the mother and the child. The measures include, among other things, dispensing multiple micronutrients to the mothers, the screening and treatment of asymptomatic urinary tract infection, the screening and treatment of syphilis, advice on quitting smoking, the administration of protein-rich supplements to malnourished mothers, and the prevention of malaria.
3. The birth weights of all children and the months of pregnancy should be measured and recorded to enable the reliable monitoring of the small birth size problem.
Source: The Lancet: Small Vulnerable Newborns, series of articles published on 9 May 2023.