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Six key interventions improve infant and child survival

Education

NEW research has identified six key health interventions that can play a critical role in improving a baby’s chance of surviving the crucial first months of life.

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The research, conducted at the University of Adelaide's Robinson Research Institute by PhD student Zohra Lassi, systematically reviewed more than 60 reproductive, maternal, infant and child health interventions recommended by the World Health Organisation, to determine the best way to prevent infant deaths.

Skin-to-skin contact, breastfeeding and the administration of antenatal corticosteroids for women at risk of preterm birth are among the top six interventions recommended by the study.

In low and middle income countries, the study found Vitamin A supplementation, hygienic umbilical cord care and the provision of insecticide treated bed nets for children, were also highly effective.

While all six interventions listed by the study have global applications, “99 per cent of all child deaths occur in low and middle income countries,” said Lassi, adding that 2.9 million newborns around the world do not live beyond their first month of life.

“We didn't specifically identify interventions for low and middle income counties, but since 99 per cent of all child deaths occur in low and middle income countries all six of these interventions are applicable to those regions, more so than where infection based mortalities are less prevalent,” she said.

She said the promotion and implementation of these interventions was lacking, particularly in sub Saharan Africa and South East Asian countries where infant death rates are highest.

“We know breastfeeding soon after birth increases a child's chance of survival by 44 per cent in low income countries.”

“[But] since literacy in these countries is low, the mothers are not aware of the significance of these interventions for their child's health,” she said.

Lassi said having local health workers empowering women through education and supportive group counciling, could improve the uptake of these interventions.

The study's co-author, Associate Professor Philippa Middelton, from the University of Adelaide's Robinson Research Institute and the Women's and Children's Health Research Institute, said the research certainly highlighted the discrepancies between low and high-income countries.

“Here in Australia we have one of the lowest infant mortality rates (3 in 1000) but Angola has 96 per 1000 and Afghanistan has 66 per 1000.

“A lot of this is what we already know – having a skilled birthing attendant, the benefits of breastfeeding – but those support mechanisms are not always resourced in low income countries, so the message is in part to those governments – many of these deaths must be avoidable,” Middelton said.

The study was published in EBioMedicine, in June 2015.

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