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The silent tragedy: How many people make noise when a preterm dies?

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Judith Grace Amoit

Globally, 2.3 million children died in the first month of life in 2022, with approximately 6,300 neonatal deaths occurring daily. This alarming statistic from the World Health Organisation highlights a critical yet often overlooked global health issue: the deaths of preterm babies. When a preterm baby dies, the world rarely pauses to notice.

In Uganda, the situation reflects this global crisis. The 2022 Uganda Demographic and Health Survey (UDHS) reports preterm birth as a leading cause of neonatal mortality, contributing significantly to the 22 neonatal deaths per 1,000 live births. Despite these figures, the deaths of preterm infants receive minimal attention in the media and public discourse, highlighting societal neglect and the urgent need for interventions like Kangaroo Mother Care (KMC).

KMC, involving skin-to-skin contact between a mother and her preterm baby, significantly improves survival rates by promoting thermal regulation, breastfeeding, and bonding. Similarly, a research study conducted in Uganda called the OMWaNA Trial, demonstrated that preterm infants receiving KMC had a substantially higher survival rate compared to those receiving standard care.

Dr. Oyella Sheila, a pediatrician and advocate for KMC, shared her personal experience through the OMWaNA KMC webinar. As a mother who practiced KMC, she recalls the emotional and physical struggles, the long hours holding her fragile child close, and the hope KMC provided. Her story underscores the broader societal neglect of preterm mortality, contrasting it with other health crises that garner widespread attention and advocacy.

In Uganda, particularly in rural areas, healthcare facilities are often under-resourced and ill-equipped to handle preterm infants’ needs. The lack of incubators, trained staff, and essential medical supplies means many preterm babies do not receive the necessary care to survive. This situation calls for urgent action and investment in healthcare infrastructure.

KMC offers a cost-effective solution, especially in resource-limited settings. The OMWaNA Trial provides compelling evidence supporting the adoption of KMC across Uganda, showing improved survival rates and benefits for mothers, including increased breastfeeding and reduced stress. However, the implementation of KMC remains inconsistent due to inadequate infrastructure and lack of awareness.

Effective KMC depends on several factors, including space for mothers to stay with their infants, training for healthcare workers, and community support. Many hospitals in Uganda lack the facilities to fully implement KMC. Necessary improvements include dedicated KMC units with comfortable beds for mothers, adequate heating, and access to clean water and sanitation.

Additionally, regular training for healthcare workers on KMC benefits and techniques is crucial.

Addressing preterm deaths also requires more than physical infrastructure; it involves raising societal awareness and advocacy. When a preterm baby dies, the impact is profound, affecting families, communities, and healthcare providers. Yet, these deaths rarely make headlines, and public outcry is minimal. This silence perpetuates neglect and underfunding for preterm care initiatives.

Breaking this silence is essential. Mothers’ and families’ voices should be integrated into KMC design through creative co-creation methodologies. Government and non-governmental organizations must prioritize funding for maternal and child health programs, focusing on preterm care. Policymakers need to recognize the importance of these investments and allocate resources accordingly.

The silent tragedy of preterm deaths is a call to action for everyone. We must not let these deaths go unnoticed.

Ms Judith Grace Amoit,  Communication Specialist,

Makerere University Centre of Excellence for Maternal Newborn & Child Health.