At the Africa regional conference of the International Confederation of Midwives (ICM) held last month in Nairobi, Kenya, one thing was clear. In order to meet the United Nations Millennium Development Goal (MDG) of reducing infant mortality by two thirds before 2015, birth attendants in large numbers must acquire the basic skills and equipment to help newborns breathe.
The WHO estimates that one million babies die each year from birth asphyxia, the inability to breathe immediately after delivery. Simple means to stimulate breathing that could easily be done by a birth attendant could save a majority of these babies. However, such lifesaving care is not available in much of the world’s poorest regions.
As part of its MDG commitment, Johnson & Johnson is working with USAID and many partners globally to address birth asphyxia through its support of the Helping Babies Breathe (HBB) program in a number of developing countries where infant mortality from birth asphyxia is still high. HBB is a global public-private partnership working towards achieving a significant reduction in newborn mortality by increasing the availability of skilled birth attendants at every birth. Nurses and midwives with HBB training have the skills to save over 90% of babies with birth asphyxia.
The ICM meeting dedicated a core session to HBB, including providing attendees hands-on HBB introductory training and a related symposium that debated why little progress has been made in combating infant mortality in Africa.
The discussion continued at the stakeholder consultation meeting the morning after the conference ended, with a more specific focus on Kenya, where five babies die every hour. These discussions were attended by representatives from the HBB global alliance, including USAID, AAP, AMREF and Johnson & Johnson. Dr. Santau Migiro, head of reproductive health in Kenya’s Ministry of Health (MOH), was also in attendance.
What became increasingly evident was that to accelerate progress, all HBB activities need to be implemented in coordination. Rather than small scale activities done in isolation, the key to making a high impact is to address the issue on a much larger scale. Collaboration and synergy among players is important to maximize efforts, funding and resources, and to advocate for policy change.
To that end, all stakeholders agreed that the best way to push HBB forward in Kenya is to work under the MOH umbrella, making it part of the overall MOH maternal and child health strategy. Already, the Kenyan MOH has made HBB competency part of the core curriculum of medical training, recognizing that all health workers have a role in impacting maternal and neonatal health.
In addition to making the most effective use of resources and funding, a harmonized approach lends itself to better monitoring and evaluation. Standard guidelines for implementation will provide more meaningful data about the results of the program.
While the immediate focus of the stakeholders meeting was implementing HBB effectively in Kenya, there was general consensus that this direction is the right way to move the HBB initiative forward across the continent.
The evidence that HBB can be effective in Africa is there already. Tanzania, where over 3000 health care workers have been trained, has seen a drop of over 47% in infant mortality.
The conference was an opportunity to get all players in the region, including over 400 midwives from 20 African countries, on the same page. While recognizing that a lot more needs to be done, attendees left with a feeling of optimism, celebration and camaraderie overall.
Rene Kiamba manages the Johnson & Johnson Family of Companies corporate contributions community support programs and initiatives in sub-Saharan Africa.