Recently, three countries with 40 percent of all newborn deaths and the world’s highest potential to save women and newborns — India, Nigeria and Ethiopia — committed to doing something brave, audacious and humbling. Thanks to a combination of strong evidence of what works, an enabling policy environment and an actionable framework, they committed to end preventable maternal newborn deaths and stillbirths by 2035.
Informed by compelling evidence pulled together by “The Lancet” Every Newborn Series, coupled with the World Health Assembly’s adoption of the Every Newborn Action Plan, endorsed by 194 countries, they responded to the call for action. Each country made commitments to action as part of their reproductive, maternal, newborn and child health development agenda and plan. They can make significant progress by increasing coverage of high-impact interventions particularly around the time of birth, serving as early models for how to go to scale, along with other front runners.
In September, India, the world’s largest democracy, took an important step towards preventing the death of women and newborns. The Indian government, along with national stakeholders, launched the Indian Newborn Action Plan focusing attention on maternal and newborn health as a top national health priority. Each year, India could save as many as 840,400 lives of mothers and newborns — more than any other country in the world — changing from business-as-usual to engaging key actors in a national movement for maternal and newborn survival.
Similarly, in October, the Nigerian government launched its “Call to Action to Save Newborn Lives” initiating the development of the Nigerian Every Newborn Action Plan. Activities outlined in the NENAP have the potential to save as many as 375,000 mothers, newborns and babies who are stillborn each year. It represents the nation’s most ambitious commitment to date for saving women and newborns, preventing stillbirths who are dying at alarming rates. Communities across the world and in the rest of Africa will be watching and learning as Nigeria tackles this formidable challenge.
Finally, just last month the government of Ethiopia, a country that has made excellent progress on improving maternal and newborn health services, particularly at the community level, made the commitment to integrate newborns into their child health strategy. Ethiopia could save as many as 76,800 mothers and newborns each year if it continues its aggressive efforts to develop and implement effective strategies to improve maternal and newborn health.
If countries as large and complex as India, Nigeria and Ethiopia can be successful, especially among their most marginalized and hard to reach communities — we will learn important lessons for how to scale for impact. It will take continuous strong leadership, quality services including facility-based births, skilled midwives, and engagement of families, communities and civil society to keep health providers accountable.
Each year around the world, 2.8 million newborns die within their first month and an additional 2.6 million are stillborn. Complications related to prematurity are now the leading killer of all children under-5. Proven interventions, such as essential newborn care (basic warmth, hygiene and the promotion of breast-feeding), neonatal resuscitation, kangaroo mother care for preterm babies and the prevention and treatment of infections, including clean cord care, are known and available in some settings but they are not reaching all of the women and newborns who need them.
As we move into 2015 and beyond, we find ourselves at the dawn of the sustainable development goals. As we move forward, we need to do better for the world’s mothers and newborns, starting by keeping them at the heart of our post-2015 health efforts. We need to reach women and their newborns with the high-impact interventions we know work. We need to overcome implementation barriers and continue to develop innovative tools for implementation and healthcare delivery in order to get to the hardest-to-reach communities.
And, as a global community, we must support government, local communities and civil society to seize critical opportunities, implement evidence-based plans, take action and ensure that the resources are available to deliver on commitments.
India, Nigeria and Ethiopia are to be commended for taking these steps toward ending preventable maternal newborn deaths and stillbirths.
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