Pregnancy schools: Panacea for reducing neonatal deaths
Some health professionals have suggested that pregnancy schools should be organised by health workers for pregnant women as one of the ways to go in reducing neonatal deaths in the country.
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They explained that pregnancy schools, which are normally organised during antenatal clinics for pregnant women, among others, offered them the opportunity to be educated on the danger signs during pregnancy and also discuss any concerns they had about their pregnancies with health workers.
The health professionals, who made these suggestions in separate interviews with the Daily Graphic, were a Senior Specialist Obstetrician and Gynaecologist at the Korle Bu Teaching Hospital, Dr Naa Baake Armah; a Paediatrician Specialist and Certified Neonatal Intensive Care Specialist, Dr Nana Okai Brako; the Programme Manager for New Born and Child Health at the Ghana Health Service (GHS), Dr Edward Antwi, and a senior midwife and senior nursing officer (paediatrics) at the Esikado Hospital, Byrony Brookman Eshun.
Neonatal deaths
They were speaking in reaction to a recent publication in the Daily Graphic in which the GHS said 170,000 neonatal deaths were recorded in the country every year due to various health conditions.
Ms Eshun said pregnancy schools were important because they helped with information sharing to enable early detection of danger signs in pregnancy that could affect the fetus and also during delivery leading to pre-term birth, birth defects, intrapartum related complications and infections.
Pointing out the fact that neonatal deaths was a sensitive indicator that posed a major burden on the country, she suggested that to reduce it, the primary area to tackle was the prenatal period.
For that reason, she said, encouraging preconception care, regular and consistent antenatal visits to rule out abnormalities, physiological investigations and intake of routine drugs during prenatal period were important.
Community engagement
Dr Brako, for his part, said community engagement and education on danger signs during pregnancy at the pregnancy schools would lead to a reduction in neonatal mortality.
Quoting figures, he said among the sustainable development goals, sub saharan Africa has the highest neonatal mortality of 28/1000 live births and Ghana, in 2017, had 25/1000 live births which reduced to 17/1000 live births in 2022.
He said for the nation to attain the target of 12/1000 live births by 2030, an accelerated effort was needed in the areas of antenatal care, intrapartum care and post-natal care.
"For a rapid decline of the mortality, we must focus on intrapartum care which consists of the correct use of the partograph during labour and delivery room resuscitation using Helping Babies Breathe (HBB) the Golden Minute," Dr Brako said.
He said adequate well-trained and motivated staff and provision of basic adequate equipment and logistics were also important in reducing neonatal deaths.
Antenatal
Dr Armah, on the other hand, said pregnancy schools were an important opportunity for education and discussion and added that pregnant women should attend antenatal for at least eight times before delivery for effective monitoring of both baby and mother.
"Labour and delivery must be conducted by trained, supervised, motivated and patient centred staff in facilities that are appropriately equipped.
The postnatal period is important for reviewing events of the pregnancy, offering continuing care and contraception," she advised.
Reducing neonatal deaths
Suggesting other ways of reducing neonatal deaths in the country, Dr Antwi, for his part, said breastfeeding should be initiated within an hour of birth explaining that exclusive breastfeeding benefited the baby, mother and community.
He mentioned healthcare services that should be provided within the first 90 minutes of the life of the child to include the application of only chlorhexidine gel on the umbilical cord to prevent infections; injection of Vitamin K to all babies soon after birth to prevent bleeding and instilling appropriate antibiotic eye drops or ointment into the newborn baby’s eyes to prevent eye infection in the new born.
"For small babies or babies born with low birth weight (birth weight less than 2.5 kilogrammes) Kangaroo Mother Care (KMC) is essential.
KMC is the practice where the baby is placed skin to skin on mother's chest and secured with a wrapper for continuous skin to skin contact.
This intervention, when properly done, is akin to placing the baby in a modern incubator," he added.
Dr Antwi suggested that for babies born outside a hospital or clinic, they must be sent to the nearest clinic or hospital for essential newborn care services immediately, not waiting for 48 hours.
