The newborn in Western and Central Africa: Understanding prior to acting

Abstract

The newborn was forgotten by public health programs aiming at reducing Under 5 Mortality in Western and Central Africa until the launch of the "Every Newborn Action Plan" in 2014. If neonatal mortality has significantly decreased in the region since 1990 (-35%), the actual number of newborn deaths has increased due to the slow reduction rate combined with high fertility rates. Stillbirths display the same patterns with rates and numbers as high, doubling the number of viable pregnancies ending with the loss of the fetus and/or newborns. The main causes of neonatal mortality are avoidable at very low cost with little qualified health professionals. Although women utilize largely maternal health services, studies show that there is no protective effect against maternal, neonatal death and stillbirth with ANC utilization and institutional delivery, a sign of the extremely poor quality of care in facilities. Public Health program specialists must understand why such cost effective interventions such as immediate breastfeeding, skin to skin care, care for birth asphyxia, hand washing are not systematically practiced by health professionals in health facilities. Many premature babies could also be saved with basic kangaroo mother care.In-depth anthropological studies are required to inform public health program managers and to help them make sound decisions based on a better understanding of behaviors and practices among both health professionals and communities.