Source: The Inquirer (Monrovia)
Liberia has again made a giant stride in addressing the issue of newborn infection and prematurity which contribute significantly to newborn deaths in the country with the approval of 7.1% Clorhexidine Digluconate (4% free chiorhexidine) for cord care and the National Guideline on Kangaroo Mother Care for the care of preterm babies.

The Liberian Government through the Health Ministry announced its approval yesterday at the head offices of the Ministry in Congo Town with the aim of fighting maternal mortality across the country.

Chiorhexidine Digluconate, or CHX is a treatment of the umbilical cord commonly known as 'navel string' and it is an antiseptic which studies showed is an effective intervention against umbilical cord infections. Its bacterial fighting potential is even more successful if CHX is applied on and around the cord on the first day of life.

The National Implementation Guideline for Kangaroo Mother Care, or KMC in the country Kangaroo Mother Care as a practice wherein newborns especially premature babies are held skin-to-skin with an adult, either the mother or the father. The practice, as the name denotes, comes from the way certain mammals, like kangaroos carry their young. KMC was developed to care for pre-mature babies in areas where incubators are unavailable or unreliable.

Speaking to reporters during the official approval release of the policy, the Assistant Minister and Deputy Chief Medical Officer Saye Dahn Baawo said that number represents a greater portion of neonatal deaths in high mortality rate settings like Liberia, where 27 percent of neonatal deaths is due to newborn infection.

Dr. Baawo explained how research has proven that the newly cut umbilical cord is a common entry point for bacteria that cause newborn infection and death and in Liberia, like many countries, potentially harmful substances like herbal mixture, talc, ash and mud are still being used in cord care despite public health programs promoting "dry cord care".

He said some people use Maggie cube and a local leaf referred to as everlasting leave to heal the umbilical cord in newborns whereas using Chiorhexidine for cleaning navel string has been found to significantly reduce newborn death risks by 23 percent.
The research also shows that over three-million newborns die globally each year and the infection is the cause of approximately 13 percent of these deaths.

It is also revealed that globally, some 15 million babies are born too early before their normal nine months birth and that 60 percent of such births occur in South Asia and sub-Saharan Africa. Prematurity is the leading cause of newborn deaths with over a million children dying with associated complications. After pneumonia, it is the second leading cause of death in children under five worldwide.

In Liberia, the pre mature birth rate is estimated to be 14% with a total number of 21,760 babies born preterm yearly. Of the estimated 4,290 neonatal deaths every year, death due to preterm birth complications represents 33% (1,450) of all neonatal deaths.

With the KMC practice, over 75% of deaths from preterm birth complications have been shown to be prevented without the availability of neonatal intensive care.

Saving premature babies is now feasible with cost effective care as Kangaroo Mother Care is an effective way to meet baby's needs for warmth, breastfeeding, protection from infection, stimulation, safety and love. It is one of the evidence-based and cost-effective interventions that will contribute to the reduction of neonatal mortality. It is less labour intensive and requires few/limited resources than conventional care, hence financially and economically feasible.

Meanwhile, the KMC came about due to the over crowdedness at a hospital and the lack of caregivers and resources in Colombia in 1978. It was discovered that mothers in continuous skin-to-skin contact with their low birth weight babies as a means of keeping such babies warm could reduce death rates in newborns. The programme actually started in 1979 in response to shortage of incubators and severe hospital infections in the Colombian Capital of Bogata.

The practice is said to promote parental attachment and confidence and boosts breast milk production. Studies also show that it normalizes temperature, heart rate, and respiratory rate in preterm and low weight babies.

• Liberia