每年近300萬名新生兒可望獲救

 

每年近300萬名新生兒可望獲救

國際消息 00:00
美國紐約/香港,2014年5月20日——今天,醫學雜誌《刺針(The Lancet)》在聯合國兒童基金會(UNICEF)總部發佈一系列具開創性的論文,指出近300萬名出生1個月內夭折的嬰兒,特別是最脆弱及難以取得服務的兒童,若在出生時得到優質的護理,大多數都能倖存。
A woman holds the hand of her newborn at the KBC Zvezdara Maternity Hospital in Belgrade, the capital. A UNICEF-supported programme in the hospital teaches women how to care for their newborns, part of an effort to support families and prevent child institutionalization. In June 2011 in Serbia, the proportion of children deprived of parental care is increasing, reflecting trends throughout Central and Eastern Europe and Central Asia. The region has the world’s greatest rate of children growing up in formal alternative care settings, which range from institutionalization to foster care. Some 1.3 million children in the region grow up in formal alternative care, including 626,000 children who live in residential institutions. While rates of child institutionalization in the region have remained stagnant, the overall placement of children in formal care is increasing, often a response to disability or poverty. And in Serbia, child institutionalization rates appear to be increasing, from 349 per 100,000 children in 2004 to 400 per 100,000 children in 2006. Still, Serbia is one of only two countries in the region to approve laws that prohibit the institutionalization of infants (the other is Romania). Institutional care for children under age three is known to be damaging to their mental and emotional development, inhibiting cognitive and speech development, impairing intelligence, and contributing to emotional detachment. Serbia is also one of only four countries in the region to ratify the United Nations Convention on the Rights of Persons with Disabilities. Children with actual or perceived disabilities are at greater risk of being institutionalized and of being abused while in residential care. UNICEF urges Governments throughout Central and Eastern Europe and Central Asia to immediately end the institutionalization of children under age three, to allocate resources to support vulnerable families, to provide alternative services for children with disabilities, and to make the needs and rights of the youngest children a priority in policymaking.

© UNICEF/NYHQ2011-1165/KATE HOLT

在貝爾格萊德的婦產科醫院,一名母親握着她剛出生孩子的手。一項由UNICEF支持的計劃在醫院教導婦女,幫助她們照顧自己的初生孩子。

Village: TIDI, Block: Girwa, District: Udaipur, Rajasthan, India. September 6, 2012. A two day old child sleeps next to its mother at a maternity ward of the Primary Health Care Center (PHC) in Tidi. Members of IKEA Foundation and UNICEF delegation visit a Primary Health Centre (PHC), Tidi. The delegation interacted with doctors, staff and patients, observing essential and critical maternal and child survival interventions getting closer to remote families and communities. They were exposed to the various services like Ante-Natal Care services, labour room, newborn care unit, Pre Natal Care services available at the center. The IKEA Foundation team along with UNICEF visit the field to see some of its projects related to Sunnan lamps, cotton projects and child survival in rural Rajasthan. The IKEA Foundation has supported UNICEF programs for more than a decade and has a corporate partnership with IKEA, working at an international and local level. â??By working together for the past 10 years, and contributing more than â?¬100 million ($125 million US*) to UNICEF projects in India so far, we have created opportunities for more than 74 million children,â? explained Per Heggenes, CEO at IKEA Foundation. â??By thinking long-term and teaming-up with UNICEF, weâ??re giving hope to many millions of families.â? UNICEF India/2012/ Prashanth Vishwanathan

© UNICEF/INDA2012-00361/PRASHANTH VISHWANATHAN

在Tidi初級衞生保健中心的婦產科病房,一名剛出生兩天的嬰兒睡在母親旁邊。

新生兒夭折高佔5歲以下兒童死亡人數的44%,比1990年的比例還要高。這些夭折的兒童往往是最貧困、最弱勢的一群。

UNICEF全球衞生項目負責人米奇.喬普拉博士( Dr Mickey Chopra )說:「我們看到在拯救5歲以下兒童生命所取得的顯著進展,但最幼小、最脆弱的兒童仍面對重大困難,他們需要關注和資源。把焦點放在剛分娩至 出生1小時這個關鍵時段,可增加母嬰存活的機會。」

根據UNICEF的報告,每年有290萬名嬰兒在出生後28天內夭折。另有260萬名嬰兒胎死腹中,其中120萬名是在母親分娩過程中,心跳停止而死亡。分娩後首24小時對產婦和嬰兒來說,都是最危險的時期,近半數母嬰死亡都在期間發生。
《刺針》雜誌「每個新生兒」系列論文提出了最有效拯救新生兒生命的方法,包括母乳餵哺、新生兒復甦法、針對早產兒的「袋鼠護理法」(母嬰皮膚持續接觸),並可有效預防及治療感染。更多資金投入、充足設備對拯救新生兒生命都十分重要。
在拯救新生兒生命工作上取得最大進展的國家,都分別特別關注母親與5歲以下兒童的全面保健計劃。例如盧旺達,在撒哈拉以南非洲地區中取得顯著進 展,該國自2000年以來,新生兒死亡人數已減少了一半。此外,一些低、中收入國家也透過培訓助產士和護士,為最貧困的家庭提供優質的分娩護理,取得了顯著成效。
一項在51個新生兒夭折率最高的國家進行的調查發現,如果所有人都能獲得該國最富裕一群所接受到的優質護理,每年將可避免60萬人死亡,相當於減少近20%死亡人數。
每年新生兒夭折人數最多的國家集中在南亞和撒哈拉以南的非洲地區,其中印度(779,000)、尼日利亞(267,000)和巴基斯坦(202,400)位居前列。在情況最險峻的國家,為母嬰健康每投放港幣7.8元(1美元),就可產生達9倍的社會和經濟效益。
A new born baby from a displaced family lies on a bed at the Mardan Medical Complex, where displaced pregnant women living in camps and communities are referred for delivery./More than 2.5 million people have been displaced since fighting began in PakistanÕs North West Frontier Province in August 2008. More than half of those displaced are children and need urgent humanitarian assistance. About 200,000 live in refugee camps and the rest in host communities. According to the United Nations Population Fund (UNFPA) out of the 6,000 displaced pregnant women some 4,300 are due to give birth in June. To tackle the lack of enough medics available and of emergency obstetric and neonatal care in the camps, UNICEF is supporting the establishment of four Maternal and Child Health Units in different camps.

© UNICEF/PAKA2009-5020/MARTA RAMONEDA

在巴基斯坦的馬丹醫院,一名初生嬰兒躺在牀上。

Rekha Verma holds her four days old son in the feeding room of the Sick New-Born Care Unit (SNCU at the district hospital Guna, Madhya Pradesh. Despite being one of the most mineral rich states in India, with vast hoards of diamonds, Madhya Pradesh is one of the poorest with 40% of its population living in poverty. The state also has some of the worst development statistics in India. Of every 1000 births in Madhya Pradesh - 310 mothers will die, while 59 new-borns will die for every 1000 live births - one of the highest infant mortality rates in the country, and compares starkly with Kerala for example where 14 infant will die out of 1000 births. This number jumps to 63 newborn deaths for every 1000 live births in rural areas. UNICEF India/ 2013/ Manpreet Romana

© UNICEF/INDA2013-00389/MANPREET ROMANA

在印度Sick New-Born Care Unit,一名母親在哺乳室抱着剛出生四天的兒子。

UNICEF和世界衞生組織將在下月推出「每個新生兒行動計劃」,以在2035年前消除可預防的產婦和兒童死亡。
《刺針》的「每個新生兒」系列論文由UNICEF、倫敦衞生與熱帶醫學院和巴基斯坦阿迦汗大學的專家等共同撰寫。
「每個新生兒行動計劃」將於UNICEF就聯合國《兒童權利公約》25周年倒數6個月時展開,以強調兒童工作上取得重大進展之餘,最弱勢兒童仍要面對的挑戰。