Implementing Existing Interventions Could Save Lives in Sub-Saharan Africa

Modest increases in selected maternal, neonatal and child health interventions could save lives in sub-Saharan Africa, according to researchers at the Johns Hopkins Bloomberg School of Public Health. They reviewed several interventions such as breastfeeding counseling and emergency obstetric care in Africa and found that nearly 4 million lives could be saved by scaling up proven health interventions in a variety of health systems. The results are part of a series of maternal, neonatal and child health research in Africa featured in the June 21, 2010 issue of PLoS Medicine.

“There is a significant gap between maternal, neonatal and child health research and practice,” said Ingrid Friberg, PhD, MHS, lead author of the study and an assistant scientist in the Bloomberg School’s Department of International Health. “But what we do know is that modest changes that are appropriate to a country’s health system can have a large impact. A 20 percent increase in coverage of selected community-based outreach interventions could save nearly 500,000 maternal, neonatal and child lives in these countries, while just increasing the quality of current facility births could save more than 100,000 maternal and neonatal lives.”

Using the Lives Saved Tool (LiST), researchers conducted a detailed analysis of nine African countries and estimated mortality reductions and additional cost for feasible increases in coverage of selected high-impact interventions. They considered three health system contexts for maternal, neonatal and child health interventions and estimated mortality reduction for 42 sub-Saharan African countries). Researchers found that modest increases in selected outreach interventions can save lives now; addressing missed opportunities for births already occurring in health facilities can also save maternal and newborn lives now; and consideration of local data and different health system settings is necessary to identify high-impact, short-term opportunities that are appropriate and feasible for given health system environments.

Despite being home to only 11 percent of the world’s population, sub-Saharan Africa has more than half of the world’s maternal, newborn and child deaths. The region is also home to two thirds of the world’s AIDS deaths and 90 percent of global malaria deaths. In 2000 the UN established the Millennium Development Goals—a series of eight international development goals that UN member states and several international organizations have agreed to achieve by 2015. Researchers believe that to achieve these goals, implementation of selected maternal, neonatal and child health interventions are critical.

“With only 5 years left to meet the Millennium Development Goals, priorities need to be selected,” said Robert Black, MD, MPH, senior author of the study, chair of the Bloomberg School’s Department of International Health and the Edgar Berman Professor in International Health. “No country can scale up and implement all possible interventions at once,” he said. “But by implementing well known interventions such as emergency obstetric care, breastfeeding counseling, kangaroo mother care for preterm babies and treatment for diarrhea and pneumonia to 90 percent of the population we could reduce mortality by as much as 4 million.”

“Sub-Saharan Africa’s Mothers, Newborns, and Children: How Many Lives Could Be Saved with Targeted Health Interventions?” was written by Ingrid K. Friberg, Mary V. Kinney, Joy E. Lawn, Kate J. Kerber, M. Oladoyin Odubanjo, Anne-Marie Bergh, Neff Walker, Eva Weissman, Mickey Chopra and Robert E. Black.

This research was supported in part by the National Academy of Sciences, the Saving Newborn Lives Program, and the Bill & Melinda Gates Foundation.

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