Stillbirth could be cut in half worldwide (OneWorld.net)

(DAKAR, 27 Apr IRIN) - preventing stillbirths can cost just US $2.32 per mother if Governments, the private sector and international institutions to adopt a package of 10 health interventions, rather than allowing the stillbirth to be an almost invisible problem.

If ten recommended interventions 99 percent implemented in 68 priority countries [low- and middle-income], the number of stillbirths may be reduced by half, said Professor Zulfiqar Ahmed Bhutta the Aga Khan University Medical Centre to the author of Karachi (Pakistan)one of a series of papers on stillbirth published in the medical journal The Lancet papers.

Although the interventions have covered 60%, stillbirth could be reduced by one quarter. Some 2.64 million fetuses die after the 28th week of pregnancy, especially in low and middle-income countries.

Interventions include: full and basic emergency obstetric care. specialized care to the birth; detection and management of fetal growth restriction; detection and management of hypertension during pregnancy; induction to the choice in pregnancy after term; insecticide-treated bednets and intermittent prophylaxis to prevent malaria. detection and treatment of syphilis. folic acid supplementation. and management of diabetes during pregnancy.

Identify solutions

Stillbirths have largely been neglected in the policy of priority for various reasons. "There was little data for stillbirths and even less for its categories - if during childbirth [during birth] or before delivery [before childbirth] - and the risk factors and little confidence that interventions could make a difference.""," said Bhutta.

The Lancet series hoping to change that perception by re-framing stillbirths so that they are not considered as an unexplained event that occurs in the uterus, but as something that is potentially preventable if appropriate care are given during pregnancy and childbirth.

Bhutta suggested in his article than less expensive solutions, such as the improvement of prenatal care, malaria prevention, detect and treat syphilis, adopted immediately, so that more expensive interventions, such as training of health professionals and to buy equipment for emergency birthscould be built gradually.

Other interventions would need long-term improvement funds, including treatment of arterial hypertension, diabetes, pregnancy after term (which lasts longer than usual) and monitoring of fetal growth problems.

Providing qualified agents at birth would reduce stillbirths during childbirth by about 23%, said Dr. Joy Lawn, the NGO Save the Children, making it the most effective measures. Almost half of women in low- and middle-income countries give birth at home without skilled assistance.

Good plans or conditional cash transfers could be used to encourage women to have their baby in a facility, since in environments where the highest rates of infant mortality occurs only half of all births take place in facilities.

Maternal mortality

In high income countries, where most of the women receive care of good enough quality in giving birth, the proportion of stillbirths is less than 10 per cent of all births.

Sub-Saharan Africa, which has a scarcity of skilled birth attendants, made progress faster than Asia to encourage women to give birth in an institution. "One year ago, the international community became extremely nervous about the lack of progress in the reduction of maternal mortality", said the grass.

A year later, native to sub-Saharan Africa mortality had fallen by 2.6%. "This marks important apparent stillbirths, much emphasis in high income countries has been because the parents have called for it. Defining a political objective overall is a good way to achieve the order of the day. ?

One third of African countries meet the Millennium development goal to reduce child mortality (goal four) and improve maternal health (goal 5), which would also reduce stillbirths.

Some investments in the reduction of mortality maternal are already having a positive effect on the number of stillbirths, but these results are not given due importance. "Governments may claim to invest more if they have counted stillbirths in the work they do already," lawn said IRIN.

Reduce the cost of life of the mother $23,000 by averted deaths, but if the stillbirth and neonatal mortality is included, the drops figure at $2,700 per life saved. "Our unique message is," care at birth may be more expensive, but it gives you the biggest bang for your buck even if you plan it properly ".".