Happy birthday to you/I saw a kangaroo in the zoo/ It looked just like you

Statistically, an African baby needs 150 years to have the same survival chance as a western one. Enter ‘kangaroo care’, a new way trialled in Malawi.

The world over, a child’s birthday is a happy occasion, a day of gifts, parties and celebration. However there is also a very uncomfortable side to this story; most birthdays also mark something darker, a more sinister reality—the day a child is born is the most dangerous day in a child’s life the world over. 

And it is does not matter whether it is in rich or poor countries. 

More children die on the first day of life more than any other, according to this report by Save the Children, and it’s particularly gloomy news for Africa—the continent remains the riskiest place to be born; the 14 countries with the highest first-day deaths are all in sub-Saharan Africa. 

Newborn deaths have declined everywhere since 1990, except in sub-Saharan Africa, where a growing number of young mothers means the number of newborns dying actually went up from 1 million to 1.1 million. 

Virtually all (98 per cent) of newborn deaths occur in developing countries, and a mother in sub-Saharan Africa is 30 times more likely than a mother in an industrialised country to lose a newborn baby at some point in her life. At this rate, it is estimated that it will take over 150 years for an African newborn to have the same chance of survival as one born in Europe or North America. 

Glimmer of hope 
What kills newborn babies? The three biggest are preterm birth, severe infections such as pneumonia, sepsis and meningitis, and complications during childbirth. But there are some glimmers of hope in all this doom and gloom. 

Some African countries have made huge improvements in keeping children alive. In 1990, one in five Rwandan children died before reaching their fifth birthday. By 2011, this had fallen to one in 20— one of the most dramatic declines in child mortality ever.  

Malawi has similarly reduced newborn mortality by 44% since 1990. The country has one of the highest rates of premature births in the world— 18% of babies are born before their due date, possibly due to poor maternal nutrition. 

Virtually free
So Malawi used a simple and virtually free way of keeping preterm babies alive. It’s called “kangaroo care”, keeping newborns wrapped close to the mother’s chest in skin-to-skin contact. Health workers around the country were trained to encourage mothers to give kangaroo care to small and preterm babies, and newborn deaths plummeted. 

It’s not known where exactly kangaroo care was first used, but it has long been touted as an inexpensive intervention for preterm newborns in low income countries, where incubators and other technology for newborn hospital units are in short supply. 

Kangaroo care is now expanding into developed countries as well—part of the bigger trend in Western countries of returning to “natural” ways of birthing and bringing up children. The Save The Children report indicates that many Western countries are moving away from incubators and other “invasive techniques” in newborn care. 

Countries where large percentages of neonatal intensive care units now routinely offer kangaroo mother care include: Denmark, Finland, Iceland, Japan, Norway, Sweden and the United States.


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