This blog post is published in conjunction with the Child Survival Call to Action, which was convened June 14-15 by the Governments of the United States, India, and Ethiopia, and is organized in close collaboration with UNICEF.
The new mothers I met at the Regional Maternity Hospital in Kyzylorda, a province in southern Kazakhstan, were as weathered as the salty desert earth all around us. Their young faces appeared determined but exhausted, hinting at the many hundreds of kilometers they had to travel to reach the hospital in time to give birth.
The newborns these mothers cradled in their arms weighed less than a handful of apples. This region historically has suffered from the country’s highest newborn mortality rates. Kyzylorda suffers from many unhealthy environmental factors, like the Aral Sea pollution crisis and toxic mining, which the local doctors tell us contributes to poor health outcomes for mothers and infants. Prematurity accounts for about 37 percent of newborn deaths worldwide. Asphyxia and infections are other leading causes of newborn deaths.
If these babies had been born before 2008, they would probably not be alive today. Before 2008, when USAID started helping the regional health department adopt World Health Organization (WHO) live birth criteria, these babies would not have received the life-saving interventions such as neonatal resuscitation that kept them alive in those precious hours after birth. In the four years since the Kyzylorda Oblast Health Department introduced neonatal care technology and adopted a 500 gram (1.1 pound) live birth definition, doctors here have saved around 200 babies’ lives. The WHO live birth criteria state that all babies showing any signs of life, such as muscle activity, a gasp for breath, or a heartbeat should be included as a live birth and provided with interventions to keep them alive. Under the Soviet-era definition, infants who were born before 28 weeks, weighing less than 1,000 grams, or measuring less than 35 centimeters, were not counted as live births if they died within seven days.