NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Tuesday, February 10, 2015

Across the world, a child’s survival is a lot like drawing a lottery ticket. Factors based purely on chance — where a child is born, how much money his or her family has and what their ethnic background is — can determine if a child lives past age 5.

That’s the conclusion from a report published last week by Save the Children, which looked at survival rates in 87 low- and middle-income countries. In 78 percent of the countries, efforts to reduce mortality have left out at least one ethnic group or economic class. At the same time, simple interventions are preventing deaths in countries like Malawi and Bangladesh.

MaMoni is one of the success stories. The program’s name means “mother-child” in Bengali. The director, Dr. Ishtiaq Mannan, works with the government to train health care workers to help mothers in underserved districts safely deliver their babies, to educate families about how to care for a newborn and to get mothers the support they need as quickly as possible. Funding comes from the U.S. Agency for International Development.

Bangladesh still sees 129,000 deaths of children under 5 each year, but in the last two decades, the mortality rate has fallen from 144 deaths to 41 deaths per 1,000 births. And while gaps remain between different socioeconomic groups, families in hard-to-reach rural areas are getting more help.

The interview has been edited for length and clarity.

What is one of the most challenging things about saving a child?

In some districts where we’ve worked, there is a tradition, particularly in Muslim families, to bathe the child [right after] he is born. Without bathing the newborn, [the families] don’t think he or she will be pure or holy. The problem is, the baby gets cold. The newborn is kept on the floor and not attended to for quite some time — 10 to 15 minutes. All the people in the delivery [room] are attending the mother. By that time, the newborn [risks] getting pneumonia. It took a lot of negotiation with the families to make them understand that you need to immediately dry, wrap and cover the newborn, and that the life of the newborn is more important [than the] religious ritual.