Saving newborns in Senegal

Reducing child mortality in the first few days of life

As the midwife places a newborn on its mother’s stomach, she notices the baby is not breathing. She quickly cuts the umbilical cord and carries the baby to a warming table. She places the resuscitator on its mouth and presses the foot pump. In seconds, the baby comes back to life.

“We used to try to resuscitate newborns with our mouths,” explains Rokhaya Ngom, the head midwife at the Kebemer District Health Center in central Senegal. “We’d get blood in our mouths and we’d almost always lose the babies. But since we’ve had the resuscitation equipment, we haven’t lost any babies born asphyxiated.”

More than one fourth of all child deaths in Senegal occur during the first month of life. So the U.S. Agency for International Development (USAID), through its Basic Support for Institutionalizing Child Survival (BASICS) project, helped the Senegalese Ministry of Health develop and test an intervention to improve newborn care in the rural District of Kebemer. The project provided equipment for newborn care to six rural health facilities and trained 329 community health care workers to provide essential care during the first few moments of life.

“Before the project, we would evacuate low birth weight babies to the regional or national hospital, leaving them in God’s hands,” says Magatte Cisse Ndiaye, a nurse in Kebemer. “Today, we have a newborn corner in our clinic where we can care for them. I have been trained to do this, thanks to the project.”

Since nearly half of babies in Kebemer are born at home, the community health care providers were also trained to promote better care for newborns at the village level through mass media and mobilization of community groups, including husbands, mother-in-laws, and religious leaders. Local radio stations advised women to deliver at a health facility and broadcast key survival messages about the need to keep the baby warm, delay the first bath, breastfeed within an hour of birth, and visit the health facility immediately when they notice danger signs.

The number of women who gave birth in a health facility rose from 53% before the intervention to 74% after the intervention. Based on the success of the program, the Government of Senegal is expected to implement a new essential newborn care policy and to extend the USAID-supported pilot initiative nationwide.