Why It Matters
An inexpensive steroid can cut deaths dramatically in premature infants. But in Malawi and surrounding countries, the drug is given to almost none of the babies who need it.
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Needless Crisis in Malawi for Babies Born Too Soon

By Pierre Barker | Wednesday, April 23, 2014

Pierre M. Barker, MD, is Senior Vice President of the Institute for Healthcare Improvement (IHI) and is responsible for IHI’s expanding portfolio of large-scale health systems improvement initiatives around the world. He wrote the following blog post for The Huffington Post. He invites you to follow him on Twitter @PierreMBarker


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In the corridor of a Malawian rural hospital, Baby Banda nestles between his mother's breasts, swaddled warmly and breathing easy. This is a near miracle; the baby weighs only 1,200 grams -- that's just over 2.5 pounds -- and was born nine weeks early. In Malawi, like many countries in the region, if you are born this early, your chances of survival are very low. But for babies like Baby Banda, there is hope: simple, affordable, effective interventions like swaddling, breastfeeding, clean care, hand pumping a few breaths at birth and a few cheap drugs can cut deaths dramatically -- especially in premature infants.

One of these drugs is a steroid -- dexamethasone. When given to a mother who goes into labor too soon, dexamethasone can accelerate maturation of her baby's lungs in just a few hours, a process that normally takes weeks in the womb. Its magical effects that help premature newborns to breathe have been known for decades, and it's now used routinely in high-income countries. But in Malawi and surrounding countries, the drug is given to almost none of the babies who need it. In a country that has not one baby ventilator, this drug can make a difference between life and death; up to half of these early-born babies can be saved from suffocation. Baby Banda's mother felt labor pains weeks before her due date and was lucky to arrive quickly at one of a handful of hospitals that were trying out the drug -- which costs less than a dollar for the course of four shots -- to prevent breathing problems in babies born too soon.

Read more about Malawi's efforts to deliver dexamethasone safely and consistently to newborns in need over at the Huffington Post.

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