State of Mali's Newborns

Issues Influencing Newborn Health in Mali

Almost 90 newborns die every day in Mali.[i]These babies are dying from infections that can be prevented through simple improved practices, such as cutting the umbilical cord with a new blade or receiving tetanus toxoid immunization during pregnancy. Still others are born not breathing, and health care workers do not have the skills to resuscitate them.

The first few hours and days after birth are the most crucial for the survival of both baby and mother; as many as half of Mali’s newborn deaths occur on the first day of life. More than half (55 percent) of women in Mali deliver at home with no skilled attendant present, and only ten percent of them receive care for their newborns in the crucial first days.Lack of transport, inability to pay fees for services and low quality of care prevent families from seeking the care their babies need. Another major barrier to postnatal care is the belief that newborns need to be protected by being kept at home for the first seven days—or sometimes for the first 40 days—following delivery.[ii]

Save the Children's Support to Newborn Health in Mali

Community-based Newborn Care Package in Bougouni

From 2002-2004, Save the Children’s Saving Newborn Lives program demonstrated a successful community-based newborn care package in the District of Bougouni, in the Sikasso Region.After conducting a situation analysis of newborn care beliefs and practices, Save the Children developed key newborn health messages, the first-ever newborn care training manual and guide for Mali, and counseling cards and job aids.Save the Children staff trained community health volunteers (relais), traditional birth attendants, grandmothers (musso koroba) and health personnel in essential care for newborns and mothers.Basic newborn messages encouraged care-givers to delay bathing the newborn to prevent hypothermia; breastfeed immediately after birth to provide the newborn with immunity against disease and to continue to exclusively breastfeed; and use a new razor blade to cut the umbilical cord at birth to prevent infection.These key messages were reinforced through local radio broadcasts.This innovative newborn package has now been adapted and integrated into Mali’s national health strategy.[iii]

Raising Awareness about Newborn Health in Mali and Influencing National Policy

Save the Children played a leadership role in raising awareness about newborn health in Mali through successful implementation of a community-based newborn package, disseminating the newborn situation analysis, and advocating for integration of the newborn in existing policies and programs.Mali’s key health policies and strategies—the national ten-year operation plan (PRODESS II), the Policies, Norms and Procedures, the national Roadmap for the Accelerated Reduction of Maternal and Newborn Mortality and Morbidity, and the National Child Survival Strategy—support the implementation of essential newborn care and the reduction of neonatal mortality.[iv]

Supporting Mali’s Maternal and Neonatal Tetanus Campaigns

Save the Children supported Mali’s national maternal and neonatal tetanus campaign through social mobilization and mass media messages about tetanus toxoid vaccinations and their ability to protect mothers and newborns from tetanus.Between 2001 and 2006, Mali’s coverage of mothers who had received the tetanus toxoid vaccination increased from 32 to 54 percent as measured by the 2006 Demographic and Health Survey.[v]

Newborn in Mali. Photo credit: Save the Children, Jonathan Hubschman.

Save the Children’s Current Newborn Health Activities in Mali

Integrating Essential Newborn Care into the Community Package Being Implemented Under the National Child Survival Strategy

Save the Children is working with the Ministry of Health and UNICEF to adapt and implement the effective Bougouni community-based newborn care package in six regions as part of the Mali Child Survival Strategy, a national program strategy for integrated maternal, newborn, and child health at the community-level.Key newborn messages promoted through this strategy include preventing hypothermia through drying, wrapping, and delayed bathing of the newborn; preventing infections through immediate and exclusive breastfeeding and cutting the umbilical cord with a clean blade; and overall hygiene and care for mother and newborn at delivery.It is anticipated that the interventions outlined in the Mali Child Survival Strategy will be phased in to reach 100% of the population of Mali by 2011.

Kangaroo Mother Care

Kangaroo Mother Care is a technique for providing special care for small newborns by placing them against the mother’s chest in continuous skin-to-skin contact to ensure warmth and encourage breastfeeding.Although Kangaroo Mother Care is an evidence-based, cost-effective method for thermal management of a stable low birth weight and/or premature baby in facility settings, it is not currently common practice in Mali.

Save the Children is collaborating with the Gabriel Touré Teaching Hospital in Bamako to establish a Kangaroo Mother Care unit and training center to facilitate taking the intervention to scale throughout the country.One of the first district-level Kangaroo Mother Care units is planned for the District of Bougouni in Sikasso Region.

Birth Asphyxia Study

Save the Children funded a study conducted by the Center for Research and Documentation on Child Survival (CREDOS), a child survival research institute linked to the Mali Ministry of Health, that tested a community-based package to reduce neonatal deaths caused by birth asphyxia.In the health zone of Ouélessébougou, community-based providers (e.g., traditional birth attendants, community health workers, leaders of women groups, auxiliary midwives) and nurses have been trained to manage birth asphyxia, one of the main causes of newborn deaths.A midwife trained by Save the Children recently remarked: “We’ve seen a lot of progress—we are learning a lot.Before [Save the Children], we didn’t know what to do when a baby couldn’t breathe.Now we know.”Results of the study will be used to provide evidence for feasibility of implementation at the community level and to inform national policy and programs.

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