World Prematurity Day: A Call to Action for Preterm Babies and Their Families

Every year on November 17, World Prematurity Day shines a light on the global challenge of preterm birth and its profound impact on families and societies. With over 13 million babies born too soon annually, this day is a rallying cry for better awareness, care, and policies to support preterm infants and their families.

The theme for 2024, "Over 13 million babies born too soon every year: Access to quality care everywhere!", underscores the urgent need to ensure quality healthcare services for all preterm babies, regardless of geography or socio-economic status.

Understanding Preterm Birth

Preterm birth refers to babies born alive before completing 37 weeks of gestation. Depending on their gestational age, preterm births are categorized as:

• Extremely preterm: Less than 28 weeks
• Very preterm: 28–32 weeks
• Moderate to late preterm: 32–37 weeks

The World Health Organization (WHO) estimates that 1 in 10 babies are born prematurely. In 2020, India reported the highest number of preterm births globally, with over 3 million, accounting for 20% of the world's total.

Causes and Challenges of Preterm Birth

While some preterm births occur due to spontaneous labor, others result from medical conditions like infections, diabetes, or high blood pressure. Despite advancements in neonatal care, preterm birth remains the leading cause of mortality among children under five. Survivors often face lifelong challenges, including:

• Respiratory complications
• Visual and hearing impairments
• Cognitive and developmental disabilities

Importance of Awareness and Prevention

World Prematurity Day is a platform to discuss solutions and preventive measures for preterm birth, such as:

• Access to prenatal care: Regular checkups can help detect and manage risks.
• Healthy lifestyle: Proper nutrition, avoiding stress, and managing chronic conditions play a vital role.
• Education: Empowering women with knowledge about warning signs and the importance of timely intervention.

India’s Preterm Birth and Mortality Statistics

India accounts for the highest number of preterm births globally, with over 3 million babies born prematurely each year. These births contribute significantly to the country’s Infant Mortality Rate (IMR) and Under-Five Mortality Rate (U5MR).

• IMR in India (2023): 27 per 1,000 live births
• U5MR in India (2023): 35 per 1,000 live births
• Preterm-related deaths: Preterm birth complications are among the leading causes of neonatal and under-five mortality in India. In 2020, an estimated 900,000 children globally died from preterm birth complications, with India contributing significantly to this number.

Causes of Preterm Birth and Deaths in India

Preterm birth and related deaths occur due to a variety of reasons:

• Medical conditions: Infections, diabetes, high blood pressure, and pregnancy complications.
• Lifestyle factors: Poor nutrition, inadequate antenatal care, stress, and substance abuse.
• Health system gaps: Limited access to quality family planning, antenatal care, and skilled childbirth services.

Government of India’s Targets and Programs

India has committed to reducing neonatal and under-five mortality as part of the Sustainable Development Goals (SDG), specifically:

• Neonatal mortality rate: To 12 per 1,000 live births by 2030.
• Under-five mortality rate: To 25 per 1,000 live births by 2030.

The Government of India has implemented several programs to address preterm births and reduce neonatal deaths:

1. India Newborn Action Plan (INAP)
2. Janani Suraksha Yojana (JSY)
3. Janani Shishu Suraksha Karyakram (JSSK)
4. Facility-Based Newborn Care (FBNC)
5. National Health Mission (NHM)
6. Kangaroo Mother Care (KMC)
7. Rashtriya Bal Swasthya Karyakram (RBSK)
8. LaQshya Program

World Newborn Week: Prioritizing Neonatal Care

World Newborn Week, observed every year from November 15 to 21, complements the mission of World Prematurity Day by focusing on newborn health and survival. This week aims to:

• Highlight the importance of early care for all newborns, particularly preterm and low-birth-weight babies.
• Advocate for family-centered care, including breastfeeding support and kangaroo care.
• Encourage health systems to prioritize neonatal care with better infrastructure and training.

State-Level Innovations in India for Preterm Births and Neonatal Care

1. Karnataka: Vatsalya Vahini

• What it is: Mobile neonatal care units equipped with incubators, oxygen, and trained staff to provide essential care to preterm and low-birth-weight babies in remote areas.
• Impact: Ensures timely referral and care for high-risk newborns in hard-to-reach regions.

2. Kerala: Amrita Institute of Medical Sciences’ Baby-Friendly Initiatives

• What it is: Kerala's public and private healthcare system focuses on breastfeeding promotion and Kangaroo Mother Care (KMC) for preterm and low-birth-weight babies.
• Impact: Kerala has one of the lowest neonatal mortality rates (NMR) in India due to a robust healthcare system and community engagement.

3. Tamil Nadu: PICME (Pregnancy and Infant Cohort Monitoring and Evaluation)

• What it is: A state-run digital tracking system that registers every pregnant woman, monitors high-risk pregnancies, and tracks neonatal outcomes, including preterm births.
• Impact: Helps identify at-risk pregnancies early and ensures timely medical intervention.

4. Odisha: Mamata Scheme

• What it is: A conditional cash transfer program that incentivizes antenatal checkups, institutional deliveries, and neonatal care.
• Impact: Encourages pregnant women to seek regular healthcare, reducing risks associated with preterm births.

5. Madhya Pradesh: Kilkari Initiative

• What it is: A voice-based mobile service that delivers maternal and child health information directly to families, including topics on preventing preterm births and neonatal care.
• Impact: Increases awareness among mothers in rural areas, empowering them to make informed health decisions.

6. Rajasthan: Rajsangam SNCU Online Monitoring

• What it is: A real-time data monitoring system for Special Newborn Care Units (SNCUs) to track preterm and low-birth-weight babies and ensure quality neonatal care.
• Impact: Strengthens neonatal care services and reduces neonatal mortality in the state.

7. Assam: Tezpur Model of Birth Preparedness

• What it is: Focuses on training healthcare workers in remote areas to manage preterm births and complications, and establishes birth preparedness plans for at-risk pregnancies.
• Impact: Improves outcomes for high-risk newborns in underserved regions.

8. Chhattisgarh: Mitanin Program

• What it is: Community health workers (Mitanins) are trained to identify high-risk pregnancies and counsel families on nutrition, antenatal care, and neonatal health.
• Impact: Mitanins act as a bridge between rural families and healthcare systems, reducing delays in care for preterm births.

9. Uttar Pradesh: Kangaroo Mother Care Initiative

• What it is: Uttar Pradesh has scaled up KMC practices in public hospitals, training healthcare providers to promote skin-to-skin contact and exclusive breastfeeding for preterm babies.
• Impact: Improves survival rates and growth outcomes for preterm and low-birth-weight infants.

10. Gujarat: e-Mamta

• What it is: A comprehensive mother-and-child tracking system that ensures preterm births and neonatal health are closely monitored through timely follow-ups and interventions.
• Impact: Reduces neonatal mortality through effective tracking and service delivery.

The Path Forward

As we commemorate these events, let’s remember that behind every statistic is a life—a baby fighting for survival, a family seeking support, and a community striving for better care. By working together, we can improve outcomes for preterm babies and give every newborn the best start in life.

This November, let’s raise our voices, illuminate landmarks in purple, and reaffirm our commitment to a future where every baby, born too soon or on time, thrives.