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每年近300万名新生儿可望获救

2014-05-20

美国纽约/香港,2014年5月20日——今天,医学杂志《刺针(The Lancet)》在联合国儿童基金会(UNICEF)总部发佈一系列具开创性的论文,指出近300万名出生1个月内夭折的婴儿,特別是最脆弱及难以取得服务的儿童,若在出生时得到优质的护理,大多数都能倖存。
A woman holds the hand of her newborn at the KBC Zvezdara Maternity Hospital in Belgrade, the capital. A UNICEF-supported programme in the hospital teaches women how to care for their newborns, part of an effort to support families and prevent child institutionalization. In June 2011 in Serbia, the proportion of children deprived of parental care is increasing, reflecting trends throughout Central and Eastern Europe and Central Asia. The region has the world’s greatest rate of children growing up in formal alternative care settings, which range from institutionalization to foster care. Some 1.3 million children in the region grow up in formal alternative care, including 626,000 children who live in residential institutions. While rates of child institutionalization in the region have remained stagnant, the overall placement of children in formal care is increasing, often a response to disability or poverty. And in Serbia, child institutionalization rates appear to be increasing, from 349 per 100,000 children in 2004 to 400 per 100,000 children in 2006. Still, Serbia is one of only two countries in the region to approve laws that prohibit the institutionalization of infants (the other is Romania). Institutional care for children under age three is known to be damaging to their mental and emotional development, inhibiting cognitive and speech development, impairing intelligence, and contributing to emotional detachment. Serbia is also one of only four countries in the region to ratify the United Nations Convention on the Rights of Persons with Disabilities. Children with actual or perceived disabilities are at greater risk of being institutionalized and of being abused while in residential care. UNICEF urges Governments throughout Central and Eastern Europe and Central Asia to immediately end the institutionalization of children under age three, to allocate resources to support vulnerable families, to provide alternative services for children with disabilities, and to make the needs and rights of the youngest children a priority in policymaking.
© UNICEF/NYHQ2011-1165/KATE HOLT
在贝尔格莱德的妇产科医院,一名母亲握着她刚出生孩子的手。一项由UNICEF支持的计划在医院教导妇女,帮助她们照顾自己的初生孩子。
Village: TIDI, Block: Girwa, District: Udaipur, Rajasthan, India. September 6, 2012. A two day old child sleeps next to its mother at a maternity ward of the Primary Health Care Center (PHC) in Tidi. Members of IKEA Foundation and UNICEF delegation visit a Primary Health Centre (PHC), Tidi. The delegation interacted with doctors, staff and patients, observing essential and critical maternal and child survival interventions getting closer to remote families and communities. They were exposed to the various services like Ante-Natal Care services, labour room, newborn care unit, Pre Natal Care services available at the center. The IKEA Foundation team along with UNICEF visit the field to see some of its projects related to Sunnan lamps, cotton projects and child survival in rural Rajasthan. The IKEA Foundation has supported UNICEF programs for more than a decade and has a corporate partnership with IKEA, working at an international and local level. â??By working together for the past 10 years, and contributing more than â?¬100 million ($125 million US*) to UNICEF projects in India so far, we have created opportunities for more than 74 million children,â? explained Per Heggenes, CEO at IKEA Foundation. â??By thinking long-term and teaming-up with UNICEF, weâ??re giving hope to many millions of families.â? UNICEF India/2012/ Prashanth Vishwanathan
© UNICEF/INDA2012-00361/PRASHANTH VISHWANATHAN
在Tidi初级衞生保健中心的妇产科病房,一名刚出生两天的婴儿睡在母亲旁边。
新生儿夭折高佔5岁以下儿童死亡人数的44%,比1990年的比例还要高。这些夭折的儿童往往是最贫困、最弱势的一群。

UNICEF全球衞生项目负责人米奇.乔普拉博士( Dr Mickey Chopra )说:「我们看到在拯救5岁以下儿童生命所取得的显着进展,但最幼小、最脆弱的儿童仍面对重大困难,他们需要关注和资源。把焦点放在刚分娩至 出生1小时这个关键时段,可增加母婴存活的机会。」

根据UNICEF的报告,每年有290万名婴儿在出生后28天内夭折。另有260万名婴儿胎死腹中,其中120万名是在母亲分娩过程中,心跳停止而死亡。分娩后首24小时对产妇和婴儿来说,都是最危险的时期,近半数母婴死亡都在期间发生。
《刺针》杂志「每个新生儿」系列论文提出了最有效拯救新生儿生命的方法,包括母乳餵哺、新生儿復甦法、针对早产儿的「袋鼠护理法」(母婴皮肤持续接触),並可有效预防及治疗感染。更多资金投入、充足设备对拯救新生儿生命都十分重要。
在拯救新生儿生命工作上取得最大进展的国家,都分別特別关注母亲与5岁以下儿童的全面保健计划。例如卢旺达,在撒哈拉以南非洲地区中取得显着进 展,该国自2000年以来,新生儿死亡人数已减少了一半。此外,一些低、中收入国家也透过培训助产士和护士,为最贫困的家庭提供优质的分娩护理,取得了显着成效。
一项在51个新生儿夭折率最高的国家进行的调查发现,如果所有人都能获得该国最富裕一群所接受到的优质护理,每年将可避免60万人死亡,相当于减少近20%死亡人数。
每年新生儿夭折人数最多的国家集中在南亚和撒哈拉以南的非洲地区,其中印度(779,000)、尼日利亚(267,000)和巴基斯坦(202,400)位居前列。在情况最险峻的国家,为母婴健康每投放港币7.8元(1美元),就可产生达9倍的社会和经济效益。
A new born baby from a displaced family lies on a bed at the Mardan Medical Complex, where displaced pregnant women living in camps and communities are referred for delivery./More than 2.5 million people have been displaced since fighting began in PakistanÕs North West Frontier Province in August 2008. More than half of those displaced are children and need urgent humanitarian assistance. About 200,000 live in refugee camps and the rest in host communities. According to the United Nations Population Fund (UNFPA) out of the 6,000 displaced pregnant women some 4,300 are due to give birth in June. To tackle the lack of enough medics available and of emergency obstetric and neonatal care in the camps, UNICEF is supporting the establishment of four Maternal and Child Health Units in different camps.
© UNICEF/PAKA2009-5020/MARTA RAMONEDA
在巴基斯坦的马丹医院,一名初生婴儿躺在牀上。
Rekha Verma holds her four days old son in the feeding room of the Sick New-Born Care Unit (SNCU at the district hospital Guna, Madhya Pradesh. Despite being one of the most mineral rich states in India, with vast hoards of diamonds, Madhya Pradesh is one of the poorest with 40% of its population living in poverty. The state also has some of the worst development statistics in India. Of every 1000 births in Madhya Pradesh - 310 mothers will die, while 59 new-borns will die for every 1000 live births - one of the highest infant mortality rates in the country, and compares starkly with Kerala for example where 14 infant will die out of 1000 births. This number jumps to 63 newborn deaths for every 1000 live births in rural areas. UNICEF India/ 2013/ Manpreet Romana
© UNICEF/INDA2013-00389/MANPREET ROMANA
在印度Sick New-Born Care Unit,一名母亲在哺乳室抱着刚出生四天的儿子。
UNICEF和世界衞生组织将在下月推出「每个新生儿行动计划」,以在2035年前消除可预防的产妇和儿童死亡。
《刺针》的「每个新生儿」系列论文由UNICEF、伦敦衞生与热带医学院和巴基斯坦阿迦汗大学的专家等共同撰写。
「每个新生儿行动计划」将于UNICEF就联合国《儿童权利公约》25周年倒数6个月时展开,以强调儿童工作上取得重大进展之余,最弱势儿童仍要面对的挑战。