Global Update: Infant Deaths Drop After Midwives Undergo Inexpensive Training

Giving midwives simple training has already been shown to save newborns’ lives, and a new study in Zambia has found that it can be remarkably cost-effective as well.

Even a small pilot project costing only $20,244 saved the lives of 97 infants, the authors estimated, meaning that it cost just $208 per life saved.

The study, published online in April in the journal Pediatrics, was paid for by the National Institutes of Health and the Bill and Melinda Gates Foundation, and conducted by American and Zambian university and government doctors.

Midwives from 18 Zambian clinics were taught a basic course in newborn care and encouraged to teach their colleagues as well. The course covers simple interventions like cleaning and warming a newborn, resuscitation, breast-feeding and diagnosing common illnesses. (Above, a birth attendant listened for a baby’s heartbeat with a clay stethoscope.)

The midwives normally handled births that were expected to be uncomplicated, with women typically going home with their babies after one night in the clinic.

The researchers compared survival rates among 20,000 babies born before the teaching and 20,000 afterward. The first-week death rate among babies had dropped by almost half, they found, to 6.8 deaths per 1,000 live births from 11.5 deaths.

Past studies have suggested that the single most important aspect of training, in terms of saving lives, is to teach midwives that an infant who is not breathing at birth can be revived with quick action — by massaging to prompt it to inhale, or using a simple resuscitator.