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  • Despite the clear evidence of these interventions coverage i

    2018-10-30

    Despite the clear evidence of these interventions, coverage is still low and therefore their impact to reduce mortality among newborns and children is very poor. The recent Lancet every newborn series (Bhutta et al., 2013, 2014) has clearly highlighted that approximately three-quarters of deaths under five years can be averted if countries implement interventions at a coverage of 70–90% by 2025 (Bhutta et al., 2013). Considering the example of TT immunization, it is quite evident that 60% increase in coverage in last 25years has led to 90% tnf alpha inhibitors in tetanus mortality in babies (Blencowe et al., 2010a). However, the coverage for insecticide treated bed nets in 2011 is still low 35.3% (5.2%–75.5%) and countries should prioritize mechanisms to increase coverage (Hill et al., 2014). Moreover, effective interventions such as hygienic cord care, which includes chlorhexidine cord cleansing, and adopting antenatal corticosteroids for preventing neonatal respiratory distress syndrome in preterm infants have very low coverage according to surveys with less than a third of women and neonates in need receiving them (Mason et al., 2014). Therefore, integrating these interventions into existing neonatal and childhood programs whereby mothers may also receive interventions such TT immunization, ITNs and corticosteroids when at risk at the same time may be an effective way to increase coverage. High coverage of available interventions by 2025 can prevent almost three-quarters of neonatal deaths, and can save around 2 million lives per year (Bhutta et al., 2014). Interventions delivered in packages, especially for the care of small and ill neonates have the potential to save 1.9 million newborn infants (Bhutta et al., 2014). Estimate suggests that available interventions can reduce neonatal deaths related to prematurity by 58%, intrapartum by 79% and infections by 84% among neonates (Bhutta et al., 2014). Therefore, the implementation of the interventions identified in this overview will be of paramount importance for improving neonatal and child survival especially in the countries with the highest burden of mortality. It is vital to understand photoperiodism these interventions are central for LMIC where neonatal and child health indicators are still not up to a high standards and many lives are either lost or their quality compromised due to a dearth of simple and effective actions (Bhutta et al., 2005). These interventions need to be deployed to all and promoted from the very outset, including the preconception period, which is vital to ensuring that women of child bearing age understand the importance of these interventions for their babies\' health and survival. A step forward to seeing improvements in annual reductions in neonatal mortality rates would be to pay more attention to the target group for the interventions; funding and resources may need to be reallocated to include stillbirth prevention which has received very little attention so far (Frøen et al., 2011). High fertility rates may also be adding to the problem. Care and resources in LMICs may be inadequate to cover already existing newborns; and increasing numbers of neonates will lead to strains on existing health care systems. Improved access to family planning, contraceptive methods, awareness and education will decrease the disparity and help efforts to achieve decreased neonatal mortality rates (Bhutta et al., 2014). Community-based delivery strategies to increase access to needed care must be foremost to bringing about a positive change in the LMICs because appropriate education and awareness needs to precede interventions. Empowerment of women, removing barriers to accessibility to health care services, increased education and awareness in communities, and shifting the focus to evidence based interventions may help in adopting healthy practices among mothers and improve child survival rates (Bhutta et al., 2014). Appropriate, culturally sensitive education and awareness provided to the communities, followed by timely implementation of discussed interventions which can be integrated with existing healthcare practices, will definitely bring the required improvement in child health and survival.