photo courtesy;Save the children Ethiopia
The leading cause of death in children under the age of five globally is complications associated with preterm birth, being premature or low birthweight. This is associated with an increased risk of death in the first month and year of life, and poorer developmental outcomes and lifelong health conditions than their peers born at term and of appropriate weight.
With appropriate care, many of these deaths and complications can be prevented allowing these small babies to survive and thrive.
This has prompted Ethiopia to come up with new low-cost tools that measure newborn babies’ feet to screen for prematurity or low birth weight. The tools are under an initiative to help tackle the leading cause of death among young children, particularly those born at home.
Developed by Save the Children and Hawassa University College of Medicine & Health Sciences (HUCMHS), the easy-to-use screening tools are color-coded and include a laminated card and a plastic tool with a 90-degree “heel holder” to guide where to place a baby’s heel for the measurement.
Save the Children’s Country Director for Ethiopia, Dragana Strinic, commented: “We know that a major cause of neonatal mortality is complications associated with preterm birth and low birth weight. This situation can be prevented when mothers know whether their baby is at risk or not. Yet, according to a recent national survey, half of women in Ethiopia are still giving birth at home with limited access to qualified health-care personnel and/or tools to screen their newborns right after birth.
The tools – informed by health workers and mothers and have already been tested in a hospital-based study – are to be rolled out in a controlled trial in southern Ethiopia as the first step towards a potential adoption in mainstream health services nationwide.
These tools can be used by mothers, family members, and health workers to help identify small babies born at home who are less likely to receive the care they need to survive and thrive. These tools could increase the number of small babies who receive life-saving care.
Ethiopia faces significant challenges in improving maternal and neonatal health. Over 50% of babies are still born at home, which increases the risk of complications during birth. The neonatal mortality rate in Ethiopia is 33 deaths per 1,000 live births, nearly double the global average of 17 neonatal deaths. Additionally, 14% of babies are born with low birth weight, which further contributes to health risks.
Ethiopia is not on track to meet the United Nations’ global goal of reducing neonatal deaths to 12 per 1,000 live births by 2030. According to Save the Children, urgent action is needed to improve healthcare access and quality.
In Hawassa in Ethiopia, Save the Children and HUCMHS designed and prototyped multiple tools with mothers and community health workers in rural areas, whose feedback directly contributed to the designs of the laminated card and plastic tool.
The tools were developed based on a body of research that shows foot length to be directly correlated with babies’ weight, and designed using Human Centered Design (HCD), an approach that creates products and services rooted in the needs of the people using them.
Simple in their design, the tools can help mothers and community members identify whether their newborns are at risk. If the baby’s longest toe falls within a green zone indicated on the tool, the baby is likely to have a healthy birth weight and size. If the baby’s longest toe is in a red zone on the tool, it suggests that the child has low birth weight and may need medical intervention, alerting families of the need to urgently take their baby to a health center.
“For many mothers, the opportunity to measure their own newborn’s foot length to understand a baby’s health status has brought happiness and fulfillment. One mother told our staff – “…there is nothing that makes mothers happier than measuring their babies by themselves and knowing the body weight condition,” said Strinic.
Save the Children and HUCMHS conducted a hospital-based study involving nearly 400 mothers in the Sidama region of Ethiopia who used the tools to measure their babies’ feet. Both tools showed high levels of sensitivity, specificity, and accuracy in identifying low birth weight and pre-term newborns when used by mothers.
Save the Children has been operating in Ethiopia for over 60 years. The organization focuses on health, nutrition, water and sanitation, protection services, education, and cash and in-kind distributions.
Distributed by APO Group on behalf of Save the Children.
