x Abu Dhabi, UAESaturday 29 July 2017

Infant death rate in Abu Dhabi falls by a fifth

Doctors tell of pride in baby care plan as improved screening brings big rise in survival rates in newborns.

The infant mortality rate in Abu Dhabi has fallen from 8 per 1,000 live births in 2010, to 6.4.
The infant mortality rate in Abu Dhabi has fallen from 8 per 1,000 live births in 2010, to 6.4.

ABU DHABI // The infant mortality rate in the emirate has dropped by 20 per cent, and is now on a par with developed countries in the West.

Health officials attribute the improvement to factors including increased screening and investigations, and sophisticated data-collection methods that allow professionals to develop targeted action plans.

The infant mortality rate in Abu Dhabi has fallen from 8 per 1,000 live births in 2010, to 6.4, compared with 7 in the United States and 5 in the United Kingdom.

One example of screening expansion is the neonatal testing for congenital heart disease, said Dr Jennifer Moore, section head of maternal and child health at the Health Authority-Abu Dhabi (Haad).

The programme was initiated last year and fully implemented across all Abu Dhabi hospitals last September. More than 18,000 newborns were screened last year and 10 children were found to have heart disease.

"What that means for each of those children is that they were picked up before they left the hospital and they were able to get further management, which included surgery for quite a few of them," Dr Moore said. "This improves their outcomes and can potentially save their lives."

Former infant mortality rates prompted Haad to conduct an in-depth investigation across all its hospitals last year by holding focus groups and meeting with neonatologists and paediatricians, said Dr Faiza Ahmed, senior officer of public health surveillance at Haad.

"That helped to not only answer our queries but to raise awareness among the group of consultants in terms of improving infant health," she said.

The most prominent gap was in neonatal care, with a significant need for neonatal intensive care units (NICU).

According to Haad's annual report last year, there are 109 NICU beds in the emirate and the average occupancy rate is 98 per cent; the optimal rate is 75 per cent. There is a shortage of neonatal specialists as well, with only 18 in Abu Dhabi.

Activating already existing policies on the ground was another challenge, officials said. Under this policy, any baby born in the emirate should receive free critical care at an Abu Dhabi Health Services Company (Seha) facility. However, only babies born to Emirati parents were being given covered care. In the middle of last year, hospitals and insurance companies resolved the problem.

As a result of the findings of the in-depth investigation, an infant health action plan was implemented last December to address the gaps and a dedicated task force will be established this year.

The transition from manual to electronic data collection has also contributed to the improvement of data quality, said Dr Asma Al Mannaei, manager of community health and surveillance at Haad.

"The information is incorporated into that system and the data is made available to Haad immediately for quality checks, validation and analysis," Dr Al Mannaei said. "Previously this process was done manually."

Perinatal conditions, such as premature birth and low birth weight, and congenital anomalies account for two-thirds of infant deaths, said Dr Ahmed. She added that the rankings were similar to countries in the West. Most deaths occur during the neonatal period - the first 28 days of life.

Educating the community has also played a significant role, said Dr Taisser M Atrak, chairman of the paediatric department and chief of neonatology at Mafraq Hospital.

"For example, we know diabetes can cause congenital anomalies, so we pick up these women before they get pregnant, during pregnancy and after pregnancy to screen them and control their sugars so that their baby comes out fine," he said.

However, there is always room for improvement, Dr Atrak said. Reducing the rate further in Abu Dhabi requires reaching out to low-income residents and increasing the number of NICU beds. "I get two or three calls a week and I cannot accept the baby because I have my unit at full capacity," Dr Atrak said. "That's the key for success, having the resources available to have the best outcome. You need the unit and you need the highly specialised team."

Despite the gaps, Dr Atrak described the drop as a matter for "pride" in Abu Dhabi.

"If you look at these stats, we are really in the forefront of the region," he said. "To make such dramatic progress within a small period of time is a significant achievement."

In most cases, a baby's health will depend on its parents' attentiveness, Dr Atrak said. "The physician will just advise and counsel, but it's the parents who have to take action."