𝐁𝐡𝐮𝐭𝐚𝐧 𝐌𝐚𝐫𝐤𝐬 𝐚 𝐃𝐞𝐜𝐚𝐝𝐞 𝐨𝐟 𝐖𝐨𝐫𝐥𝐝 𝐏𝐫𝐞𝐦𝐚𝐭𝐮𝐫𝐢𝐭𝐲 𝐃𝐚𝐲 𝐎𝐛𝐬𝐞𝐫𝐯𝐚𝐧𝐜𝐞𝐬

…𝑰𝒎𝒑𝒓𝒐𝒗𝒊𝒏𝒈 𝑪𝒂𝒓𝒆 𝒇𝒐𝒓 𝑩𝒉𝒖𝒕𝒂𝒏’𝒔 𝑷𝒓𝒆𝒕𝒆𝒓𝒎 𝑩𝒂𝒃𝒊𝒆𝒔

By Bikash Mishra

Bhutan joins the world in raising awareness on World Prematurity Day. It was first observed in Europe in 2008 to celebrate and bring together families of premature babies, government, society and the health care workers to discuss the complications and the struggles faced by the parents of premature children, the children themselves, and the challenges faced by the healthcare workers as well as the government while looking into the preventive measures of premature births.

Joining the world, Bhutan started observing World Prematurity Day from November 17, a decade ago in 2014.According to the neonatologist, Dinesh Pradhan at Gyaltsuen Jetsun Pema Wangchuck Mother and Child Hospital (MCH).

Prematurity Day is usually celebrated in Thimphu as well as in the regional hospitals like Mongar and Gelephu. Dinesh Pradhan claimed that these hospitals are equipped with facilities for Newborn Intensive Care Units (NICU). Parents of premature babies are provided with facilities such as beds, water dispensers, microwave oven and a charging point for their electronic gadgets.

According to Dinesh Pradhan, premature death is the leading cause of death for children below five years since 2015. He said, “However, most of the premature deaths among infants occur within a month old, particularly in Bhutan.”
Moreover, 90 percent of the premature deaths takes place in low income countries with 10 percent of deaths occurring in high income countries. As per the National Health Survey (NHS) conducted last year, new born mortality rate before reaching one month in 2012 was 21 per 1000 newborns. But last year, the mortality rate dropped to 6.9 percent, roughly 7 per 1000 newborns, showing improvement in the new born care facilities over a decade.

The extreme premature babies born in less than 28 weeks at MCH hospital in Thimphu stood at 72 percent in 2017. This case has dropped to 43 percent last year.

Healthcare workers face challenges despite the decrease in the mortality rate among new born babies whereby more than 60 percent of dead cases in infants are preterm babies.

According to the neonatologist, the residential location is a major factor causing preterm death. For instance, the survival rate of preterm babies born in Trashigang is lesser than the ones born in the national or regional hospitals. The preterm babies struggles to reach Mongar hospital from Trashigang hospital, usually boarded on an ambulance that lack of adequate facilities. Dinesh Pradhan said, “The healthcare workers don’t have necessary facilities and equipment to maintain baby’s body temperature. We also don’t have trained nurses for neonatal transport.”

Healthcare workers are also failing to address parent’s psychological concerns. Tandin Pem, a nurse with MCH said that it is difficult for them to deal with parents undergoing trauma, unable to accept the reality of their prematurely born babies. “Some parents cannot bear the pain of seeing their preterm babies suffering,” she said.

Dinesh Pradhan shows green flag to enhance psychological support for the parents. He plans on surveying the parents. He said that qualified counsellors will be visiting at MCH for a few times in a week to assess their mental condition starting from next month.

Nima Dorji, a senior nurse at MCH pointed out another challenge faced by the healthcare providers. He claimed that there are more inexperienced nurses in MCH after most of the skilful and experienced nurses have left the hospital for greener pasture. “New nurses face more difficulty in handling preterm babies as they lack experience in the field,” said Nima Dorji.

The healthcare workers are providing support to the parents and newborns through Kangaroo Mother Care (KMC). KMC is a method providing skin-to-skin contact between mothers and preterm babies, has proven effective in maintaining body temperature and promoting faster stabilization and weight gain. KMC was initially introduced in Thimphu which is now being expanded to other Dzongkhags and primary health care centers, enhancing neonatal care across Bhutan.

Another support system in place is known as Comprehensive Mother and Child Health Care Program. This program includes modalities such as fertility services and preconception care. “Availing preconception services helps healthcare workers optimize the health of the mother before she becomes pregnant, reducing the chance of delivering prematurely” said Dinesh Pradhan.

Some of the ongoing initiatives to reduce premature birth includes the drafting of the Bhutan Newborn Action Plan for the next five years. MCH will revise the Midwifery Guideline for pregnancy care.

Dinesh Pradhan said that awareness event has been carried out for the public outreach by inviting media organizations like Bhutan Broadcasting Services (BBS) and Kuensel.

During the World Prematurity Day, Thimphu’s National Memorial Chorten is lit up in purple light to create awareness This year the World Prematurity Day was observed on November 17, 2024 under the theme “Over 13 million babies born too soon every year: Access to Quality Care Everywhere.”