Bright future for Brunei babies
BANDAR SERI BEGAWAN
INFANT Care in Brunei has grown by leaps and bounds in 2014 with the completion and introduction of several projects and initiatives but new challenges lie ahead with the rise of non-communicable diseases among expecting mothers in the Sultanate.
All babies born in 2015 will undergo hearing screening to allow health professionals to identify those with hearing loss or deafness, allowing for better management of their problems at an earlier stage.
The Minister of Health Yang Berhormat Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Hj Adanan Begawan Pehin Siraja Khatib Dato Seri Setia Hj Mohd Yusof made the announcement earlier in November.
He said the new screening – which will mitigate future disadvantages in language development among those affected – would be first rolled out at the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, followed by all other district hospitals.
The screening aims to test every newborn's hearing before they leave the hospital, with nurses and midwives trained to perform the tests.
Meanwhile, the completion of the much anticipated Women and Children's Block was announced yesterday during the key handing-over ceremony at the site.
Construction of the $69 million building began in May 2011. It contains 11 floors and houses 353 beds .
The public can expect a wide range of general and specialist services such as the maternity, neonatal, obstetrics and paediatrics ward, obstetrics, gynaecology clinic and paediatric intensive care unit.
Brunei's Specialist Training Programme in paediatrics also received a boost as the Royal College of Paediatrics and Child Health from the United Kingdom approved of Brunei to adopt its curriculum, the Minister of Health revealed in November.
Infant mortality rate remains low
The most recent statistics available this year showed Brunei's infant mortality rate to be 9.3 per 1,000 live births in 2012, with perinatal mortality – defined by the World Health Organisation (WHO) as the number of stillbirths and deaths in the first week of life – at 7.5 deaths per 1,000 births.
The Minister of Health cited these numbers as hugely positive when compared to mortality rates of almost 100 in 1,000 in the country over 60 years ago.
He explained that the steady reduction in mortality was a direct result of the provision of “accessible, equitable and affordable healthcare through universal health coverage emphasising primary healthcare.”
To further mitigate deaths, MoH recently introduced a six in one vaccine for infants, replacing the existing oral polio vaccine with an injectable form. Under the National Immunisation Programme, 95 per cent of children under five are immunised.
Globally, an overall reduction in child mortality has been observed but reductions in perinatal and neonatal (newborn) mortality have stagnated.
With the day of birth representing the time of greatest risk of death and disability for babies and their mothers – contributing to around half of the world's 289,000 maternal deaths – the Minister called on health professionals in Brunei to utilise the Newborn Health Action Plan endorsed by the WHO to reduce stillborns and newborn deaths.
Three maternal deaths were reported in 2012, with statistics recorded between 2008 and 2011 fluctuating between one and no reported deaths.
Non-communicable diseases (NCDs)
Despite reporting encouraging numbers in accessibility, delivery and infant mortality, a number of challenges have been identified by health professionals and various studies.
Head of Obstetrics and Gynaecology at RIPAS Hospital Dr Hjh Siti Nor Azmah Abdullah told The Brunei Times that couples – especially those with pre-existing conditions such as hypertension and diabetes – needed to plan their pregnancies with the assistance of health professionals to prevent any negative outcomes to the mother and the baby.
She said social and cultural issues continue to affect many, explaining that women with existing conditions will decide against medical treatment, instead seeking out alternatives for fear of harming their babies.
“In an unplanned pregnancy you are a little less prepared, and at a disadvantage in many ways, because of the potential harm these conditions can have on your baby,” she said.
“Planned pregnancies, early booking and regular checkups have been shown to give a better outcome for both mother and child.”
The High Risk Clinic which offers treatment for pregnant women with existing conditions has the facilities and manpower to meet specialised needs, with the only practical issue being transport for patients who live in districts such as Kuala Belait.
According to a recent study published in the Brunei International Medical Journal, overweight first-time mothers in the Sultanate are more likely to have induced labour and emergency caesarean sections.
The study, reviewing all pregnant women delivering their first child at RIPAS between 2009 and 2010, reported that underweight mothers had the highest rate of normal vaginal delivery at 80 per cent compared to 69 per cent of high Body Mass Index (BMI) and 63 per cent with normal BMI.
The Brunei Times