The World Health Organization has defined birth defects as structural or functional anomalies (for example, metabolic disorders) that occur during intrauterine life. They can be identified during pregnancy, at birth and at times, detected only later. Birth defects may be caused by one or more genetic, infectious, nutritional or environmental factors and are one of the most important causes of newborn and childhood deaths, chronic illness and disability.
An estimated 303,000 newborns die every year, worldwide, due to birth defects. In addition to mortality, birth defects cause long-term disability, which has significant impacts on individuals, families, healthcare systems, and societies. On World Birth Defects Day, WHO and its Member States in the South-East Asia Region and globally raised their collective voice to increase awareness for all birth defects and improve access to quality care and treatment.
To mark the awareness of this day, the WHO Regional Director for South-East Asia, Dr Poonam Khetrapal Singh, gave a long and informative statement that highlighted many important issues.
In her statement, she said that in 2019 birth defects accounted for more than 530,000 deaths globally, including more than 117,000 deaths in the Region - around 22 per cent of the global total. They were the third most common cause of child mortality in the Region, and the fourth most common cause of neonatal mortality, constituting 12 per cent of all neonatal deaths. In addition to mortality, birth defects can cause long term morbidity and disability, which in low- and middle-income countries causes a strain on the health system and, social and family resources.
"In all countries of the Region, WHO will continue to intensify efforts to increase birth defect prevention, surveillance, care and research, accelerating the World Birth Defects Day (WBDD) movement," she added.
She further went on to say, "Amid the COVID-19 response, WHO continues to support all countries of the Region to protect, defend and advance progress in all areas of health, including accelerating reductions of maternal, neonatal and under-five mortality - since 2014, a Flagship Priority. All Member States have in place national action plans to prevent and control birth defects, and have initiated hospital-based birth defects surveillance. Six Member States - Bangladesh, Bhutan, India, Maldives, Myanmar and Nepal - continue to provide high-quality data to a WHO-supported online surveillance database, which by the end of 2021, had registered more than 4 million births, including around."
45,000 babies born are born every year with birth defects. As part of Region-wide efforts to eliminate measles and rubella by 2023 - another Flagship Priority - all countries of the Region have introduced rubella vaccination of girls, reporting an average of 83 per cent coverage. The several Member States now fortified foods such as wheat flour with folic acid, vitamin B-12 and iron, and include interventions for common birth defect management and care within national child health programmes.
For the Region to achieve key targets and goals - including a 35 per cent reduction in folic acid-preventable neural tube defects, a 50 per cent reduction in thalassemia births, and to eliminate congenital syphilis - several priorities must be addressed. First, gaps in rubella immunization must be closed, and access to good quality antenatal care improved.
Such care should incorporate counselling that encourages pregnant women to avoid unnecessary medications and X-rays, prevent exposure to toxic environmental elements, and avoid harmful products such as tobacco and alcohol.
Second, access to prenatal screening technologies such as ultrasound must be increased, in addition to clinical and laboratory screening of newborns and infants. Primary health care providers should be trained to support diagnosis and referral, which in most health systems is feasible.
Third, the quality of medical therapy, surgery, rehabilitation and palliative care services must be enhanced, and referral pathways better defined and utilized. Affected children and their families must have ongoing access to appropriate mental health and psycho-social support services, and be free of stigma and discrimination. Fourth, data collection, monitoring and evaluation must continue to be strengthened, and policies and programmes assessed on an ongoing basis. Equity, efficiency and impact must continue to define all we do.
Dr Poonam concluded her statement by saying, "Our WBDD movement must continue to build. Birth defects are common, costly, and critical. Across the Region, they account for an increasingly large proportion of under-five mortality as other causes continue to decline. Together, we must continue to integrate interventions to increase birth defect prevention, surveillance, care and research across programme areas, accelerating progress towards our Flagship Priorities and "Sustain. Accelerate. Innovate" vision. On World Birth Defects Day, WHO reaffirms its commitment to ensuring every woman and child can survive and thrive, and transform our Region and world."
WHO's South-East Asia Region comprises 11 Member states: Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.
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