Sociology

Neonatal mortality pertains to the death of a baby born alive within a specific period of 28 days. These may be divided into two categories according to the time of death.  If the neonate dies within the first week or seven days after being born, this is called early neonatal mortality.  On the other hand, if the death occurs after the first week but within the duration of 28 days after birth, this is called late neonatal mortality.  Studies, which have been backed by statistics from countries across the globe, have pointed out that the main causes for neonatal mortality are inadequate or inappropriate care given to the newborn babies within and outside the hospitals.  There have been many cases too that also indicate the insufficient nutrition that mothers have during their pregnancies, which often result into neonates with weaker resistances against even the milder forms of infection. 

This paper discusses about the neonatal mortality condition in Seychelles.  The datasets used to achieve this objective are those from the World Bank, UNICEF, WHO, and the UNDP.  The World Bank and UNDP datasets are important in describing the economic conditions of the people of Seychelles.  Datasets from WHO and UNICEF provide the necessary statistical data about neonatal mortality in the subject country.

Seychelles is a small country with a tropical climate.  Although the country is part of the African continent, it is detached from the mainland as a group of islands situated in the Indian Ocean.  The country is a republic which has had a history of socialism.  The socialist period in its history was also the point which established a tradition of making health care universal.  In 1991, the government shifted into a republican form with multi-party system.  (World Bank)  Seychelles has no basic industry and its agriculture is not productive enough to bolster its economy.  The country is highly dependent on imports and, in exchange, it semi-processes its meager raw materials, such as coconuts, fishes, and other marine products, for exports.  However, its main source of income is in the service sector, particularly tourism.  Because of this, the economy is very vulnerable to financial shocks that can occur in countries from whom it depends for imported products and for tourism.  In fact, the country already has incurred debts that reached record levels above US800 million or around 134 percent of GDP in 2008. (World Bank)  Although the countrys economic foundation is not very solid, it has social indicators that can be compared to most developed economies of the west.  This has been made possible when an all-inclusive welfare system was established in the 1970s.  The welfare system has been able to lessen significantly the gap between the rich and poor, provide homes for families earning little, and subsidize the aged and those without work.  However, what makes it even more outstanding is the fact that Seychelles has been granting its citizens with free and universal access to health care and high standard of education system.  (World Bank)  With a human development index of 0.845, the Seychellois enjoy a much higher standard of living compared to their African neighbors. (UNDP)  Its neonatal mortality rate is one of the lowest in the continent and even the world.  However, with the economic crisis the country is now experiencing, especially with its debt, there are fears that the government may be forced to give up some of the welfare programs it is providing the people.  The health situation may turn from good to bad soon and may even increase the neonatal mortality rate in the country.

In 1987, Seychelles recorded 31 infant deaths within one year after they were born.  Of this number, 28 were neonatal mortalities. (WHO)  Compared to neonatal mortality rates of other countries, including the highly developed ones, this was quite low.  According to the World Health Organization, the causes of such deaths vary from infectious and parasitic diseases, congenital defects of the circulatory system and the heart, conditions related to perinatal period, and preterm births.  Among such causes, the most common were acquired conditions prior to the births, which mean that the neonates already had very weak resistances even during the stage when they were still unborn.

This cause accounts for 16 of the neonatal mortalities that occurred in 1987.  The other common causes are hypoxia and birth asphyxia at six and diseases of the respiratory system at three.  This was already considered as a great improvement when compared to the infant mortality rate in the 1960s when there were 50 deaths for every 1,000 live births. (SMDJ)  By the mid-1990s, this was further reduces along with the significant decrease of maternal deaths and instances of neonatal tetanus.  This development can be attributed to the efforts of the national government to allocate an increasing amount of funds to its Ministry of Health.  Although the 1990s also saw the increase of health care services provided by the private sector, the government continued to provide free medical services to the people.  The mothers and their neonates were able to avail of such services easily, which resulted into the prevention of neonatal deaths.  The increasing number of Seychellois availing of medical and health services by both the public and private sectors was indicative that the promotion of health consciousness among them by the Ministry of Health was successful.  The concept of health for all has been complemented by the individual citizens own concern for his or her health.  (SMDJ)   Therefore, the efforts of the government to develop a healthier country was appreciated well by the people by showing an increasing levels of responsibility towards their own and their childrens health, including those of neonates.

From the year 2000 to 2003, Seychelles recorded a 27 neonatal mortalities or an average of 6.75 per year.  (WHO) This was definitely a significant reduction of the neonatal mortality rate from the 1987 level.  In a year 2000 data from the WHO, the most common cause of death among neonates was preterm births at 46 percent followed by birth asphyxia at 22 percent.  The improvement achieved in the neonatal health conditions can be explained by the countrys development of its basic services and its educational system.  Seychelless urban population totally has access to clean water.  100 percent of the people living in the rural areas also have sanitation facilities.  (UNICEF)  Meanwhile, 92 percent of the adult population is literate in a 2003-2008 statistical survey.  More women have been able to complete secondary education than men although the gap is not wide.

Despite these marked improvements in the past three decades, Seychelles is currently facing huge challenges in its economy because of the crushing debt burden it has incurred due to trade imbalances.  This may affect its health programs in the years ahead. Because of the level of development it has achieved in the past years, the UNICEF and UNFPA have significantly lessened its aid.  However, WHO continues to support the country.  Nevertheless, the government must continue to make the health situation in the country better and reduce further neonatal mortalities caused by preterm births by improving maternal education.  There have been breakthroughs in this regard though by the effort to inform the people regarding primary health care.  The Ministry of Health, with the support of the private sector and the professionals in the medical field, has been successfully providing such education.