Born Healthy: tackling the burden of birth defects

26 October 2016

Every year around five million babies are born with birth defects (also known as congenital disorders), most of them in developing countries. Birth defects are rapidly becoming the leading cause of childhood mortality and morbidity, and survivors face a lifetime of ill-health and the attendant problems of poverty, stigma and discrimination.

Genetic abnormalities cause or worsen a large proportion of birth defects. Better healthcare - often simple, affordable interventions - could prevent or ameliorate around 70% of birth defects, which include disorders such as cleft palate, club foot and spina bifida. 

In 2010 the World Health Assembly called on its member states to take action on birth defects - whilst recognising that many countries simply do not have access to the knowledge and tools to achieve real change. 

The PHG Foundation's response was to develop a pioneering free Health Needs Assessment Toolkit for Congenital Disorders, a unique tool to help health professionals and planners in low and middle income countries around the world plan and develop new services for birth defects.  

Three years in the making, during which time it was piloted in Latin America, the toolkit was launched in 2012 and is already making an impact, having been instrumental in changing government health policy on newborn screening in Uruguay, and is a significant feature in health initiatives across Latin America, India and in Europe. 

About the health needs assessment toolkit for congenital disorders 

The toolkit is built on the health needs assessment approach which is common currency in UK public health, but not routinely used in the developing world. The toolkit guides users through a systematic process to:

  • Assess the health needs of their population using the best available data about congenital disorders in 192 countries
  • Access expert guidance on what can be done to improve prevention, diagnosis, treatment and care in 17 major topic areas
  • Consider the ethical, legal and social implications relevant to their locality
  • Engage important stakeholders, including patients themselves, in the needs assessment and planning process
  • Plan services to meet the needs of their population
  • Undertake advocacy activities to encourage policy makers to take ownership of the issue and commit to action

Collaboration and impact 

As a global leader in public health and genomics the PHG Foundation was able to muster international experts to help develop the toolkit and get it tested in Latin America and India. Collaboration with colleagues at University College London and the London School of Hygiene and Tropical Medicine enabled us to include up-to-date epidemiological data on congenital disorders and create a functional online resource that guides users through the process of collecting evidence of health needs and planning and implementing strategies for prevention, treatment and care that are suited to their local circumstances. 

Partners in delivering the toolkit

The  toolkit was formally handed over to a consortium of health partners in Brazil in  April 2014, allowing them to continue this work at a national centre of  excellence in genetics and congenital disorders provided by the  Universidade Federal do Rio Grande do Sul, its associated Hospital  Clinicas Porto Alegre and the Brazilian National Institute for Medical and  Population Genetics (INaGEMP). 

Our Brazilian colleagues  have been passionate champions for this project from the start and have  demonstrated exceptional leadership in fostering dissemination of the toolkit  across Latin America and further afield. Against the backdrop of their government's support through the Brazil Without Borders initiative, they are  committed to tackling the burden of congenital disorders through international  collaboration and will continue to promote and  develop the toolkit and update the global health data it contains. The  PHG Foundation will continue to be involved in an advisory capacity.

What are birth defects?

Birth defects (also called congenital disorders) refer to any physical abnormality present from birth, though in many cases they are not recognised until much later.

These conditions affect some aspect of the body's structure or function, and may therefore have profound impacts on health and development of the child. Birth defects vary widely, but the majority - such as Down's syndrome, sickle cell anaemia, congenital heart disease and thalassaemia - have genetic causes. They can also arise from environmental factors e.g. poor maternal nutrition, infections, or exposure to alcohol, drugs and chemicals during pregnancy. Some birth defects are due to a combination of genetic and environmental factors.

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