Newborn Health Scale Up
Framework for Zambia
Dr. Penelope Kalesha
Child Health Specialist
Ministry of Com. Dev. Mother and Child Health
Births and Deaths and inequity
Total Population
Annual Births
.
11479000
468000
Mothers
Maternal mortality rate (per 100,000 live births, adjusted)
Annual no. of maternal deaths
750
3510
Babies
Stillbirth rate (per 1000 deliveries)
31
Neonatal mortality rate (per 1000 live births)
37
Annual no. of neonatal deaths
Percentage NMR gap betw een poorest and least poor
18044
39%
Children
Under 5 mortality rate (per 1000 live births)
182
Annual no. of under 5 deaths
85176
Annual no. of postnatal deaths
67132
NMR as percentage of under 5 mortality
20%
Ra
Trends of under five and infant mortality
rates in Zambia
240
222
220
U5MR
IMR
Projections to 2015
211
194
200
194
186
180
173
168
156
160
158
Cu
rre
nt
tr
140
140
130
M
115
120
100
100
G
D
94
88
85
85
en
d
G
oa
l4
82
80
64
60
NNR
40
28
20
0
19
55
9
-5
4
-6
0
6
19
9
-6
5
6
19
19
70
Child Health Overview
Source: World Health Chart, WHO- 2001
4
-7
9
-7
5
7
19
4
-8
0
8
19
19
85
9
-8
4
-9
0
9
19
19
95
9
-9
4
-0
0
0
20
9
-0
5
0
20
0
01
-
1
20
5
2 4/7/2015
The Information Problem
Source WHO
The majority of
deaths…
with the minority
of information
Goal and Objectives of Scale Up
Goal: To accelerate the reduction of neonatal
morbidity and mortality
The scale up of newborn health care will focus on 3
strategic objectives that will guide programming and
selection of interventions
Rationale for Scale Up
• Two thirds of newborn deaths could be prevented
with a higher coverage of essential maternal
newborn and child health (MNCH) service
packages that are already articulated within
policies and plans. The strengthening of some
specific newborn healthcare aspects could save a
large number of newborn lives every day.
Critical time periods:
• Pre-pregnancy , Pregnancy, Labour, delivery and
the first 1-2 hours of life, Early neonatal period (week
1), Late neonatal period (weeks 2-4)
Newborn Health Scale up Framework
•
Strategic Objective 1: To strengthen capacity to improve newborn health
care at all levels of the health care delivery system
o
o
o
•
Strategic Objective 2: To increase the availability, access and utilization of
quality newborn health care services
o
o
o
o
o
•
1.1 Strengthen capacity to increase and improve essential newborn care
1.2 Strengthen national, provincial, district and community level planning, management and supervision
1.3 Strengthen Reporting, Monitoring and Evaluation
2.1 Improve health care facilities and service delivery sites
2.2 Improve provision and access to quality newborn health care and services
2.3 Strengthen referral and outreach systems
2.4 Strengthen advocacy towards increased commitment, resources and integrated newborn health policy
and programming
2.5 Foster and Strengthen Partnerships
Strategic Objective 3: To empower communities to improve community
maternal and newborn health care practices, and support the continuum
of care
o
o
o
o
o
3.1: Influence behaviour change towards healthy newborn care practices and strengthen community
involvement and support
3.2: Strengthen community involvement and support for the continuum of care
3.3: Establish and strengthen Home Based Newborn Care (HBNC)
3.4: Establish and strengthen community IMCI strategy
3.5: Strengthen multisectoral community response to newborn health
Most important interventions?
PREVENTIVE (Skilled care at birth)
•
•
•
•
•
•
•
•
Labour, birth and 1-2 hours after birth
Monitoring progress of labour,
maternal and foetal well-being with
partograph
Social support (companion) during
birth
Immediate newborn care
(resuscitation if required, thermal
care, hygienic cord care, early
initiation of breastfeeding)
Emergency obstetric and newborn
care for complications
Antibiotics for preterm premature
rupture of membranes
Antenatal corticosteroids for preterm
labour
Prevention of mother-to-child
transmission of HIV+
TREATMENT (Postnatal care for all
newborns)
•
•
•
•
•
•
•
•
•
Newborn period (after the first 1-2
hours after birth up to 1 month)
Exclusive breastfeeding
Thermal care
Hygienic cord care
Prompt care-seeking for illness
Extra care of low-birth-weight
(LBW) infants
Immunization
Management of newborn illness
Prevention of mother-to-child
transmission of HIV+
Adapted by WHO/CAH from the Lancet Neonatal
Survival series, Lancet Child Survival series
Opportunities for Scale-Up
•
Policy and Planning
•
National Pre-service and In-service
Training
•
Promising National Interventions
and Pilot Programs
•
Community and Facility Based
Strategies
•
•
Key opportunities in policy and
programmes to save newborn lives
Prioritization and Selection of
Strategies/Interventions
Prioritization/ Selection of
Strategies/Interventions
• Situation analysis
• Prioritizing and choosing
interventions
• Intervention delivery
• Monitoring and evaluation
Progress to 2015- Child Health
We can work together to make
a big difference for mothers,
newborns and the future?
Thank you!