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Kate Holt/Jhpiego

Newborn Health

Despite global efforts to develop and promote high-impact interventions for newborn health, 2.6 million babies die each year within the first 28 days of life, with more than three-quarters of these deaths occurring in sub-Saharan Africa and South Asia. An additional 2.6 million babies are stillborn each year: half of these are during labor and birth, most are preventable, and nearly all occur in low- and middle-income countries. Improvements in the prevention of newborn death have lagged behind those for maternal and child health, and 45% of all under-five deaths happen during the newborn period. Yet, three-quarters of newborn deaths are preventable with simple, inexpensive, high-quality interventions.

MCSP harnessed global and country-level resources to prevent newborn deaths. This included advocacy and technical support to implement key interventions that address the major causes of newborn death — intrapartum complications, newborn infections, and complications of preterm birth. As part of an integrated package of maternal and newborn care, we focused on providing appropriate, timely, and high-quality essential newborn care on the day of birth and during the postnatal period, including:

  • Newborn resuscitation to manage asphyxia;
  • Kangaroo Mother Care (KMC) for premature and low birth weight newborns; and
  • Newborn infection prevention and management.

To advance these critical newborn health interventions, and in recognition of the fact that many newborn deaths can be prevented through improved care of women before and during pregnancy, we emphasized integration with maternal care while strengthening health services and the household-to-hospital continuum of care. MCSP collaborated and worked with partners through global initiatives — such as Saving Newborn LivesSurvive & Thrive Global Development AllianceUN Commission on Lifesaving CommoditiesEvery Newborn Action Plan, the Kangaroo Mother Care Acceleration Partnership, and others — to ensure newborn health remains on global and national agendas. Country partnerships included governments, local partners, and communities where the Program supported policy strengthening and scale-up of evidence-based newborn interventions.

These collective efforts contributed to strengthening skills and improving the quality of newborn health services through improved coverage and quality of essential newborn care, newborn resuscitation, essential care for small babies, prevention of umbilical infection through use of chlorhexidine, and appropriate management of possible severe bacterial infection.

Key Results

  • Through the Every Newborn Action Plan (ENAP) Country Implementation Group, MCSP contributed to the newborn health policy agenda, while sharing Program learning and gathering information to disseminate to MCSP countries. The Program’s work on newborn resuscitation in Rwanda, scale-up of newborn interventions in Bangladesh, and the KMC Acceleration Partnership Community of Practice were included in the ENAP 2016 progress report, Reaching the Every Newborn 2020 Milestones.
  • MCSP supported the launch of the World Health Organization’s (WHO) Quality, Equity, and Dignity Network for Maternal, Newborn, and Child Health in Malawi. The Program continued to support the implementation of the WHO maternal and newborn health quality framework to improve the quality of integrated routine maternal and newborn healthcare, and supported MCSP country programs to implement integrated approaches.
  • Since its inception, MCSP co-hosted four workshops of the KMC Acceleration Partnership, with delegations attending from more than 10 countries, including six priority countries. The workshops convened experts and champions, including MCSP/Maternal and Child Health Integrated Program staff, professional association members, academics, and ministry of health representatives to develop shared practices by interacting around successes, problems and solutions, and to build a common store of KMC knowledge.
  • MCSP finalized two briefers for program implementers and clinicians that present WHO guidelines on basic newborn resuscitation and optimal feeding of low-birthweight infants. MCSP shared the briefs on its website and social media channels, as well as with partners (WHO, USAID, UNICEF, and Saving Newborn Lives) and MCSP in-country networks to circulate widely among networks of country-level implementers.
  • The Program participated in planning the global, multi-partner effort to assess facilities to document standards of care of small, sick newborns across low- and middle-income countries. MCSP led negotiations with its in-country programs, USAID missions, and MOHs to initiate assessments in Nepal and Rwanda.
  • MCSP improved care of small babies through accelerating uptake of bCPAP (bubble continuous positive airway pressure) in countries with newborn programs. In Nigeria, MCSP initiated ongoing communications among the federal MOH, USAID’s Center for Accelerating Innovation and Impact/Dalberg, and partners to develop a national-level action plan to introduce and scale up bCPAP implementation. MCSP worked with facilities to address challenges, such as the cost of oxygen paid for by patients. As a result of The Program’s action, the cost of oxygen decreased by 50% at one of the local hospitals.
  • MCSP supported the development of state-level operational plans based on the national scale-up of chlorhexidine (CHX) in Nigeria. MCSP provided technical assistance to Liberia to develop a national CHX scale-up plan, informed by Nigeria’s experience. This resulted in the development of Liberia’s national CHX plan covering the period 2017–2021.