Photo: The Bill & Melinda Gates Foundation. This blog was originally published in Impatient Optimists. Written by Gary Garmstadt, Amie Newman, Wendy Prosser.
I am optimistic about the possibilities within reach for newborn health and I hope you are too. Here’s why. The first-ever Global Newborn Health Conference occurred last week. It was a powerful experience to be surrounded by policy makers, program managers, researchers, practitioners, and champions for newborn health from around the world. We have better data and better information on causes of death, simple, cost-effective solutions and delivery strategies to save newborn lives. But that’s not the only reason I’m optimistic.
It was particularly inspiring to see moms join the effort from around the world, in the room, with newborn infants in their arms and laps. Many more mothers joined in by watching the web-stream and taking to social media: blogs, Tumblrs, and Twitter using #newborn2013 and #NewbornActionPlan to share their own experiences, spread awareness of the issues in global newborn health, and offer solutions. It’s a perfect example of the impetus in action for expanding the traditional group of newborn health champions, using creativity, and engaging a strong array of partners beyond our immediate sphere of influence that will help us, ultimately, save newborn lives.
Why is this important? Because if we are to make true progress when it comes to newborn health and lives, we must be innovative and recognize the ways in which newborn health is embedded within a broad, complex system with many influential leverage points and influential people along the way.
A story from Honduras captures this idea. A community in the southern part of the country introduced a new health strategy aimed to advance newborn health but, interestingly, utilized a leverage point that didn’t directly involve newborns. The plan urged pregnant women to develop birth preparedness plans, and included improvements in the quality of care at the facility level.
To ensure that women would get prenatal care, this town made it a law that husbands are required to take their wives to the clinic for prenatal care. If a husband didn’t comply, he found himself sweeping the streets. The town is using social stigma to encourage positive behavior change.
It’s rather unorthodox, but this change received buy-in from community leaders, lawmakers, law enforcement, health personnel, and, most importantly, the wives. It changed the way community members looked at prenatal care: it’s now a family responsibility with transparent oversight by the community.
So, not only did this leverage point exist outside the health system, it’s an example of the kind of lever that exists, within this complex system of newborn health, which is not directly linked to a newborn baby’s health.
We know of the influence a mother’s health and care has on a newborn, as well as of cultural norms, policies related to education--especially for girls, and even the nutritional status of young women before they become pregnant. A healthy newborn now has more opportunities to grow into a healthy child with more chances to become a healthy, productive adult, to start the cycle again and to contribute to long-term economic prospects of poor countries.
We know that the newborn is the nexus to improving everything else along the lifecycle. And this is the challenge facing the newborn community now—we can’t look only at the 28 days after birth; we must look at the entire system. We can’t go it alone as a newborn health community.
With the energy created by this conference, we have the opportunity to build on the extraordinary advances made in maternal and child health, and more recently in newborn health. Just as in child health, so much can be done that is simple. But we have to think outside the box, beyond the usual domain of maternal, newborn and child health.
My hope is that the energy generated at the Global Newborn Health Conference will continue and expand into the broader context, leading to new partnerships and use of a wider array of and more innovative levers like the ones I’ve discussed in this post, for impact on newborn health.
The conversation and hard work continues. We will bring this creativity and inspiration, along with the evidence and knowledge we currently have about what works to improve newborn health, to our broader work on investing in women and girls. Catapult is an example of a new mechanism for taking action to empower and improve the lives of women and girls; there you will find number of project through which you can make a difference.
As we now prepare for the Women Deliver conference, an opportunity to highlight the critical importance of investing in the health and well-being of girls and women, in May in Kuala Lumpur, we recognize that this extremely valuable investment in girls and women must start with a healthy newborn.
This blog was originally published by Save the Children UK
In the 1940s the British government created a Welfare State that promised to look after citizens from the “cradle to the grave”. This outlined a commitment to provide universal health coverage to all people, regardless of wealth, from the first moment of life until the last.
Unequal life chances
Returning home to the UK from the first Global Newborn Conference in South Africa, I was reminded of how unequal the survival chances of babies are because of where they happen to be born.
Last year, 3 million babies died in the first month of life. Around half of these deaths occurred on the very first day, and 2.6 million more babies were stillborn.
In the 21st century it is unacceptable that so many babies die.
Almost all of these deaths happen in low and middle-income countries. More specifically, they happen in the poorest and most marginalised communities and where mothers have lower levels of education.
But if we applied the knowledge we have been using for decades in high-income countries to prevent newborn deaths, almost all of these babies could have survived.
If a woman becomes pregnant in the UK, she has access to skilled health workers who provide the care she needs before, during and after childbirth.
At the time of childbirth, if there are complications for the mother or baby, specialist health workers and equipment are available.
All services are provided free at the point of use so the cost of health care doesn’t deter the mother from seeking care as soon as she needs it.
A high quality of care is expected, and if it is not provided we have a right to complain. If a mother or child dies then it is perceived as the exception, even unacceptable.
These things we take for granted in countries like the UK are not the norm in all parts of the world.
Where newborn death rates are high, where quality services are not available, there is too often a sense of acceptance that this is just the way things are.
The vision of EVERY ONE, Save the Children’s global campaign for child survival, is that no child under the age of five should die from preventable causes, and that public attitudes will not tolerate unnecessary child deaths.
A global newborn action plan
That is why we are getting behind a Global Newborn Action Plan that will catalyse action to end preventable newborn deaths as part of wider efforts to improve the health of women and children.
On 7 May, Save the Children will be publishing our annual State of the World’s Mothers report, which will show the countries where babies have the best and worst chances of surviving their first day, and where we need to focus our energies.
Click here to find out more about the Global Newborn Action Plan and how you can contribute.
“The act of giving life should not cause death” – Graça Machel, Global Newborn Health Conference
Photo: Save the Children. This blog was originally published by Save the Children's EVERY ONE Campaign. Written by Steve Haines.
Late last year the Ugandan Parliamentary Committee on Health declared ‘a crisis in human resources for health’. The country has around half the health workforce it needs. They refused to sign the health budget until something was done to address the shortage in health workers with midwifery skills in Uganda. Concessions were made, but still the health budget is far short of what’s needed.
In a district clinic in the town of Jinja we saw just how important ‘human resources for health’ are. We met Florence, a midwife, who showed us the skills she was taught by Save the Children’s Saving Newborn Lives program and partners, under Uganda's ‘Helping Babies Breathe’ initiative. Using simple procedures and resuscitation equipment Florence is saving newborn babies’ lives every day, and reducing the staggering number of deaths caused each year by complications like birth asphyxia, one of the three leading causes of newborn death. It was humbling to see how much could be done by Florence with the right equipment and the right training.
The challenge Uganda faces is that there are not enough Florences to go around. When trained health workers are there, they face long hours, work without enough of the right equipment, in facilities that are often inadequate. Access to quality health services remains a problem for many Ugandans, and pregnant mothers still often turn to inadequately trained traditional birth attendants to deliver their babies.
The loss of life of these mothers and children is a tragedy every day, but it doesn’t make the headlines – or even the bylines. We spoke to the Editor of a national newspaper who told us that we needed a new way of talking about the issue that inspired action. Everyone we spoke to had a story to tell about a friend or relative who they had lost in childbirth or a baby’s life that was never lived. These stories went beyond the statistics and showed the need for a sustained campaign, building a case for investing in health services.
We spoke to Members of Parliament who are passionate campaigners for saving the lives of mothers and children about what needed to be done. They told us that while progress has been made, the response to the challenge was still being spread too thinly across too many issues. They told us to prioritise and to push for change.
There’s a powerful platform forming with partners who are committed to addressing the problem. And it’s not just the NGOs: the private sector, Government and members of the media are engaged with the challenge.
So where do we start? Well I’d say: start with Florence. We need more, well trained, well-resourced health workers in Uganda. We also need to recognize excellence against all odds and encourage and support more champions for mothers and newborns.
We need a movement that can support those advocates trying make this happen. We need the evidence and the messages that make the case and can inspire action. And we need to continue to demonstrate how these lives can be saved.
Uganda has a bold vision of becoming a prosperous country by 2030. A healthy mother and a healthy child is the very bedrock of a productive society. Safely delivered children, healthy mothers, protection from disease and a good diet all add up to a healthy population that can drive this vision.
While I was in Uganda, discussions were underway on the next Budget. More money is not the only answer - a large proportion of the health services are delivered by private and not for profit organisations - but it’s a start. For health workers like Florence it’s the way they will get their job done. And for the poorest mothers in Uganda it’s a lifeline.
Photo: A Newly delivered baby at CH Rennie Hospital, Margibi County, Liberia.This blog was orignally published by MCHIP. Written by Dr. Olusola Oladeji.
For the first time, chlorhexidine is being introduced into Liberia for cord care and will be included in the country’s essential medicines list. The policy change signed into effect earlier this month was facilitated by MCHIP and Save the Children (SC), with funding from USAID.
A freshly cut umbilical cord is an easy entry point for bacteria, with the potential for cord infection and even sepsis. However, chlorhexidine is being recognized as an extremely effective intervention to save newborn lives: if applied on the first day, it has been found to reduce newborn mortality risks by 23%.
Liberia is now proving its commitment to improving newborn health by approving 7.1% chlorhexidine digluconate (4% free chlorhexidine) for cord care, as well as endorsing the National Guidelines on Kangaroo Mother Care (KMC) for the care of the country’s preterm babies. KMC is an easy and inexpensive intervention that effectively uses skin-to-skin contact to improve very small newborns’ chances of survival. This contact promotes warmth and regulates the baby’s temperature (including effectively preventing and treating hypothermia), encourages weight gain and uptake and duration of breastfeeding, and reduces infection.
According to a Ministry of Health and Social Welfare (MoHSW) press release: “Chlorhexidine will be applied to the tip of the cord, the stump and around the base of the stump cord of all babies delivered in Liberia immediately after cutting the cord as with repeat application once daily until the cord separates; and the Kangaroo Mother Care guideline will be used by the policy makers, planners, implementers and partners to guide the establishment and implementation of Kangaroo Mother Care services at National, Regional, County and health facility levels to ensure survival and optimal development of preterm and low birth weight babies.”
In a setting like Liberia, where the neonatal mortality rate due to newborn infection is a staggering 27%, this is very hopeful news!
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The Healthy Newborn Network Blog provides timely information and insights from the global newborn health field and seeks to promote dialogue on important newborn health issues. The blog is a platform for the HNN Editors and guest contributors to post commentaries on current happenings in the newborn health field. The content of each post and comments expressed on the HNN blog are those of the individual contributors and do not necessarily represent the views and opinion of the HNN or its Partner Organizations. >>Read a note on leaving comments
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