In 2013, the Government of Bangladesh signaled its commitment to newborn health through A Promise Renewed: Child Survival Call to Action that scaled up Helping Babies Breathe nationally. The commitment endorsed four new interventions: Chlorhexidine as part of essential newborn care, appropriate use of antenatal corticosteroid and kangaroo mother care for preterm births, and treatment of possible serious bacterial infections at union-level health facilities.
However, despite strong political commitment, neonatal mortality remains high in Bangladesh with 18 deaths per 1000 live births (UN Interagency Group for Child Mortality Estimation, 2017). While Bangladesh has been a global leader in establishing newborn health policies, like many other countries, it has experienced challenges in scaling up some key newborn interventions nationally.
Under the current Health Nutrition and Population Sector Programme (HPNSP 2017-2022), the Ministry of Health and Family Welfare has created a plan to scale up interventions including Special Newborn Care Unit (SCANU) for sick newborns. As outlined in the HPNSP, the Directorate General of Family Planning (DGFP) has developed a costed operation plan and is undertaking extensive efforts to adapt existing monitoring systems. As previous checklists were mainly focused on family planning, newly developed checklists are positioned to be comprehensive and include newborn health.
With support from Save the Children’s Saving Newborn Lives project (SNL), DGFP organized a workshop to review and update monitoring tools in September 2018. During the workshop, DGFP participants discussed context, gaps and rationality for program improvement and updated the existing monitoring tools, including:
- Supervision, observation and performance checklist
- Family Welfare Assistant (FWA) register validation tool
- Satellite clinic monitoring checklist
- Union Health and Family Welfare Center monitoring checklist
- Maternity Care Welfare Centers (MCWC) monitoring checklist
- Logistics monitoring checklist and Upazila Family Planning Office monitoring check list
- Maternal Child Health unit monitoring checklist
In a follow up workshop in November 2018, participants finalized checklists to endorse the updated monitoring tools. Contents of the supervision checklists mainly addressed administrative, HR, management, data entry regarding maternal, reproductive, neonatal, child and adolescent health services, family planning program and infection prevention issues.
The 8 checklists now consist of:
- FWA Register validation tool
- Satellite Clinic monitoring check list
- MCH unit monitoring check list
- Union Health and Family Welfare Center monitoring check list
- MCWC monitoring check list
- Logistics monitoring check list
- Upazila family planning office monitoring check list
- Revised monitoring check list by domain
National to upazila level managers will use these checklists during their supervisory visits. These updated systems now incorporate key newborn indicators and newly revised checklists to capture strengthened monitoring data at both community- and facility-level for program improvement to further improve quality of service and program data.