Training CHWs to address maternal and newborn needs during emergencies can save hundreds of lives.

Unang Yakap, A Hug to Remember – Philippine’s Initiative for Mothers and Babies and the Essential Intra-Partum and Newborn Care (EINC) Training Package

Trainers of Community Health Workers survey training materials during Typhoon Haiyan, Philippines. Photo by Save the Children.

Back in 2000, the Philippines committed to reduce maternal, newborn and child mortality. Throughout the decade, progress has been made to reach its MDG 4 & 5 goals, however, over 32,000 Filipino newborns still die every year during their first month of life and more than one third of these deaths happen during a baby’s first day of life. Unang Yakap– meaning “The First Embrace” – is now the flagship program for Early Essential Newborn Care (EENC), the WHO Western Pacific Region (WPRO), and UNICEF’s Regional Office for East Asia and the Pacific (EAPRO), embraced and led by the Department of Health (DOH). Save the Children and MERLIN have engaged to support the implementation and scale up of the training package for trainer of trainers (TOT) and frontline midwives for the recent areas affected by Typhoon Haiyan. Midwives and others with midwifery skills are critical to address maternal and newborn health, particularly in emergency settings, where essential factors such as access to care before, during and after pregnancy are severely restricted. The aftermath of disasters leaves pregnant mothers and newborns at greatest risk of developing complications, infections, or contracting illnesses like diarrhea, which are common in these settings.

I travelled to the Philippines in the first days of January to join the emergency response for Haiyan where I was introduced to Kalusugan ng Mag-Ina Inc. (KMI translated as “Health of Mother and Child), a local organization founded and run by a group of pediatricians, obstetricians and neonatologists. Dr. Maria Asunction Silvestre and Dr. Katherine Ann Reyes from KMI, leaders of the Essential Intra-Partum and Newborn Care (EINC) training package shared with me their approach, and we both agreed to support and speed-up the training in order to reach the typhoon-affected areas.

Two weeks later, I received an invitation to participate in the pilot TOT training at Bohol province. I met again with Dr. Silvestre as well as WHO technical officer, Dr. Jacqueline Kitong along with other trainers. Together we prepared action plans for the next wave of trainings that will target Ilo Ilo province.

The training aims to build a pool of trainers at both hospital and primary health care levels. It will be integrated into Basic-Emergency Obstetric and Neonatal Care (BEmONC) and Comprehensive-Emergency Obstetric and Neonatal Care (CEmONC) training schemes and will contribute in licensing existing governmental and private birthing centers. The skills-based training includes newborn resuscitation techniques and plans for supportive supervision and mentorship of the TOTs as they will proceed to release the 3 days “Quality Assurance EINC workshop” for front-line midwives at rural health units and stations.

In low resource places like the isolated islands of Ilo-Ilo, frontline skilled health workers are often a mother’s and baby’s only chance of survival. Investing in building their skills even during an acute phase of an emergency is a lifesaving activity and a hope for building community resilience. Operational research has shown that supportive supervision and mentorship help health workers to feel confident in using their new skills. Scaling up trainings like EINC should be a priority for health programs in emergency settings like that of Typhoon Haiyan.

Save the Children and Merlin staff work together to demonstrate resuscitation techniques to Community Health Workers. Photo by Save the Children – Typhoon Haiyan, Philippines. 
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