{"id":4550,"date":"2013-05-09T00:00:00","date_gmt":"2013-05-09T00:00:00","guid":{"rendered":"http:\/\/www.healthynewbornnetwork.org\/news-item\/skilled-midwives-may-be-the-key-to-healthy-babies\/"},"modified":"2016-02-08T23:54:12","modified_gmt":"2016-02-08T23:54:12","slug":"skilled-midwives-may-be-the-key-to-healthy-babies","status":"publish","type":"news-item","link":"https:\/\/www.healthynewbornnetwork.org\/news-item\/skilled-midwives-may-be-the-key-to-healthy-babies\/","title":{"rendered":"Skilled Midwives May be the Key to Healthy Babies"},"content":{"rendered":"<p>At the heart of the problem is the fact that millions of women lack access to a physician or healthcare facility.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"author":7211,"featured_media":4552,"template":"","acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Healthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/skilled-midwives-may-be-the-key-to-healthy-babies\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Skilled Midwives May be the Key to Healthy Babies - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"At the heart of the problem is the fact that millions of women lack access to a physician or healthcare facility. &nbsp;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/skilled-midwives-may-be-the-key-to-healthy-babies\/\" \/>\n<meta property=\"og:site_name\" content=\"Healthy Newborn Network\" \/>\n<meta property=\"article:modified_time\" content=\"2016-02-08T23:54:12+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/IPS_2.jpg_0.png\" \/>\n\t<meta property=\"og:image:width\" content=\"160\" \/>\n\t<meta property=\"og:image:height\" content=\"160\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/news-item\/skilled-midwives-may-be-the-key-to-healthy-babies\/\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/news-item\/skilled-midwives-may-be-the-key-to-healthy-babies\/\",\"name\":\"Skilled Midwives May be the Key to Healthy Babies - 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The Every Newborn Action Plan Measurement Improvement Roadmap details the challenges in measurement and provides a multi-year, multi-partner pathway to improving metrics, including testing and standardizing indicator definitions and developing new tools.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">71\r\n<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1513274052338{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of newborn deaths that are preventable with access to quality health care\r\n<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1<\/span>\/<span class=\"ticker\">3<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1517246179677{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">babies do not have a birth certificate by their first\u00a0birthday<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456360643415{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of priority Every Newborn indicators identified<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]See <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> for more newborn health specific epidemiology including rates, trends, and causes of death.\r\n\r\nEpidemiology is the \u201cstudy of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.\u201d Epidemiology examines how health conditions are distributed among a population and seeks to understand the risks or causes associated with those conditions.[\/vc_column_text][vc_column_text]The numbers of stillbirths and neonatal deaths, and the causes, are generated through modeled estimates using information from national civil registration databases, household surveys, surveillance systems, and special studies. High-quality, universal birth and death registration are required to provide nationally representative, timely data, and to signify a shift in social norms to value counting every newborn baby and stillbirth. Increasing global momentum to improve the data is important, and highlights the human face of those who are counted the least\u2014newborn babies and stillbirths.[\/vc_column_text][vc_text_separator title=\"Key resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Every-Newborn-Metrics-Cards_3.pdf\" target=\"_blank\" rel=\"noopener\">Every Newborn Metrics Report Cards<\/a><\/li>\r\n \t<li><a href=\"http:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/supplements\/volume-15-supplement-2\" target=\"_blank\" rel=\"noopener\">Count every newborn, a measurement improvement roadmap for coverage data<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/series\/everynewborn\" target=\"_blank\" rel=\"noopener\">The Lancet Every Newborn Series (2014)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/every-newborn-action-plan\/\" target=\"_blank\" rel=\"noopener\">The Every Newborn Action Plan<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/184225\" target=\"_blank\" rel=\"noopener\">The WHO Technical consultation on newborn health indicators<\/a><\/li>\r\n \t<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/153544\" target=\"_blank\" rel=\"noopener\">Strategies toward ending preventable maternal mortality (EPMM)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthdatacollaborative.org\/fileadmin\/uploads\/hdc\/Documents\/the-roadmap-for-health-measurement-and-accountability.pdf\" target=\"_blank\" rel=\"noopener\">The Roadmap for Health Measurement and Accountability<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/teams\/maternal-newborn-child-adolescent-health-and-ageing\/epidemiology-monitoring-and-evaluation\/maternal-health\" target=\"_blank\" rel=\"noopener\">WHO Maternal, Newborn, Child and Adolescent Health and Ageing (Maternal and newborn health monitoring)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Epidemiology","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"data-epidemiology","to_ping":"","pinged":"","post_modified":"2022-10-19 17:59:04","post_modified_gmt":"2022-10-19 21:59:04","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=120","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":126,"post_author":"7211","post_date":"2015-10-21 15:19:14","post_date_gmt":"2015-10-21 15:19:14","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Severe newborn infections\u2014including sepsis, meningitis, and <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/pneumonia\/\">pneumonia<\/a>\u2014are a major cause of morbidity and mortality among newborns in low- and middle-income countries.<\/h2>\r\nRecent analyses estimate that globally, approximately 400,000 newborns die each year as a result of severe infections, over one-sixth of the total burden of newborn deaths. Most of these deaths could be averted through:\r\n<ol>\r\n \t<li>preventive measures, such as improving hygiene practices, and<\/li>\r\n \t<li>timely and appropriate care for sick newborns.<\/li>\r\n<\/ol>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">17<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252549558{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of neonatal deaths caused by severe bacterial infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">400<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252596727{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of newborns who die each year as a result of severe infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">8<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1653422219529{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\">percentage of neonatal deaths caused by pneumonia<\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Prevention\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]Preventive measures during the antenatal and intrapartum periods can reduce the risk of congenital and newborn infections while protecting the health of the mother. Before and during pregnancy, women can be screened and treated for syphilis and vaccinated against diseases like tetanus. In addition to preventing subsequent infection in the newborn, treating maternal infections during pregnancy \u2013 such as antibiotics for prolonged, preterm rupture of membranes or chorioamnionitis -- can also greatly reduce the risk for preterm birth, a leading cause of newborn mortality as well as prevent serious newborn infection.\r\n\r\nClean birth practices reduce the rate of newborn infections at home and implementation of consistent, high-quality infection control practices reduces newborn infections in facility settings. Hygienic umbilical cord care, including using a sterile instrument to cut the cord and, when appropriate and per national guidelines, <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/chlorhexidine-for-umbilical-cord-care\/\">applying chlorhexidine to the newborn cord stump<\/a>, can also reduce infection and preventable death. <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/breastfeeding-and-feeding-of-small-and-sick-newborns\/\">Early and exclusive breastfeeding<\/a> also reduces the likelihood of newborn infections in several ways, including providing critical support to boost immune system development and avoiding the introduction of potentially harmful substances to the immature gut.\r\n\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Management\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]WHO recommends that newborns and young infants should be hospitalized when they have signs of possible <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/treatment-of-possible-severe-bacterial-infection\/\">serious bacterial infection, and treated<\/a> with 7 days of a combination of injectable antibiotics \u2013 gentaminin and ampicillin (or penicillin). In many or most low and middle-income countries (LMICs), such hospital-based treatment is not routinely feasible for many families for a number of cultural, geographic, and financial barriers. In these circumstances, recent evidence has led WHO to recommend outpatient antibiotics to such newborns and young infants to successfully treat the illness. The recommended antibiotic course is a combination of injectable and oral antibiotics: 2 days of once-daily gentamicin combined with 7 days of twice-daily oral amoxicillin. A follow up visit at 4 days of treatment is recommended to ensure adherence to the antibiotics and to ensure improvement in the newborn\u2019s condition. When referral from outpatient facility to hospital is accepted by families, the health center provider should ensure that the newborn or young infant is first given a dose of gentamicin and amoxicillin since even short delays in initiation of treatment can mean the difference between life and death.\r\n\r\nSaving newborn lives from life-threatening infections is now indeed feasible, acceptable, and effective in reducing preventable newborn and young infant deaths, and should be a top public health priority.\r\n\r\n<strong>Key Resources:\u00a0<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25274969\/\">Respiratory Distress in the Newborn <\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/SafeOxygen_english_7.6.17.pdf\">Safe and effective oxygen use for inpatient care of newborns<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/InfectionPrevention_english_7.6.17.pdf\">Safe and effective infection prevention for inpatient newborn care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/07\/DNH_TechBrief_MgmtNewbornInfection_7.15.19.pdf\">Management of newborn infections during inpatient care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.nature.com\/articles\/pr2013207\">Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Severe infections","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"severe-infections","to_ping":"","pinged":"","post_modified":"2022-10-18 14:43:52","post_modified_gmt":"2022-10-18 18:43:52","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=126","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":124,"post_author":"7211","post_date":"2015-10-21 15:18:57","post_date_gmt":"2015-10-21 15:18:57","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]<\/p>\n<h2>In order to meet our maternal and newborn health objectives, we need health professionals and community health workers that:<\/h2>\n<ul>\n<li>Are readily available where and when needed<\/li>\n<li>Have the necessary knowledge and skills for the services they are providing<\/li>\n<li>Are appropriately motivated to provide the needed service<\/li>\n<li>Are adequately supported and enabled with supervision, support systems (supply chain and\u00a0information systems), necessary infrastructure (space, water, electricity, and communications), and more<\/li>\n<\/ul>\n<p>Ensuring that this set of conditions is met depends on adequate human resources policy and management.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">82<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004009799{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of global births that were assisted by suitably qualified health workers between 2016 and 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">66<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004076215{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of women in least developed countries that were assisted by suitably qualified health workers during birth between 2016 and 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]Over the past decade and a half, considerable emphasis within global maternal-newborn health programs has been placed on \u201cskilled birth attendance,\u201d i.e., births assisted by suitably qualified health workers. This reflects the observation that for women delivering at home without ready access to emergency obstetrical care, support from traditional birth attendants proved inadequate to substantially reduce risk of death for the mother or newborn. Considerable effort has been expended in many settings to help ensure that women give birth with the assistance of qualified human resources, specifically a health worker, and generally in a health facility.<\/p>\n<p>However, in many instances there has not\u00a0been equal attention given to the actual substance of the care provided or the necessary supports to enable health workers to provide adequate care. In recent years, there has been increasing attention in program work to the quality and content of maternal-newborn services, particularly around the time of birth. This is reflected in current work at the World Health Organization on improving quality of maternal-newborn health care.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]Part of what is implied in the \u201cskilled birth attendance\u201d strategy is that assisting in childbirth does not necessarily require a physician. Many interventions related to maternal-newborn health can be competently delivered by categories of health workers with comparatively modest training.<\/p>\n<p>Accordingly, certain maternal-newborn services can be provided by categories of health workers labelled as \u201ccommunity health workers\u201d (CHWs). This is a broad designation that includes:<\/p>\n<ul>\n<li>Health auxiliaries with training sometimes approaching that of registered nurses<\/li>\n<li>Paid full-time workers with several months of basic training<\/li>\n<li>Non-salaried but financially \u201cincentivized\u201d workers, typically working less than full-time<\/li>\n<li>Volunteers providing services on a periodic or intermittent basis with little or no financial incentives<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_single_image image=\"13796\" add_caption=\"yes\" alignment=\"center\" css_animation=\"appear\"][vc_column_text]In some settings, there is more than one tier of CHWs.\u00a0When robustly supported (as they can be under project conditions), non-salaried and volunteer CHWs have been demonstrated as effective for various maternal- and newborn-related services. There are fewer examples of such work being effectively delivered at national scale, under non-project conditions. A very important but frequently neglected factor is the supports needed for effective programs.<\/p>\n<p>The issue is not so much,<\/p>\n<ul>\n<li><em><strong>can <\/strong>CHWs be effective for a particular service?<\/em><\/li>\n<\/ul>\n<p>But rather,<\/p>\n<ul>\n<li><em><strong>what supports are necessary<\/strong> for effectiveness?<\/em><\/li>\n<\/ul>\n<p>And,<\/p>\n<ul>\n<li><em><strong>are such supports feasible at scale<\/strong> under normal, non-project conditions?<\/em><\/li>\n<\/ul>\n<p>Program efforts commonly address health worker knowledge and skills. This is typically done primarily by training. Motivation is less often given focused attention. Certainly, some aspects of performance can be positively affected by financial incentives, although such incentives can also have unintended negative consequences. However, motivation is more than just a matter of incentives.<\/p>\n<p>In many settings, legitimate and illegitimate absences from work significantly undermine reliable access to services. This can be a consequence, for example, of frequent off-site trainings. There are also many settings where health workers are either frequently away from their posts without authorization or where they offer services only for very limited periods of time each day.<\/p>\n<p>Even when health workers are at their posts, their practices are affected not only by material they may have been exposed to in training but also by other influences on what they consider appropriate care. For example, health workers may be well aware of what treatments are recommended or authorized in national treatment guidelines but may -- for any number of reasons -- prefer to offer treatments not reflected in official protocols. For human resources program efforts to be effective in ensuring availability of appropriate care, they need to respond to the actual factors influencing health worker practices.<\/p>\n<p>Supervision is often mentioned as an important performance factor in health worker practices. Certainly under project conditions, there are numerous examples of \u201csupportive technical supervision\u201d or \u201cmentoring\u201d that appear to have made a positive contribution to quality of care. There are, however, far fewer examples of this function being effectively delivered under non-project conditions. Health-facility-level quality improvement efforts can serve a somewhat similar function, whereby groups of health staff work collectively to improve performance, holding each other accountable.[\/vc_column_text][vc_column_text]<strong>Key resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/77764\">WHO Recommendations: Optimizing health worker roles for maternal and newborn health<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Human resources for health","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"human-resources","to_ping":"","pinged":"","post_modified":"2023-08-02 15:22:01","post_modified_gmt":"2023-08-02 19:22:01","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=124","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":247,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Africa","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"africa","to_ping":"","pinged":"","post_modified":"2016-02-11 21:42:43","post_modified_gmt":"2016-02-11 21:42:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&#038;p=247","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":209,"post_author":"7211","post_date":"2015-10-21 22:02:07","post_date_gmt":"2015-10-21 22:02:07","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in Nigeria (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%222%25%20Diarrhoea%22%2C%22value%22%3A%222%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%221%25%20Tetanus%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%23f79468%22%7D%2C%7B%22title%22%3A%2218%25%20Pneumonia%22%2C%22value%22%3A%2218%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2218%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2218%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2228%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2228%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%2215%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%2215%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%224%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%224%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2213%25%20Other%20conditions%22%2C%22value%22%3A%2213%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686244318411{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&amp;source=gmail&amp;ust=1551964625737000&amp;usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686244412550{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">34.9<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686244399261{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">1.4<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1650977405095{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">32<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686244387133{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">22.5<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686244333920{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">43.3<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1650977440695{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">42<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696857653{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">9.9<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births &lt;37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686244369163{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">1047<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1456672501605{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Nigeria","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"nigeria","to_ping":"","pinged":"","post_modified":"2023-10-30 16:12:52","post_modified_gmt":"2023-10-30 20:12:52","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&#038;p=209","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"external_link":"http:\/\/www.ipsnews.net\/2013\/05\/skilled-midwives-may-be-the-key-to-healthy-babies\/"},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/4550"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/news-item"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/4550\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/4552"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=4550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}