{"id":23794,"date":"2017-03-02T14:38:40","date_gmt":"2017-03-02T19:38:40","guid":{"rendered":"http:\/\/www.healthynewbornnetwork.org\/?p=23794"},"modified":"2022-09-22T23:25:43","modified_gmt":"2022-09-23T03:25:43","slug":"coauthor-new-research-cord-care-practices-lot-information-not-complete-picture","status":"publish","type":"post","link":"https:\/\/www.healthynewbornnetwork.org\/blog\/coauthor-new-research-cord-care-practices-lot-information-not-complete-picture\/","title":{"rendered":"Coauthor of new research on cord-care practices: \u201cWe have a lot of information but not a complete picture\u201d"},"content":{"rendered":"

Patricia Coffey<\/a>, coauthor of Umbilical cord-care practices in low- and middle-income countries: a systematic review<\/a>, says that neonatal sepsis is responsible for more than 15 percent of neonatal deaths globally and is the third leading cause of death during the first month of life. A newly cut umbilical cord can be a pathway for bacteria that can cause newborn sepsis and death. Optimal umbilical cord care practices, including application of chlorhexidine gel, have the potential to prevent neonatal deaths, while harmful traditional cord-care practices are often cited as a public health concern.<\/p>\n

Coffey facilitates the Chlorhexidine Working Group<\/a>, a group of donors, implementers, and private-sector companies that has been meeting regularly for the past several years to advance the use and scale-up of 7.1% chlorhexidine gluconate to prevent infection of the umbilical cord in appropriate settings. She said she was aware of some formative research studies that documented use of traditional cord care practices in low-resource settings, and that the working group often discusses traditional cord care practices, especially harmful ones. \u201cSo we wondered, are they that common? We wanted to get a better understanding of what practices were, how many were potentially harmful, and how these practices were relevant to the introduction of 7.1% chlorhexidine gluconate for umbilical cord care,\u201d she said.<\/p>\n

Coffey and coauthor Siobhan Brown<\/a> reviewed 46 articles from 15 countries. They found clusters of studies in countries like Zambia and Uganda where much is known about cord care practices. But they think there is much unpublished data and would like to encourage others to publish.<\/p>\n

Coffey said she learned there is a strong tradition in almost all countries they studied of people wanting to do something with the cord: \u201cThey say they want the cord wound to heal, to heal faster, and the cord to fall off more quickly.\u201d Some practices, she said, were not surprising, for example, applying toothpaste, ash, or burnt leaves.<\/p>\n

One example that stood out was python oil, and another was a similar substance from two very different geographic areas: rotten tree powder in Turkey and powder from an old door in Tanzania. Some substances would be considered potentially harmful, for example, dung \u2013 a few countries reported use of chicken, cow, and lizard dung. Another practice was washing the umbilical cord with water used to wash a woman\u2019s genitalia. \u201cSome of these practices may be harmful, while others may be less so or possibly not harmful. Fortunately such practices seem to be increasingly less common,\u201d Coffey said.<\/p>\n

Coffey noted \u201cthat we have a lot of information on cord care practices in a few countries but not a complete picture across low- and middle-income countries.\u201d<\/p>\n

\u201cAnother surprise,\u201d she said, \u201cwas our tendency to think families will take care of a facility-born baby differently, but it seems the same things happen to babies no matter where they\u2019re born when it comes to umbilical cord care.\u201d Coffey suggested practitioners need to think about that as they introduce new practices such as the application of chlorhexidine.<\/p>\n

Coffey said the study helped her realize that when introducing products such as chlorhexidine for cord care, \u201cwe need to pay more attention to existing practices. It is unrealistic to expect families to abandon current practices immediately or to swap out practices that are done more than once in a day for something that is very different.\u201d<\/p>\n

She said that good behavior change communication, with follow-up to observe behaviors and support the transition, could help align current and new practices. \u201cFamilies generally do cord care for a number of days, not just once, so there\u2019s potential for a substitution of existing practice with the new multiple-day regimen.\u201d<\/p>\n

Read the article: Umbilical cord-care practices in low- and middle-income countries: a systematic review\u00a0>>><\/strong><\/a><\/p>\n

\n

\"\"Dr. Patricia S. Coffey<\/strong> is a program advisor and leader of the Health Technologies for Women and Children group within the PATH Devices and Tools Global Program. Dr. Coffey has more than 25 years of experience in product development and implementation research of newborn, maternal, and reproductive health technologies for low-resource settings.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Patricia Coffey, coauthor of Umbilical cord-care practices in low- and middle-income countries: a systematic review, says that neonatal sepsis is responsible for more than 15 percent of neonatal deaths globally and is the third leading cause of death during the first month of life. A newly cut umbilical cord can be a pathway for bacteria … Continued<\/a><\/p>\n","protected":false},"author":7211,"featured_media":23801,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"acf":[],"yoast_head":"\nHealthy 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\/blog\/coauthor-new-research-cord-care-practices-lot-information-not-complete-picture\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Coauthor of new research on cord-care practices: \u201cWe have a lot of information but not a complete picture\u201d - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"Patricia Coffey, coauthor of Umbilical cord-care practices in low- and middle-income countries: a systematic review, says that neonatal sepsis is responsible for more than 15 percent of neonatal deaths globally and is the third leading cause of death during the first month of life. 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An international nonprofit organization, we save lives and improve health, especially among women and children. By mobilizing partners around the world, we take innovation to scale, working alongside countries primarily in Africa and Asia to tackle their greatest health needs. Together, we deliver measurable results that disrupt the cycle of poor health.\r\n\r\n<strong>Our approach \u2028<\/strong>\r\n\r\nPATH blends the entrepreneurial spirit of business, the scientific expertise of a research institution, and the passion and on-the-ground experience of an international NGO.\r\n\r\n<img class=\"aligncenter size-full wp-image-755\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/unit-onlinear13-0514.jpg\" alt=\"unit-onlinear13-0514\" width=\"240\" height=\"180\" \/>\r\n\r\n<i>We\u2019re accelerating innovation to improve health \u2028and save lives.\r\nRead more in our\u00a0<a href=\"http:\/\/path.org\/annual-report\/2013\/index.php\">2013 online annual report<\/a>.\u00a0Photo: PATH\/Dave Simpson.<\/i>\r\n<p class=\"MsoNormal\" style=\"mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\">For nearly 40 years, we have been pioneers in the development and delivery of health solutions.\u00a0<a href=\"http:\/\/path.org\/about\/platforms.php\">We accelerate innovation across five platforms<\/a>\u2014vaccines, drugs, diagnostics, devices, and system and service innovations\u2014that harness our entrepreneurial insight, scientific and public health expertise, and passion for health equity. Our work bridges borders, sectors, and disciplines to shape the next generation of health innovations and maximize their lifesaving potential.<\/p>\r\n<b>Defining innovation<\/b>\r\n\r\nWe are known for developing lifesaving health technologies with global impact. From the\u00a0<a href=\"http:\/\/path.org\/projects\/vaccine_vial_monitor.php\">vaccine vial monitor<\/a>\u00a0that alerts health workers when a vaccine has been damaged by heat to\u00a0<a href=\"http:\/\/path.org\/our-work\/diagnostic-technologies.php\">low-cost diagnostics<\/a>\u00a0that detect malaria, diabetes, and other health threats in minutes, our tools and technologies reach millions of people around the world.\r\n\r\n \r\n\r\nBut innovation is more than technology. We also bring innovation to:\r\n\r\n \r\n<ul>\r\n \t<li><strong>\u00a0 \u00a0Collaboration.\u00a0<\/strong>We connect hundreds of diverse partners, mobilizing the expertise and resources of in-country and public, private, and nonprofit partners to improve lives.<\/li>\r\n \t<li><b>\u00a0 \u00a0Community engagement.<\/b>\u00a0We tap the insights and expertise of the people we serve to create affordable, effective, and culturally relevant solutions with enduring health impact.<\/li>\r\n \t<li><b>\u00a0 \u00a0Market dynamics.<\/b> \u00a0We create market-based solutions to bring health products and services in reach for low-income consumers.<\/li>\r\n \t<li><b>\u00a0 \u00a0Health systems.\u00a0<\/b> We strengthen health systems by improving health care delivery, policies, financing, and processes to ensure lifesaving innovations are delivered efficiently and equitably.<\/li>\r\n<\/ul>\r\n<b>Taking innovation to scale<\/b>\r\n<p class=\"MsoNormal\" style=\"mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\">Across all of our innovations, we use a rigorous process to accelerate the best ideas through our development pipeline. We research and develop targeted health solutions, test and refine them, seek policy changes and regulatory approvals to pave the way for their use, and then introduce and scale them up where they are needed.<\/p>\r\n<p class=\"MsoNormal\">This is one of our unique strengths\u2014working across the spectrum from development to delivery, channeling the tremendous potential of inventive ideas, scientific discovery, and groundbreaking collaborations into better health and opportunity for all.<\/p>\r\n<!--EndFragment-->\r\n<h2>What we do<\/h2>\r\nPATH, as the secretariat of the Chlorhexidine Working Group, leads an international collaboration of organizations committed to advancing the use of 7.1% chlorhexidine digluconate for umbilical cord care through advocacy and technical assistance. PATH is working to establish manufacturing in selected African countries to increase availability of the product at affordable pricing.","post_title":"PATH","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"path","to_ping":"","pinged":"","post_modified":"2016-12-15 13:14:58","post_modified_gmt":"2016-12-15 18:14:58","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&p=753","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"}],"issues":[{"ID":118,"post_author":"7211","post_date":"2015-10-21 15:18:04","post_date_gmt":"2015-10-21 19:18:04","post_content":"[vc_row][vc_column][vc_column_text]\r\n<h2 style=\"text-align: center;\"><em>As of 2022, the below information reflects outdated global consensus and guidance. For up-to-date guidance on umbilical cord care, including chlorhexidine, please visit the <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/umbilical-cord-care\/\">Umbilical Cord Care page<\/a>.<\/em><\/h2>\r\n[\/vc_column_text][vc_btn title=\"Umbilical Cord Care\" color=\"1\" size=\"lg\" align=\"center\" button_block=\"true\" link=\"url:https%3A%2F%2Fwww.healthynewbornnetwork.org%2Fissue%2Fumbilical-cord-care%2F|title:Umbilical%20cord%20care\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator][vc_column_text]\r\n<h2><strong><a href=\"#getready\">Get Ready\u00a0\u00a0\u00a0<\/a><\/strong>|\u00a0 \u00a0<strong><a href=\"#plan\">Plan\u00a0<\/a><\/strong>\u00a0 |\u00a0 \u00a0<strong><a href=\"#execute\">Execute\u00a0\u00a0<\/a><\/strong>\u00a0|\u00a0 \u00a0<strong><a href=\"#about\">About\u00a0\u00a0\u00a0\u00a0<\/a><\/strong>|\u00a0 \u00a0<strong><a href=\"#country\">Country Specific Resources<\/a><\/strong><\/h2>\r\n<h2><\/h2>\r\n[\/vc_column_text][\/vc_column][\/vc_row][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 style=\"text-align: justify;\">Ensuring optimal cord care at birth and during the first week of life, including use of chlorhexidine, especially in settings having poor hygiene, is a crucial strategy to prevent life-threatening sepsis and cord infections and avert preventable neonatal deaths.<\/h2>\r\n<p style=\"text-align: justify;\">Chlorhexidine digluconate is a broad spectrum antiseptic that is available in a range of concentrations and has been safely used for over 40 years for a variety of health-related applications; but its specific use for umbilical cord care was uniquely tested in three clinical trials in Nepal, Bangladesh, and Pakistan, in the form of 7.1% chlorhexidine digluconate (CHX). Given the promising results of the trials, in 2013 the World Health Organization (WHO) added CHX to its <a href=\"http:\/\/www.who.int\/medicines\/publications\/essentialmedicines\/en\/\" target=\"_blank\" rel=\"noopener noreferrer\">Model List of Essential Medicines for Children<\/a>; and in 2014 the WHO issued a new <a href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/97603\/1\/9789241506649_eng.pdf?ua=1\" target=\"_blank\" rel=\"noopener noreferrer\">guideline<\/a> on umbilical cord care, which included a formal recommendation on the use of chlorhexidine.<\/p>\r\n[\/vc_column_text][vc_column_text]\r\n<p style=\"text-align: justify;\">This webpage was developed by the <a href=\"#about\">Chlorhexidine Working Group<\/a>\u00a0(CWG) to help policy makers, program managers, and donors facilitate the introduction of 7.1% chlorhexidine digluconate into existing essential newborn care services in low- and middle-income countries. The document, <a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHXstory_From-Research-to-Use_01.22.18.pdf\">From Research to Use: Saving Newborn Lives with Chlorhexidine for Umbilical Cord Care<\/a> chronicles the history and accomplishments of the CWG. The webpage consists of three phases, <strong><a href=\"#getready\">Get Ready<\/a><\/strong>, <strong><a href=\"#plan\">Plan<\/a><\/strong>, and <strong><a href=\"#execute\">Execute<\/a><\/strong>, and is based on the experiences of the CWG partners in introducing chlorhexidine in various countries (see <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/guide-implementing-7-1-chlorhexidine-digluconate-umbilical-cord-care\/\">Guide to Implementing 7.1% chlorhexidine digluconate for umbilical cord care: Three phases to ensure sustainable implementation<\/a>). Each phase\u00a0is composed of activities that facilitate introduction and scale-up. The phases do not necessarily occur in a sequential manner; however, as some activities\/components across the three phases may\u00a0occur simultaneously while others are dependent upon the results of activities from a previous phase.<\/p>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_cta h2=\"Chlorhexidine Global Scale-Up Tracker\" style=\"outline\" color=\"sandy-brown\" css=\".vc_custom_1503604990256{border-radius: 5px !important;}\"]\r\n\r\n[caption id=\"attachment_17423\" align=\"alignright\" width=\"250\"]<a href=\"https:\/\/www.healthynewbornnetwork.org\/chlorhexidine-dashboard\/\"><img class=\"wp-image-17423\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Dashboard-Thumbnail-1-300x211.jpg\" alt=\"Dashboard Thumbnail\" width=\"250\" height=\"176\" \/><\/a> Click on the map to view the tracker[\/caption]\r\n\r\nOver 25 countries are now moving toward implementation of chlorhexidine for umbilical cord care. The global scale-up tracker is a real-time, interactive dashboard that illustrates the global progress of chlorhexidine implementation and scale-up. Dashboard users can see a wealth of information regarding the current status of chlorhexidine engagement in these countries, including policy status, type of product used, location of use, regulatory status, and locations of local manufacture.[\/vc_cta][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">2.4<\/span>M<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1651600731322{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">Newborn lives are claimed every year across the world*<\/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\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">7<\/span>%<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1651600713114{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">Of the deaths are caused by sepsis and other infectious conditions of the newborn*<\/span><\/h3>\r\n<h6>*Represents the most recent data available. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further<\/h6>\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\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">23<\/span>%<\/strong><\/h1>\r\n[\/vc_column_text][vc_empty_space][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1461187100208{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">Reduction in neonatal mortality when 7.1% chlorhexidine digluconate was used on the first day of life, as demonstrated by the clinical trials conducted in South Asia.<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1460150566355{margin-top: 0px !important;margin-bottom: 0px !important;border-top-width: 0px !important;background-color: #ffffff !important;}\"][vc_column][vc_cta h2=\"Cautionary note\" color=\"sandy-brown\"]\r\n<h3 style=\"text-align: justify;\"><strong>As with all medications, care must be taken to ensure that the product is used appropriately. 7.1% chlorhexidine digluconate for umbilical cord care should be kept out of eyes and ears and should be applied only to the umbilical stump.<\/strong><\/h3>\r\n<h3 style=\"text-align: justify;\">In 2015, it came\u00a0to the attention of the global Chlorhexidine Working Group (CWG) that 7.1% chlorhexidine digluconate aqueous solution (liquid) for umbilical cord care was mistakenly applied to the eyes of at least five children in Nigeria, causing eye injury.\u00a0\u00a0 Chlorhexidine has been in use for over 50 years and has a well\u2013characterized safety profile when used as directed. The formulation of chlorhexidine digluconate used for cord care (7.1% w\/v), when used as directed, is effective in preventing neonatal sepsis due to bacterial exposure through the fresh umbilical stump. \u00a0However, it can cause serious harm if applied to the eyes and should also not be put into the ear canal. It is important that persons and organizations responsible for chlorhexidine for umbilical cord care programs and for the distribution of the chlorhexidine for umbilical cord care product to caregivers ensure that instruction is provided on the appropriate use of the product, including appropriate warnings.<\/h3>\r\n<h3><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/memorandum-safety-concerns-over-misuse-of-chlorhexidine-chx\/\">Memorandum: Safety Concerns Over Misuse of Chlorhexidine (CHX)<\/a><\/h3>\r\n<h3><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/alert-no-133-chlorhexidine-71-digluconate-chx-reports-of-serious-eye-injury-due-to-errors-in-administration\/\">Alert No. 133: Chlorhexidine 7,1% digluconate (CHX): Reports of serious eye injury due to errors in administration<\/a><\/h3>\r\n[\/vc_cta][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=\".vc_custom_1636735661384{background-color: #ef814a !important;}\"]<a name=\"getready\"><\/a>\r\n<h1 style=\"text-align: center;\"><span style=\"color: #ffffff;\"><strong>Get Ready<\/strong><\/span><\/h1>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<p style=\"text-align: justify;\">Successful program implementation requires the coordinated effort of the key stakeholders and alignment of policies and guidelines. The first step is to <strong>gain consensus<\/strong> through consultations with various key stakeholders in the public and private sectors. Further <strong>evidence for implementation<\/strong> may need to be generated if stakeholders believe that gaps in operational evidence exist. The final component of coordinating the effort is to <strong>align policies and guidelines<\/strong> for chlorhexidine implementation.<\/p>\r\n<a href=\"#top\"><strong>Back to CHX HOMEPAGE<\/strong><\/a>[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_single_image image=\"15591\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/activity-1-gaining-consensus-chlorhexidine\/\"><strong>Activity 1: Gaining Consensus<\/strong><\/a>\r\n<ul>\r\n \t<li>CWG Tech Brief (<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-technical-brief-umbilical-cord-cleansing-saves-newborn-lives\/\" target=\"_blank\" rel=\"noopener noreferrer\">English<\/a>,<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHX-Technical-Brief_final-for-translation__2017-11-20_FR-1.pdf\">\u00a0fran\u00e7ais<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHX-Technical-Brief_final-for-translation__2017-11-20_PT-1.pdf\">Portugu\u00eas<\/a>)<\/li>\r\n \t<li>CWG Chlorhexidine Products and Uses\u00a0in Healthcare (<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-products-and-uses-in-health-care\/\" target=\"_blank\" rel=\"noopener noreferrer\">English<\/a>,\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/les-produits-a-base-de-chlorhexidine-et-leurs-utilisations-dans-le-domaine-des-soins-de-sante\/\" target=\"_blank\" rel=\"noopener noreferrer\">fran\u00e7ais<\/a>,\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Chlorhexidine-Applications-PT_Aug_2015-2015-08-20.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Portugu\u00eas<\/a>)<\/li>\r\n \t<li>UN Commission on Life-Saving Commodities for Women and Children\u00a0<a href=\"http:\/\/www.path.org\/publications\/detail.php?i=2381\" target=\"_blank\" rel=\"noopener noreferrer\">Policy\/Advocacy Toolkit<\/a><\/li>\r\n \t<li>Results of the randomized controlled trials in\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(06)68381-5\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Nepal<\/a>,\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(11)61848-5\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Bangladesh<\/a>, and\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(11)61877-1\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Pakistan<\/a>, and the\u00a0<a href=\"http:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/1471-2458-13-S3-S15\" target=\"_blank\" rel=\"noopener noreferrer\">meta-analysis<\/a>\u00a0of the three trials<\/li>\r\n \t<li>Chlorhexidine gel versus aqueous solution\u00a0<a href=\"http:\/\/journals.lww.com\/pidj\/Abstract\/2010\/11000\/Chlorhexidine_Gel_Versus_Aqueous_for_Preventive.4.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">randomized noninferiority trial<\/a><\/li>\r\n \t<li>Chlorhexidine\u00a0<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2386993\/\" target=\"_blank\" rel=\"noopener noreferrer\">safety data<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-for-umbilical-cord-care-game-changer-for-newborn-survival\/\" target=\"_blank\" rel=\"noopener noreferrer\">Chlorhexidine for umbilical cord care: game-changer for newborn survival?<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/DRC-Group-work_outline.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">DRC Technical Working Group structure and outline<\/a>\u00a0(fran\u00e7ais)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/R%C3%A9sum%C3%A9-sur-les-%C3%A9vidences-scientifiques-de-lutilisation-de-la-Chlorhexidine-digluconate-7-1_0.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">DRC\u00a0R\u00e9sum\u00e9 sur les \u00e9vidences scientifiques de l\u2019utilisation de la Chlorhexidine(CHX) digluconate 7.1%<\/a>\u00a0(fran\u00e7ais) \u00a0[DRC scientific evidence presentation]<\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHX-Nepal-meeting-report-12-02-2011-FINAL-1.pdf\">Chlorhexidine for Umbilical Cord Care: Evidence Base and the Way Forward<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Coffey-P.-et-al.-umbilical-cord-care-practice-in-low-and-middle-income-countries-1.pdf\">Umbilical cord-care practices in low- and middle-income countries: a systematic review<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final_CHX_Meeting-Report_EN_140429.pdf\">Technical Report: Report on the Regional Meeting for Francophone West Africa on the use of Chlorhexidine for Umbilical Cord Care<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Herrick-et-al_Modeling-the-potential-impact-of-emerging-innovations_2017.pdf\">Modeling the potential impact of emerging innovations on achievement of Sustainable Development Goals related to maternal, newborn, and child health<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Mullany_Safety-and-impact-of-chlorhexidine-antisepsis-interventions_Ped-Inf-Dis-J_2006.pdf\">Safety and Impact of Chlorhexidine Antisepsis Interventions for Improving Neonatal Health in Developing Countries<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Sazawal-S-et-al-Pemba-Island-chlorhexidine-trial-Lancet-GH-2016.pdf\">Efficacy of chlorhexidine application to umbilical cord on neonatal mortality in Pemba, Tanzania: a community-based randomized controlled trial<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Semrau-KEA-et-al-ZamCAT-main-analysis-Lancet-GH-2016.pdf\">Effectiveness of 4% chlorhexidine umbilical cord care on neonatal mortality in Southern Province, Zambia (ZamCAT): a cluster-randomised controlled trial<\/a><\/li>\r\n \t<li>Antiseptic brief (<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Antiseptic-brief_Final-for-translation_11-30-17_EN.pdf\">English<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Antiseptic-brief_Final-for-translation_3-11-30-17_FR.pdf\">fran\u00e7ais<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Antiseptic-brief_Final-for-translation_3-11-30-17_PT.pdf\">Portugu\u00eas<\/a>)<\/li>\r\n \t<li>Generic CHX PPT\u00a0(<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final-for-translation_Generic-CHX-Presentation-updated-January-19-2018.pptx\">English<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final-for-translation_Generic-CHX-Presentation-updated-January-19-2018_F....pptx\">fran\u00e7ais<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final-for-translation_Generic-CHX-Presentation-updated-January-19-2018_P....pptx\">Portugu\u00eas<\/a>)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/the-innovation-countdown-report-2030-reimagining-global-health\/\">The Innovation Countdown Report 2030: Reimagining global health<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/activity-2-building-evidence-implementation-chlorhexidine\/\"><strong>Activity 2: Building Evidence for Implementation<\/strong><\/a>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Madagascar-Formative-Research-Presentation_English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Madagascar formative research<\/a><\/li>\r\n \t<li><a href=\"https:\/\/bmcinthealthhumrights.biomedcentral.com\/articles\/10.1186\/1472-698X-14-12\">Ethiopia formative research<\/a><\/li>\r\n \t<li>Bangladesh operations research<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Bangladesh_CHX-operations-research_report_2010Jan20.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\u00a0report\u00a0<\/a>and\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Bangladesh_Programatic-Presentation_Winch-2011.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">presentation<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/PATH-Chlorhexidine-Product-Attribute-Study-Bangladesh-2008.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Bangladesh product attribute study<\/a><\/li>\r\n \t<li>India (Uttar Pradesh)\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/results-from-chx-survey-india\/\" target=\"_blank\" rel=\"noopener noreferrer\">formative research\u00a0results<\/a>\u00a0and\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-end-to-end-analysis-focusing-on-uttar-pradesh\/\" target=\"_blank\" rel=\"noopener noreferrer\">end-to-end analysis<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHX-Market-Research-in-Kenya_PATH-FINAL_19Feb2015.pdf\">Market research for 7.1% chlorhexidine digluconate: Kenya<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/FINAL_Nigeria-market-research_v9_12.9.2014.pdf\">Market research for 7.1% chlorhexidine digluconate: Nigeria<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Muriuki-et-al_KenyaCHX_2017.pdf\">Health care providers\u2019 perspectives regarding the use of chlorhexidine gel for cord care in neonates in rural Kenya: implications for scale-up<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Walsh-et-al_Newborn-Cord-Care-Practices-in-Haiti.pdf\">Newborn cord care practices in Haiti<\/a><\/li>\r\n<\/ul>\r\n<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/activity-3-aligning-policies-guidelines-chlorhexidine\/\"><strong>Activity 3: Aligning Policies and Guidelines<\/strong><\/a>\r\n<ul>\r\n \t<li>CWG\u00a0Country Guidance\u00a0(<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final-for-translation_CWG-Country-Guidance_Jan-19-2018_EN.pdf\">English<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final-for-translation_CWG-Country-Guidance_Jan-19-2018_FR.pdf\">fran\u00e7ais<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Final-for-translation_CWG-Country-Guidance_Jan-19-2018_PT.pdf\">Portugu\u00eas<\/a>)<\/li>\r\n \t<li>CWG\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Supplementary-Country-Guidance-EN_Sept_2015-2015-08-21.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Supplementary Country Guidance<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Policy-Developement-DRC-CHX-FR-format.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">DRC \u00c9laboration d\u2019une politique nationale concernant l\u2019introduction de la chlorhexidine \u00e0 7,1 % pour les soins du cordon ombilical<\/a>\u00a0(fran\u00e7ais) [DRC national policy development plan]<\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Ghana_Chlorhexidine-Policy-Brief-FINAL.pdf\">Chlorhexidine Digluconate 7.1% Gel Press Release<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=\".vc_custom_1460145487524{background-color: #ef814a !important;}\"]<a name=\"plan\"><\/a>\r\n<h1 style=\"text-align: center;\"><span style=\"color: #ffffff;\"><strong>Plan<\/strong><\/span><\/h1>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<p style=\"text-align: justify;\">The next phase should be to plan for initial implementation. Key components of implementation planning include: developing\u00a0<strong>demand generation<\/strong> strategies, <strong>orientation and training<\/strong>\u00a0of service providers, considering <strong>product manufacturing and distribution<\/strong> options, developing a <strong>monitoring and evaluation<\/strong> plan, and developing a <strong>financing<\/strong> strategy.<\/p>\r\n<a href=\"#top\"><strong>Back to CHX HOMEPAGE<\/strong><\/a>[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_single_image image=\"16266\" onclick=\"custom_link\" img_link_target=\"_blank\" link=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/HNN-Chlorhexidine-PLAN-Graphic.jpg\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/component-1-integrating-demand-generation-chlorhexidine\/\"><strong>Component 1: Integrating Demand Generation<\/strong><\/a>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/driving-demand-chlorhexidine-human-centered-design-toolkit-development-demand-generation-materials\/\">Driving Demand for Chlorhexidine<\/a>: a human-centered design toolkit for the development of\u00a0demand generation materials<\/li>\r\n \t<li>Demand Generation\u00a0<a href=\"http:\/\/sbccimplementationkits.org\/demandrmnch\/\" target=\"_blank\" rel=\"noopener noreferrer\">Implementation Kit (I-Kit)<\/a>\u00a0for Underutilized, Life-Saving Commodities<\/li>\r\n \t<li>Madagascar\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-flyer\/\" target=\"_blank\" rel=\"noopener noreferrer\">flyer<\/a>\u00a0and\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-poster\/\" target=\"_blank\" rel=\"noopener noreferrer\">poster<\/a>\u00a0for AroFoitra (Malagasy)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Resultats-du-pretest-des-materiels-IEC-pour-AroFoitra-.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Madagascar Resultats du pretest des materiels IEC pour AroFoitra<\/a>\u00a0(fran\u00e7ais) \u00a0[results of the pretest of IEC materials for AroFoitra]<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Plan-com-CHX_final1.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Madagascar Strat\u00e9gie de communication<\/a>\u00a0(fran\u00e7ais)\u00a0[Madagascar communication strategy for AroFoitra]<\/li>\r\n<\/ul>\r\n[\/vc_column_text][vc_column_text]<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/component-2-orientationtraining-chlorhexidine\/\"><strong>Component 2: Orientation\/Training<\/strong><\/a>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Nepal_Chlorhexidine-Training-Manual2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Training materials for single-day application<\/a>\u00a0(from Nepal)<\/li>\r\n \t<li><a href=\"http:\/\/www.medicalaidfilms.org\/film\/how-to-use-chlorhexidine-for-umbilical-cord-care\/\" target=\"_blank\" rel=\"noopener noreferrer\">How to use chlorhexidine for umbilical cord care<\/a>\u00a0(link to training video)<\/li>\r\n \t<li>Madagascar formation des agents de sante (fran\u00e7ais)\u00a0[Madagascar health worker training materials]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/programme-introductive-de-prevention-de-linfection-du-nouveau-ne-par-la-chlorhexidine-71-pommade-formation-des-agents-de-sante-cahier-du-formateur\/\" target=\"_blank\" rel=\"noopener noreferrer\">Cahier du formateur<\/a>\u00a0[trainer notebook]<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/programme-introductive-de-prevention-de-linfection-du-nouveau-ne-par-la-chlorhexidine-71-pommade-formation-des-agents-de-sante-carnet-du-participant\/\" target=\"_blank\" rel=\"noopener noreferrer\">Carnet du participant<\/a>\u00a0[participant book]<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-job-aid\/\" target=\"_blank\" rel=\"noopener noreferrer\">Madagascar job aid<\/a>\u00a0(Malagasy)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Nepal_Poster-Kawach-eng.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Nepal job aid<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-training-manual-sbas-lhws-sindh-pakistan\/\" target=\"_blank\" rel=\"noopener noreferrer\">Sindh Province (Pakistan) training materials<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/TS_CHX_IFU_Poster_Update_v3_rev04.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Aqueous solution (liquid) instructions for use<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHX-Posters05-PRESS02-how-to-use_Kenya.pdf\">How to apply chlorhexidine gel and solution: Instructions for use from Kenya<\/a><\/li>\r\n \t<li>Brief on correct use (<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Brief-on-Correct-Use_Final-for-translation_12-05-17_EN.pdf\">English<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Brief-on-Correct-Use_Final-for-translation_2-12-05-17_FR.pdf\">fran\u00e7ais<\/a>,\u00a0<a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Brief-on-Correct-Use_Final-for-translation_2-12-05-17_PT.pdf\">Portugu\u00eas<\/a>)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/path-chlorhexidine-product-attribute-study-2008\/\">PATH Chlorhexidine Product Attribute Study (2008)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/component-3-product-manufacturing-distribution-chlorhexidine\/\"><strong>Component 3: Product Manufacturing and Distribution<\/strong><\/a>\r\n<ul>\r\n \t<li>Chlorhexidine Market Sizing Tool (Utilizing\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-market-sizing-tool-utilizing-user-estimates\/\" target=\"_blank\" rel=\"noopener noreferrer\">User Estimates<\/a>, Utilizing\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-market-sizing-tool-utilizing-market-size-estimates\/\" target=\"_blank\" rel=\"noopener noreferrer\">Market Size Estimates<\/a>)<\/li>\r\n \t<li>CWG Production Strategy (<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Production-Strategy-EN_November_2015-2015-11-06.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">English<\/a>,\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Production-Strategy-FR_November-2015-2015-11-06.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">fran\u00e7ais<\/a>)<\/li>\r\n \t<li>CWG\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Guidance-to-Procurers-EN_APR_2016.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Procurement Guidance<\/a><\/li>\r\n \t<li>CWG\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/list-of-manufacturers-of-7-1-chlorhexidine-digluconate-for-umbilical-cord-care-2021\/\">List of manufacturers of 7.1% chlorhexidine digluconate for umbilical cord care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Standard-Patient-Information-Leaflet-English_October_2015.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Patient information\u00a0leaflet<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Chlorhexidine-in-Nepal-A-Public-Private-Partnership-Case-Study.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Nepal Public Private Partnership Case Study<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][vc_column_text]<a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/component-4-monitoring-evaluation-chlorhexidine\/\"><strong>Component 4: Monitoring and Evaluation (M&E)<\/strong><\/a>\r\n<ul>\r\n \t<li>CWG\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Performance-Indicators-CHX.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Performance Indicators<\/a><\/li>\r\n \t<li>Every Newborn Action Plan\u00a0<a href=\"http:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/1471-2393-15-S2-S8\" target=\"_blank\" rel=\"noopener noreferrer\">indicators<\/a>\u00a0(includes chlorhexidine)<\/li>\r\n \t<li><a href=\"http:\/\/dhsprogram.com\/publications\/publication-DHSQM-DHS-Questionnaires-and-Manuals.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Demographics and Health Surveys (DHS) newborn module<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.livessavedtool.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Lives Saved Tool (LiST)<\/a><\/li>\r\n \t<li>Demographic and Health Surveys (DHS)\u00a0<a href=\"http:\/\/dhsprogram.com\/pubs\/pdf\/DHSQM\/DHS7_Module_Newborn_Care_EN_01Mar2016_DHSQM.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">newborn module<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][vc_column_text]<strong>Component 5: Financing\u00a0 <\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/national-strategy-for-scale-up-of-chlorhexidine-in-nigeria\/\">National Strategy For Scale-Up Of Chlorhexidine in Nigeria<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-costed-scale-up-plan-in-madagascar\/\">Chlorhexidine costed scale-up plan in Madagascar<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=\".vc_custom_1460145515019{background-color: #ef814a !important;}\"]<a name=\"execute\"><\/a>\r\n<h1 style=\"text-align: center;\"><span style=\"color: #ffffff;\"><strong>Execute<\/strong><\/span><\/h1>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<p style=\"text-align: justify;\">The final phase is to execute the CHX implementation plan and continuously monitor how it is being implemented to determine if the desired outcomes are being achieved. Data from the initial phase of implementation should be disseminated to key stakeholders within the country. If the program is not being implemented as planned, corrective action should be taken. Ministries of Health or key stakeholders may wish to disseminate data about the progress of CHX implementation in their country through international conferences or publications to help other countries accelerate implementation of CHX.<\/p>\r\n<a href=\"#top\"><strong>Back to CHX HOMEPAGE<\/strong><\/a>[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_single_image image=\"15603\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\r\n<ul>\r\n \t<li>Chlorhexidine for umbilical cord care\u00a0presentations at the Global Maternal Newborn Health Conference (October 2015):\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Introduction-of-Chlorhexidine-in-Sindh-Pakistan.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Introduction of Chlorhexidine in Sindh, Pakistan<\/a> (MCHIP)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/INTRODUCTION-DE-LA-CHLORHEXIDINE-DIGLUCONATE-71-EN-RDC.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Introduction de la Chlorhexidine Digluconate 7,1% dans les soins ombilicaux en RDC<\/a> (MSH\/SIAPS)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Saving-the-Pair-%E2%80%93-Integrated-Scale-up-of-CHX-and-Miso-in-Rural-Madagascar.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Saving the Pair \u2013Integrated Scale-up of Chlorhexidine and Misoprostol for Newborns and Mothers in Rural Madagascar<\/a> (JSI Research and Training Institute)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Institutionalizing-Chlorhexidine-Program-and-Maintaining-Coverage-in-Nepal.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Institutionalizing Chlorhexidine Program and Maintaining Coverage Chlorhexidine Cord Care Program in Nepal<\/a> (JSI Research and Training Institute)<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Timeline-Nepal-progress-towards-CHX-sustainability.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Nepal progress towards program sustainability (timeline)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/national-strategy-for-scale-up-of-chlorhexidine-in-nigeria\/\">National Strategy For Scale-Up Of Chlorhexidine in Nigeria<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-costed-scale-up-plan-in-madagascar\/\">Chlorhexidine costed scale-up plan in Madagascar<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Implementation-Guide-3-1.pdf\">Guide to implementing 7.1% chlorhexidine digluconate for umbilical cord care: Three phases to ensure sustainable implementation<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Establishing-Quality-Product-Supply-of-Chlorhexidine-for-Umbilical-Cord-Care.pptx\">Establishing Quality Product Supply of Chlorhexidine for Umbilical Cord Care<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Institutionalizing-Chlorhexidine-Program-and-Maintaining-Coverage-in-Nepal.ppt\">Institutionalizing Chlorhexidine Program and Maintaining Coverage in Nepal<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/INTRODUCTION-DE-LA-CHLORHEXIDINE-DIGLUCONATE-71-EN-RDC.pptx\">Introduction de la chlorhexidine digluconate 7,1% dans les soins ombilicaux en RDC (fran\u00e7ais) [Introduction of 7.1% chlorhexidine digluconate for umbilical cord care in DRC]<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Saving-the-Pair_Integrated-Scale-up-of-CHX-and-Miso-in-Rural-Madagascar.ppt\">Saving the Pair: Integrated Scale-up of Chlorhexidine and Misoprostol in Rural Madagascar<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Timeline-Nepal-progress-towards-CHX-sustainability-1.pdf\">Timeline of Nepal progress towards CHX program sustainability<\/a><\/li>\r\n \t<li><a href=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHXstory_From-Research-to-Use_01.22.18-1.pdf\">From Research to Use: Saving Newborn Lives With Chlorhexidine for Umbilical Cord Care<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=\".vc_custom_1460149292456{background-color: #ef814a !important;}\"]<a name=\"about\"><\/a>\r\n<h1 style=\"text-align: center;\"><span style=\"color: #ffffff;\"><strong>About<\/strong><\/span><\/h1>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<p style=\"text-align: justify;\">The Chlorhexidine Working Group (CWG) is an international collaboration of organizations committed to advancing the use of 7.1% chlorhexidine digluconate (delivering 4% chlorhexidine) for umbilical cord care through advocacy and technical assistance. PATH serves as the Secretariat of the CWG.<\/p>\r\n<a href=\"#top\"><strong>Back to CHX HOMEPAGE<\/strong><\/a>[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_single_image image=\"15798\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\r\n<ul>\r\n \t<li>CWG <a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-terms-of-reference_April-2016.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Terms of Reference<\/a><\/li>\r\n \t<li>CWG <a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/NEW-FORMAT_CWG-strategy-statement_03.20.15-1.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Strategy Statement<\/a><\/li>\r\n \t<li>CWG Capacity Statement (<a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Capacity-Statement-English_August_2015.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">English<\/a>, <a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CWG-Capacity-Statement-PT_Aug_2015-2015-08-20.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Portugu\u00eas<\/a>)<\/li>\r\n<\/ul>\r\n<strong>Members include individuals representing:<\/strong>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<ul>\r\n \t<li>PATH [Secretariat]<\/li>\r\n \t<li>ayzh<\/li>\r\n \t<li>Bill & Melinda Gates Foundation<\/li>\r\n \t<li>Boston University<\/li>\r\n \t<li>Burnet Institute<\/li>\r\n \t<li>Centre for Infectious Disease Research in Zambia<\/li>\r\n \t<li>Clinton Health Access Initiative<\/li>\r\n \t<li>Drugfield Pharmaceuticals Ltd. (Nigeria)<\/li>\r\n \t<li>Duke University<\/li>\r\n \t<li>Global Health Action<\/li>\r\n \t<li>Jhpiego<\/li>\r\n \t<li>John Snow, Inc.<\/li>\r\n \t<li>Johns Hopkins Bloomberg School of Public Health<\/li>\r\n \t<li>Johnson & Johnson (USA)<\/li>\r\n \t<li>Lomus Pharmaceuticals Pvt. Ltd. (Nepal)<\/li>\r\n \t<li>Maternal and Child Survival Program<\/li>\r\n \t<li>Ministry of Health, DRC (Reproductive Health)<\/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>Ministry of Health, Ethiopia (Maternal & Child Health)<\/li>\r\n \t<li>Ministry of Health, Kenya (Child & Adolescent Health)<\/li>\r\n \t<li>Ministry of Health, Liberia (Family Health)<\/li>\r\n \t<li>Ministry of Health, Malawi (Reproductive Health)<\/li>\r\n \t<li>Ministry of Health, Mozambique (Child Health)<\/li>\r\n \t<li>Promoting the Quality of Medicines\/United States Pharmacopeia<\/li>\r\n \t<li>PSI<\/li>\r\n \t<li>Save the Children\/Saving Newborn Lives<\/li>\r\n \t<li>SHOPS Plus\/Abt Associates<\/li>\r\n \t<li>Systems for Improved Access to Pharmaceuticals and Services\/Management Sciences for Health<\/li>\r\n \t<li>United Nations Children\u2019s Fund<\/li>\r\n \t<li>United States Agency for International Development<\/li>\r\n \t<li>Universal Corporation Ltd. (Kenya)<\/li>\r\n \t<li>University of Illinois at Chicago<\/li>\r\n \t<li>University Research Corporation<\/li>\r\n \t<li>World Health Organization<\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=\".vc_custom_1511361090172{background-color: #ef814a !important;}\"]<a name=\"country\"><\/a>\r\n<h1 style=\"text-align: center;\"><span style=\"color: #ffffff;\"><strong>Country Specific Resources<\/strong><\/span><\/h1>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<strong>Bangladesh: <\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/bangladesh-national-newborn-health-situation-analysis-report-2014\/\">National Newborn Health Situation Analysis Report 2014<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/end-preventable-child-deaths-2035-bangladesh-call-action\/\">End preventable child deaths by 2035: Bangladesh Call for Action <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/bangladesh-chlorhexidine-operations-research-study-2008-2009\/\">Bangladesh chlorhexidine operations research study 2008-2009<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/impact-of-cord-cleansing-with-chlorhexidine-on-neonatal-mortality-in-rural-bangladesh-a-communitybased-clusterrandomised-trial\/\">Impact of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh a community based trial<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Bangladesh_CHX-operations-research_phase-2-user-instructions_English_2009Feb01.pdf\">Chlorhexidine poster<\/a><\/li>\r\n<\/ul>\r\n<strong>Democratic Republic of the Congo:<\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/INTRODUCTION-DE-LA-CHLORHEXIDINE-DIGLUCONATE-71-EN-RDC.pdf\">Chlorhexidine Introduction in the DRC <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/overview-of-the-chlorhexidine-work-structure-for-democratic-republic-of-the-congo\/\">Chlorhexidine working group structure in the DRC<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Infection-ombilicale.pdf\">Chlorhexidine PowerPoint Presentation <\/a><\/li>\r\n<\/ul>\r\n<strong>India: <\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/effect-4-chlorhexidine-cord-colonization-among-hospital-community-births-india-randomized-controlled-study\/\">Effect of 4% chlorhexidine on cord colonization among hospital and community births in India: a randomized controlled study<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CHX-End-to-End-CHX-WG-121230.pdf\">Chlorhexidine end-to-end analysis focusing on Uttar Pradesh <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/results-from-chx-survey-india\/\">Results from chlorhexidine survey<\/a><\/li>\r\n<\/ul>\r\n<strong>Madagascar<\/strong>:\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/presentation-des-resultats-du-pretest-des-materiels-iec-pour-arofoitra\/\">Results of the pretest of IEC materials for the chlorhexidine program in Madagascar<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-formative-research-presentation\/\">Chlorhexidine Formative Research Presentation <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-job-aid\/\">Chlorhexidine Job Aid<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-flyer\/\">Chlorhexidine Flyer<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/madagascar-chlorhexidine-poster\/\">Chlorhexidine Poster <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/programme-introductive-de-prevention-de-linfection-du-nouveau-ne-par-la-chlorhexidine-71-pommade-formation-des-agents-de-sante-cahier-du-formateur\/\">Training toolkit for community health workers <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/saving-pair-integrated-scale-chlorhexidineand-misoprostol-newborns-mothers-rural-madagascar\/\">Saving the Pair \u2013Integrated Scale-up of Chlorhexidine and Misoprostol for Newborns and Mothers in Rural Madagascar<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-costed-scale-up-plan-in-madagascar\/\">Chlorhexidine Scale-up Plan<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Notice-CHX-FB01.pdf\">Chlorhexidine medical notice<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/arofoitra-flyer-malagasy\/\">Chlorhexidine Flyer<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/investiguer-les-pratiques-courantes-et-les-perceptions-autour-du-soin-du-cordon-ombilical-et-lacceptabilite-de-arofoitra-par-les-cibles\/\">Study on umbilical cord care practices<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Plan-com-CHX_final1.pdf\">Communications Strategy<\/a><\/li>\r\n<\/ul>\r\n<strong>Nepal: <\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/timeline-nepals-progress-towards-chlorhexidine-program-sustainability\/\">Timeline of Nepal\u2019s progress towards chlorhexidine program sustainability<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/institutionalizing-chlorhexidine-program-maintaining-coverage-chlorhexidine-cord-care-program-nepal\/\">Institutionalizing Chlorhexidine Program and Maintaining Coverage \u2013 Chlorhexidine Cord Care Program in Nepal<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/introducing-chlorhexidine-in-nepal\/\">Chlorhexidine Introduction in Nepal<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-in-nepal-a-public-private-partnership-case-study\/\">Case Study<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-in-nepal-a-public-private-partnership-case-study-july-2013\/\">USAID, JSI Nepal Case Study <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/innovation-in-reducing-neonatal-death-using-chlorhexidine-in-nepal-a-case-study\/\">Innovation in reducing neonatal death using Chlorhexidine in Nepal- a case study<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-cleansing-of-the-umbilical-cord-in-nepal-leading-by-example-and-saving-lives\/\">Chlorhexidine cleansing of the umbilical cord in Nepal: leading by example and saving lives<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/study-on-cord-care-practices-focus-group-discussion-with-occupational-castes\/\">Study on cord care practices focus group discussion<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/a-study-on-cord-care-practices-semi-structured-interview-with-recently-delivered-women\/\">Semi-structured interview with mothers who recently gave birth<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/a-study-on-cord-care-practices-semi-structured-interview-with-mothers-in-law\/\">Semi-structured interview with mother-in laws<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/a-study-on-cord-care-practices-focus-group-discussion-with-mothers-in-law\/\">Study on cord care practices focus group discussion with mother in laws<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/study-on-cord-care-practices-semi-structured-interview-with-cord-cutting-occupational-groups\/\">Semi-structured interview with cord cutting occupational groups<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-navi-care-program\/\">Chlorhexidine poster<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Nepal_CHX-presentation-for-Nigeria-meeting_October2012.pdf\">Nepal chlorhexidine presentation<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-navi-care-program-2\/\">Chlorhexidine navi care program<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/preliminary-experience-with-chlorhexidine-for-cord-care-in-nepal\/\">Preliminary experience with chlorhexidine for cord care in Nepal<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/fighting-newborn-infection-chlorhexidine-in-rural-nepal\/\">Fighting newborn infection in rural Nepal<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/community-trial-of-newborn-skin-and-umbilical-cord-cleansing-on-neonatal-mortality-in-nepal\/\">Community trial of newborn skin and umbilical cord cleansing on neonatal mortality in Nepal<\/a><\/li>\r\n<\/ul>\r\n<strong>Nigeria: <\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/nigeria-every-newborn-action-plan-a-plan-to-end-preventable-newborn-deaths-in-nigeria-launch-version\/\">Nigeria Every Newborn Action Plan: A Plan to End Preventable Newborn Deaths in Nigeria<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/national-strategy-for-scale-up-of-chlorhexidine-in-nigeria\/\">National Strategy for Scale-up of Chlorhexidine in Nigeria<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/RESOURCE_MamaYe-Nigeria-leaflet-drugs.pdf\">Mame Ye Nigeria brochure <\/a><\/li>\r\n<\/ul>\r\n<strong>Pakistan:\u00a0 <\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/chlorhexidine-training-manual-sbas-lhws-sindh-pakistan\/\">Chlorhexidine Training Manual for SBAs and LHWs <\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/introduction-chlorhexidine-sindh-pakistan\/\">Introduction of chlorhexidine in Pakistan<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.healthynewbornnetwork.org\/resource\/evaluation-of-topical-application-of-chlorhexidine-to-the-umbilical-cord-for-reduction-in-omphalitis-neonatal-mortality-in-pakistan\/\">Evaluation of topical application of chlorhexidine to the umbilical cord for reduction in omphalitis neonatal mortality in Pakistan<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][\/vc_column][\/vc_row]","post_title":"Chlorhexidine for umbilical cord care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"chlorhexidine-for-umbilical-cord-care","to_ping":"","pinged":"","post_modified":"2022-09-20 16:54:48","post_modified_gmt":"2022-09-20 20:54:48","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=118","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":55231,"post_author":"7211","post_date":"2022-09-20 15:41:44","post_date_gmt":"2022-09-20 19:41:44","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1663702110176{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 style=\"text-align: justify;\">Ensuring optimal umbilical cord care at birth and during the first week of life is a crucial strategy to prevent life-threatening sepsis and cord infections and avert preventable neonatal deaths.<\/h2>\r\nThe World Health Organization (WHO) <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789240045989\">recommends<\/a> clean, dry umbilical cord care for all newborns, including those born in facilities, at home, and in humanitarian settings. Proper cord care includes using clean, sterile blades and ties, keeping the stump clean using soap and water, and drying thoroughly with a clean cloth after getting wet. In most settings, proper clean, dry umbilical cord care is sufficient to prevent infection.\r\n\r\nHowever, in settings where harmful traditional substances are placed on the cord, WHO recommends using chlorhexidine digluconate in addition to clean, dry cord care. Chlorhexidine digluconate (CHX) is a broad-spectrum antiseptic that is available in a range of concentrations, and has been safely used for over 40 years for a variety of health-related applications. Its specific use for umbilical cord care was originally tested in three clinical trials in Nepal, Bangladesh, and Pakistan, in the form of 4% chlorhexidine, delivered through a 7.1% chlorhexidine digluconate gel. In 2013 the WHO added CHX to its\u00a0<a href=\"http:\/\/www.who.int\/medicines\/publications\/essentialmedicines\/en\/\">Model List of Essential Medicines<\/a>; and in 2014 the WHO issued <a href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/97603\/1\/9789241506649_eng.pdf?ua=1\">guidelines<\/a>\u00a0on umbilical cord care, which included a formal recommendation on the use of chlorhexidine. This guidance was subsequently <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789240045989\">updated<\/a> in 2022, reflecting the current recommendation for CHX use in certain settings.\r\n\r\nCHX is the primary recommendation for settings where harmful traditional substances, such as oils, compresses, native plants, or other organic substances, are commonly placed on the umbilical cord. It was previously recommended for settings with high rates of home birth and neonatal mortality, where mothers, traditional birth attendants, and community health workers can be trained to administer CHX; as a result, this may be included as a recommendation in some national protocols.\r\n\r\nIn humanitarian settings, clean and dry umbilical cord care is the standard, but the use of chlorhexidine digluconate is also included as a recommendation in the <a href=\"https:\/\/iawgfieldmanual.com\/manual\">Inter-Agency Field Manual for Reproductive Health in Humanitarian Settings (IAFM),<\/a> the gold-standard for sexual and reproductive care in fragile and humanitarian settings. The IAFM includes CHX for cord care as a recommendation during the onset of emergencies, as part of the <a href=\"https:\/\/iawgfieldmanual.com\/manual\/misp\">Minimum Initial Service Package<\/a> (MISP), and as part of comprehensive maternal and newborn health (MNH) services. Additionally, chlorhexidine digluconate is included as a supplementary commodity in the <a href=\"https:\/\/www.unfpa.org\/sites\/default\/files\/resource-pdf\/IARH-Kits-6th-Edition_Manual_English.pdf\">Inter-Agency Reproductive Health Kits<\/a> (RH Kits), which provide the supplies necessary to implement the MISP at the onset of a humanitarian response.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_empty_space][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">2.4<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1666120145784{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">newborn deaths worldwide in 2020<\/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\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">7<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1666120079406{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of deaths caused by sepsis and other infectious conditions of the newborn in 2020<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_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 <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.\u00a0<\/em><\/h6>\r\n[\/vc_column_text][vc_separator][vc_empty_space][vc_cta h2=\"Cautionary note\"]\r\n<h3 style=\"text-align: justify; line-height: 13.5pt; background: #F7F7F7; margin: 0in 0in 18.75pt 0in;\"><strong><span style=\"font-size: 10.0pt; font-family: 'Arial',sans-serif; color: #333333;\">As with all medications, care must be taken to ensure that the product is used appropriately. 7.1% chlorhexidine digluconate for umbilical cord care should be kept out of eyes and ears and should be applied only to the umbilical stump.<\/span><\/strong><b><\/b><\/h3>\r\n<h3 style=\"text-align: justify; line-height: 13.5pt; background: #F7F7F7; margin: 0in 0in 18.75pt 0in;\"><b><span style=\"font-size: 10.0pt; font-family: 'Arial',sans-serif; color: #333333;\">Since 2015, there have been over <\/span><\/b><a href=\"https:\/\/www.who.int\/news\/item\/28-08-2020-chlorhexidine-7-1-digluconate-(chx)-aqueous-solution-or-gel-(10ml)-reports-of-serious-eye-injury-due-to-errors-in-administration\"><span style=\"font-size: 10.0pt; font-family: 'Arial',sans-serif;\">40 reported cases<\/span><\/a><b><span style=\"font-size: 10.0pt; font-family: 'Arial',sans-serif; color: #333333;\"> of incorrect administration of CHX in nine countries in sub Saharan Africa, specifically when CHX in both liquid and gel form have been mistaken for eye medication. In these reported cases, 7.1% chlorhexidine digluconate in both liquid and gel forms for umbilical cord care was mistakenly applied to the eyes, causing eye injury.\u00a0\u00a0 Chlorhexidine has been in use for over 40 years and has a well\u2013characterized safety profile when used as directed. The formulation of chlorhexidine digluconate used for cord care (7.1% w\/v), when used as directed, is effective in preventing neonatal sepsis due to bacterial exposure through the fresh umbilical stump. \u00a0However, it can cause serious harm if applied to the eyes and should also not be put into the ear canal. It is important that persons and organizations responsible for chlorhexidine for umbilical cord care programs and for the distribution of the chlorhexidine for umbilical cord care product to caregivers ensure that instruction is provided on the appropriate use of the product, including appropriate warnings.<\/span><\/b><\/h3>\r\n<h3 style=\"line-height: 13.5pt; background: #F7F7F7; margin: 0in 0in 18.75pt 0in;\"><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/memorandum-safety-concerns-over-misuse-of-chlorhexidine-chx\/\"><span style=\"font-size: 10.0pt; font-family: 'Arial',sans-serif; color: #e05533;\">Memorandum: Safety Concerns Over Misuse of Chlorhexidine (CHX)<\/span><\/a><b><\/b><\/h3>\r\n<h3 style=\"margin-top: 0in; line-height: 13.5pt; background: #F7F7F7;\"><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/alert-no-133-chlorhexidine-71-digluconate-chx-reports-of-serious-eye-injury-due-to-errors-in-administration\/\"><span style=\"font-size: 10.0pt; font-family: 'Arial',sans-serif; color: #e05533;\">Alert No. 133: Chlorhexidine 7,1% digluconate (CHX): Reports of serious eye injury due to errors in administration<\/span><\/a><b><\/b><\/h3>\r\n[\/vc_cta][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Key Resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/globalhealthmedia.org\/videos\/care-of-the-cord\/\">Video on proper cord care for practitioners (2015)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/publications\/i\/item\/WHO-MHP-HPS-EML-2021.02\">WHO Model List of Essential Medicines (22nd list, 2021)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/savechildrenusa-my.sharepoint.com\/personal\/hwartinger_savechildren_org\/Documents\/HNN\/Page%20Drafts\/who.int\/publications\/i\/item\/WHO-MHP-HPS-EML-2021.03\">WHO Model List of Essential Medicines for Children (8<sup>th<\/sup> list, 2021)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789240045989\">WHO recommendations on maternal and newborn care for a positive postnatal experience (2022)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/iawgfieldmanual.com\/manual\">Inter-Agency Field Manual for Reproductive Health in Humanitarian Settings (2018)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/iawgfieldmanual.com\/manual\/misp\">Minimum Initial Service Package (2018)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.unfpa.org\/sites\/default\/files\/resource-pdf\/IARH-Kits-6th-Edition_Manual_English.pdf\">Inter-Agency Reproductive Health Kits<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/news\/item\/28-08-2020-chlorhexidine-7-1-digluconate-(chx)-aqueous-solution-or-gel-(10ml)-reports-of-serious-eye-injury-due-to-errors-in-administration\">Chlorhexidine 7,1% digluconate (CHX) aqueous solution or gel (10ml): Reports of serious eye injury due to errors in administration (2020)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/memorandum-safety-concerns-over-misuse-of-chlorhexidine-chx\/\">Memorandum: Safety Concerns Over Misuse of Chlorhexidine (CHX) (2019)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/alert-no-133-chlorhexidine-71-digluconate-chx-reports-of-serious-eye-injury-due-to-errors-in-administration\/\">Alert No. 133: Chlorhexidine 7,1% digluconate (CHX): Reports of serious eye injury due to errors in administration (2019)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Umbilical cord care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"umbilical-cord-care","to_ping":"","pinged":"","post_modified":"2022-12-27 14:18:49","post_modified_gmt":"2022-12-27 19:18:49","post_content_filtered":"","post_parent":0,"guid":"https:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=55231","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[],"countries":[],"featured_image":23801,"ft_img_caption":"","about_the_author":"","author_image":false},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/23794"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=23794"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/23794\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/23801"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=23794"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/categories?post=23794"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/tags?post=23794"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}