{"id":10986,"date":"2014-04-02T00:00:00","date_gmt":"2014-04-02T00:00:00","guid":{"rendered":"http:\/\/www.healthynewbornnetwork.org\/resource\/effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey\/"},"modified":"2017-08-21T18:08:46","modified_gmt":"2017-08-21T22:08:46","slug":"effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey\/","title":{"rendered":"Effectiveness of Antenatal Clinics to Deliver Intermittent Preventive Treatment and Insecticide Treated Nets for the Control of Malaria in Pregnancy in Mali: A Household Survey"},"content":{"rendered":"

Background<\/u>: WHO recommends intermittent-preventive-treatment (IPTp) with sulphadoxine-pyrimethamine (SP) and insecticide-treated-nets (ITNs) to prevent malaria in pregnancy in sub-Saharan Africa, however uptake remains unacceptably low. We evaluated the effectiveness of antenatal clinics (ANC) to deliver two doses of IPTp and ITNs to pregnant women in Segou district, Mali.<\/span><\/p>\n

 <\/div>\n
Methods<\/u>: We used household data to assess the systems effectiveness of ANC to deliver IPTp and ITNs to pregnant women and used logistic regression to identify predictors of ANC attendance, receipt of IPTp and ITN use during pregnancy, and the impact on community effectiveness.<\/div>\n
 <\/div>\n
Results<\/u>: Of 81% of recently pregnant women who made at least one ANC visit, 59% of these attended during the eligible gestational age for IPTp. Of these, 82% reported receiving one dose of SP and 91% attended ANC again, of whom 66% received a second dose, resulting in a cumulative effectiveness for 2-dose IPTp of 29%, most of whom used an ITN (90%). Cumulative effectiveness of 2-dose SP by directly observed therapy (DOT) was very low (6%). ITN use was 92%, and ANC was the main source (81%). Reported and ANC-card data showed some doses of SP are given to women in their first trimester. Women were less likely to receive two doses by DOT if they were married (OR 0.10; CI 0.03, 0.40), or lived <5 km from the health facility (OR 0.34; CI 0.14, 0.83). A high household person-LLIN ratio predicted low ITN use in pregnant women (OR 0.16; CI 0.04, 0.55).<\/div>\n
 <\/div>\n
Conclusion<\/u>: Our findings suggest poor adherence by health workers to provision of IPTp by eligible gestational age and DOT, contributing to low effectiveness of this strategy in this setting. ITN delivery and use among women was substantially higher. Efforts to improve health worker adherence to IPTp guidelines are needed to improve service delivery of IPTp.<\/div>\n","protected":false},"excerpt":{"rendered":"

WHO recommendations to prevent Malaria.<\/p>\n","protected":false},"author":3998,"featured_media":10988,"comment_status":"open","ping_status":"open","template":"","toolkit":[],"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\/resource\/effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Effectiveness of Antenatal Clinics to Deliver Intermittent Preventive Treatment and Insecticide Treated Nets for the Control of Malaria in Pregnancy in Mali: A Household Survey - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"WHO recommendations to prevent Malaria.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.healthynewbornnetwork.org\/resource\/effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey\/\" \/>\n<meta property=\"og:site_name\" content=\"Healthy Newborn Network\" \/>\n<meta property=\"article:modified_time\" content=\"2017-08-21T22:08:46+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/PLoS_19.jpg\" \/>\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\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey\/\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/effectiveness-of-antenatal-clinics-to-deliver-intermittent-preventive-treatment-and-insecticide-treated-nets-for-the-control-of-malaria-in-pregnancy-in-mali-a-household-survey\/\",\"name\":\"Effectiveness of Antenatal Clinics to Deliver Intermittent Preventive Treatment and Insecticide Treated Nets for the Control of Malaria in Pregnancy in Mali: A Household Survey - 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However, there are many opportunities during pregnancy to reduce these risks.<\/h2>\n<p>While traditional antenatal care (ANC) is understood mainly to focus on obstetrical issues, contacts with pregnant women also provide important opportunities to deliver other preventive clinical interventions as well as counseling and health education on birth preparedness, danger signs and appropriate response, key practices at household level during and after pregnancy, and family planning.[\/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\">88<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690993922335{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of women age 15-49 who received at lease one ANC visit during pregnancy globally (2016-2021)<\/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\">65<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690993939923{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of women age 15-49 who received four or more ANC visits during pregnancy globally (2016-2021)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][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\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Opportunities for ANC\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]The prioritization of specific ANC interventions should vary by setting. For example, in areas of high malaria risk, intermittent presumptive treatment and use of insecticide-treated mosquito nets are very important. How we reach pregnant women with services and messages must also vary by setting. There are certainly advantages to having fully-qualified health professionals like nurses or nurse-midwives provide services; however many aspects of the needed services could be provided by cadres of health auxiliaries with less training. In some settings, greater reach is achieved by providing services on an outreach basis. Over the past 15 years, the standard model for ANC has been \u201cfocused ANC,\u201d a four-visit schedule. In 2016 the World Health Organization reviewed this model and issued new recommendations.[\/vc_column_text][vc_text_separator title=\"Key Resources\"][vc_column_text]<\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/updated-who-recommendations-for-malaria-chemoprevention-among-children-and-pregnant-women-who\/\" target=\"_blank\" rel=\"noopener\">Updated WHO recommendations for malaria chemoprevention among children and pregnant women<\/a> (2022)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/ending-preventable-maternal-mortality-epmm-a-renewed-focus-for-improving-maternal-and-newborn-health-and-wellbeing\/\" target=\"_blank\" rel=\"noopener\">Ending Preventable Maternal Mortality (EPMM): A Renewed Focus for Improving Maternal and Newborn Health and Wellbeing<\/a> (2021)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/recommendations-antenatal-care-positive-pregnancy-experience\/\">WHO recommendations on antenatal care for a positive pregnancy experience<\/a> (2016) + Executive Summary<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Antenatal care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"antenatal-care","to_ping":"","pinged":"","post_modified":"2023-08-02 12:32:20","post_modified_gmt":"2023-08-02 16:32:20","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=114","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&p=126","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":136,"post_author":"7211","post_date":"2015-10-21 15:21:03","post_date_gmt":"2015-10-21 15:21:03","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>Integrating postpartum family planning services and counseling into childbirth care is vital to newborn and maternal health and survival.<\/h2>\r\nOffering contraceptive counselling and a wide range of modern methods along the continuum of childbirth care has shown to increase contraception use, which enables women to choose when and if to have a baby. Family planning use is considered postpartum if the woman initiates and uses a method in the first twelve months after childbirth. Postpartum reproductive health and family planning also includes services initiated after miscarriage or abortion. Pregnancies that are spaced by at least two years after a live birth and six months after a miscarriage or induced abortion can reduce the risk of complications and adverse newborn outcomes. Maternal survival is also impacted as women who practice healthy timing and spacing of pregnancies are less likely to die in childbirth or from pregnancy complications. Integrating contraception counseling and services into quality antenatal, postnatal, and newborn care is a <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/immediate-postpartum-family-planning\/\">proven intervention<\/a> and should be included in both facility and community based services.[\/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\">163<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666117399105{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of women with <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(22)00936-9\/fulltext\">unmet need for modern contraception services in 2019<\/a><\/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\">1.7<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667922548234{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of fewer newborn deaths annually if <a href=\"https:\/\/www.guttmacher.org\/fact-sheet\/investing-sexual-and-reproductive-health-low-and-middle-income-countries\">unmet contraceptive need is met <\/a>in LMICs<\/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\">700<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667922954092{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of stillbirths that could be averted annually if <a href=\"https:\/\/www.guttmacher.org\/report\/adding-it-up-investing-in-sexual-reproductive-health-2019\">unmet contraceptive need is met<\/a> in LMICS<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"More on Family Planning\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Family planning methods:<\/strong> There are <a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\">many methods available<\/a>, under many different brand names. Modern methods include oral contraception pills, implants, injectable, intrauterine devices (IUDs), emergency contraception, male and female condoms, male and female sterilization, and lactational amenorrhea method (LAM). Additional methods include withdrawal, the calendar or rhythm method, and other fertility based methods. Some are more effective than others, and many rely on proper use to ensure effectiveness. Most of these contraceptives can be <a href=\"https:\/\/postpartumfp.srhr.org\/\">safely used immediately postpartum<\/a>; the rest can be initiated shortly after delivery, within a few weeks to six months.\r\n\r\nThe lactational amenorrhea method (LAM) is <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9678098\/\">98% effective<\/a> for the first six months postpartum. LAM prevents pregnancy while the mother is exclusively breastfeeding. It becomes less effective when other foods and liquids, like formula, are included, so women who are unable to exclusively breastfeed should consider other methods.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Spacing of pregnancy:<\/strong>\u00a0Use of family planning helps achieve healthy spacing of pregnancies, which is critical to a healthy pregnancy and delivery and to newborn survival. When pregnancies are too close together (less than 24 months between the last live birth and the next pregnancy), the risk of low birth weight, preterm birth, and newborn death increases; when pregnancy begins within six months of the last live birth, these complications are even more likely. Furthermore, when a mother who is still nursing an infant of any age becomes pregnant again, it is difficult to meet the nutritional needs of the mother, nursing baby, and fetus.\r\n\r\n<strong>Timing of pregnancy:<\/strong>\u00a0Studies have shown that both newborns and mothers have the healthiest outcomes when pregnancies occur after age 18. When mothers are <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4562289\/\">younger than 18<\/a>, they and their infants face increased risk of birth\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/complications-during-childbirth\/\">complications<\/a>, including stillbirth, low birth weight, and preterm birth. When possible, it is recommended to time pregnancies appropriately, especially by delaying first pregnancy until at least age 18. Adolescents, regardless of marital status, should have access to contraceptive methods to delay pregnancy.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_single_image image=\"56227\" add_caption=\"yes\"][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/training-resource-package-for-family-planning\/\">Training Resource Package for Family Planning\u00a0<\/a><\/li>\r\n \t<li><a href=\"https:\/\/fphandbook.org\/\">Family Planning Global Handbook for Providers<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/immediate-postpartum-family-planning\/\">High Impact Practices for Family Planning \u2013 Immediate Postpartum Family Planning<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/negative-effects-of-short-birth-interval-on-child-mortality-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis\/\">Negative effects of short birth interval on child mortality in low and middle income countries: a systematic review and meta analysis<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\">WHO Family planning\/contraception methods<\/a><\/li>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9678098\/\">Postpartum contraception: the lactational amenorrhea method<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Reproductive health & family planning","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"reproductive-health-family-planning","to_ping":"","pinged":"","post_modified":"2023-02-07 16:00:38","post_modified_gmt":"2023-02-07 21:00:38","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=136","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"additional_authors":"J. Hill, K. Kayentao, M. Tour\u00e9, et al.","authors":false,"other_organizations":"","language":["en"],"type":"articles","external_links":[{"link":"http:\/\/www.plosone.org\/article\/fetchObject.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0092102&representation=PDF"}],"files":[{"file":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Hill-Keyentao-Toure.pdf"}],"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&p=247","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":197,"post_author":"7211","post_date":"2015-10-21 22:00:28","post_date_gmt":"2015-10-21 22:00:28","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 Mali (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%223%25%20Diarrhoea%22%2C%22value%22%3A%223%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%236ab165%22%7D%2C%7B%22title%22%3A%2210%25%20Pneumonia%22%2C%22value%22%3A%2210%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2238%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2238%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2225%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2225%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%226%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%226%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%225%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2211%25%20Other%20conditions%22%2C%22value%22%3A%2211%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686242663657{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\" el_id=\"countryMap\"][\/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&source=gmail&ust=1551964625737000&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_1686242737981{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">33.4<\/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_1686242747656{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">2<\/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_1650895751888{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">36<\/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_1686242724759{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">23.4<\/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_1686242676607{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">67.3<\/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_1650895772577{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">59\r\n<\/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_1698696527401{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">6.1<\/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 <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_1686242693026{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">440<\/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_1456601282741{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":"Mali","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"mali","to_ping":"","pinged":"","post_modified":"2023-10-30 16:07:22","post_modified_gmt":"2023-10-30 20:07:22","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=197","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"partners":[]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/10986"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/3998"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=10986"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/10986\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/10988"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=10986"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=10986"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}