{"id":9634,"date":"2013-01-09T00:00:00","date_gmt":"2013-01-09T00:00:00","guid":{"rendered":"http:\/\/www.healthynewbornnetwork.org\/resource\/a-study-on-cord-care-practices-focus-group-discussion-with-mothers-in-law\/"},"modified":"2022-10-03T11:46:35","modified_gmt":"2022-10-03T15:46:35","slug":"a-study-on-cord-care-practices-focus-group-discussion-with-mothers-in-law","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/a-study-on-cord-care-practices-focus-group-discussion-with-mothers-in-law\/","title":{"rendered":"A Study on Cord Care Practices: Focus Group Discussion with Mothers in Law"},"content":{"rendered":"<p>This focus group discussion with mothers in law tests their knowledge of the umbilicus and rates their opinions of chlorhexidine formulations.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This focus group discussion with recently mothers in law tests their knowledge of the umbilicus and rates their opinions of chlorhexidine formulations.<\/p>\n","protected":false},"author":7211,"featured_media":9636,"comment_status":"open","ping_status":"open","template":"","toolkit":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - 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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&amp;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 &amp; 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 &amp; 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 &amp; Child Health)<\/li>\r\n \t<li>Ministry of Health, Kenya (Child &amp; 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&#038;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&#038;p=55231","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"additional_authors":"","authors":false,"other_organizations":"JSI\/Nepal Family Health Program II","language":["en"],"type":"tools_guidelines","external_links":[{"link":""}],"files":[{"file":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Nepal_TOOL-5-FGD-with-MILs.doc"}],"regions":[{"ID":251,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Asia","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"asia","to_ping":"","pinged":"","post_modified":"2016-02-11 21:51:07","post_modified_gmt":"2016-02-11 21:51:07","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&#038;p=251","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":205,"post_author":"7211","post_date":"2015-10-21 22:01:35","post_date_gmt":"2015-10-21 22:01:35","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 Nepal (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%221%25%20Diarrhoea%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%234cadc9%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%2230%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2230%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2227%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2227%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%227%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%227%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%2213%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%2213%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2213%25%20Other%20conditions%22%2C%22value%22%3A%2213%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686243919924{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&amp;source=gmail&amp;ust=1551964625737000&amp;usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686243984785{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">16.2<\/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_1686246052416{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">4.2<\/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_1651076793008{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">60<\/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_1686244002529{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">15.7<\/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_1686243937970{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">77.2<\/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_1651076816817{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">42<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696810911{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">11.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births &lt;37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686243963635{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">174<\/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_1456604101532{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":"Nepal","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"nepal","to_ping":"","pinged":"","post_modified":"2023-10-30 16:12:05","post_modified_gmt":"2023-10-30 20:12:05","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&#038;p=205","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"partners":[{"ID":620,"post_author":"2478","post_date":"2011-12-11 00:17:41","post_date_gmt":"2011-12-11 00:17:41","post_content":"<p>John Snow, Inc., and our nonprofit JSI Research &amp; Training Institute, Inc., are public health management consulting and research organizations dedicated to improving the health of individuals and communities throughout the world.<\/p>\r\n<p>JSI's mission is to improve the health of underserved people and communities and to provide a place where people of passion and commitment can pursue this cause.<\/p>\r\n<p>For 35 years, Boston-based JSI and&nbsp;<a href=\"http:\/\/www.jsi.com\/JSIInternet\/About\/affiliates.cfm\">our affiliates<\/a>&nbsp;have provided high-quality technical and managerial assistance to public health programs worldwide. JSI has implemented projects in 106 countries, and currently operates from eight U.S. and 81 international offices, with more than 500 U.S.-based professionals and 1,600 host country staff.<\/p>\r\n<p>JSI is deeply committed to improving the health of individuals and communities worldwide. We work in partnership with governments, organizations, and host-country experts to improve quality, access and equity of health systems worldwide. We collaborate with government agencies, the private sector, and local nonprofit and civil society organizations to achieve change in communities and health systems.<\/p>\r\n<h2>What we do<\/h2>\r\nJSI is actively engaged in ending preventable newborn and child deaths in the most under-served areas of the world. Despite important progress made, 6.6 million children under the age of five globally die each year because they lack immunizations, clean water, basic nutrition and essential newborn and child health care. \r\n\r\nSince the early 1980s, JSI has implemented child health programs in more than 80 countries throughout Africa, the Middle East, Latin America, and Asia. From supporting essential newborn care to under-five child health interventions, we have strengthened community, health facility, and health system efforts to help children live longer and better lives. JSI\u2019s expertise spans a wide variety of areas, including training community health volunteers, strengthening integrated community case management, improving performance of health facility workers, improving national supply chains, increasing the use of data for decision-making, developing health policy, and more. \r\n\r\nOver the past three decades, JSI has been at the forefront of innovations in neonatal and child health. For example, JSI was noted as a world leader in vitamin A supplementation programs, and has been instrumental in advancing diarrheal disease control and community-based pneumonia care programs. Over the past five years, JSI has helped lead the use of the antiseptic chlorhexidine for umbilical cord care to reduce newborn mortality from sepsis. In 2013, JSI\u2019s Chlorhexidine Navi (Cord) Care Program in Nepal was a Grand Prize winner in the Saving Lives at Birth Grand Challenges initiative, and in 2014, it was selected as one of four USAID-wide initiatives that its new Development Laboratory will work to scale-up in 20 countries.\r\n\r\nJSI is currently a partner on USAID's global flagship Maternal and Child Survival Program, providing technical leadership in the areas of child health and immunization. In addition, JSI supports USAID\u2019s Acting on the Call: Ending Preventable Child and Maternal Deaths and the global initiative, Ending Preventable Child Deaths from Pneumonia and Diarrhea by 2025.\r\n\r\nTo learn about ongoing child health work, read staff posts on the JSI blog, The Pump.","post_title":"John Snow Inc.","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"john-snow-inc","to_ping":"","pinged":"","post_modified":"2016-01-21 00:20:18","post_modified_gmt":"2016-01-21 00:20:18","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&#038;p=620","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"}],"views":"1376","ft_img_caption":""},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/9634"}],"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\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=9634"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/9634\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/9636"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=9634"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=9634"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}