National scale up o priority newborn interventions: curre status - - PowerPoint PPT Presentation

National scale up o priority newborn interventions: curre status and way forwa By Joby George

Bangladesh Neonatal Foru 5th International Conferen (SYMPOSIUM 1) March 03, 2018

52 48 42 41 37 32

30 35 40 45 50 55

Bangladesh NMR

39% 42% 45% 47% 57% 60%

1990 1995 2000 2005 2010 5 10 15 20 25 Year NMR Trend NMR Target % N

Bangladesh Demographic and Health Surv

28 22

50% 60% 70% 80% 90% 100%

R trend and targets

22 16

19 12

61%

010 2015 2020 2025 2030 0% 10% 20% 30% 40% 50% ear % Newborn death

• Expon. (NMR Trend )

urvey 1993, 1997, 2000, 2004, 2007 2011, 2014

Maternal Health interventions Newborn hea interve

• 3. Essential new

newborn resu

Bangladesh Declaration fo Deaths by 2035

Skilled birth attendance (CSBAs and Midwives) Functional and 24/7 BEmONC and CEmONC at strategically located facilities

newborn resu application o

• 4. Antenatal ste

premature lab Kangaroo mo (KMC) for pre birth weight b

• 5. Neonatal sep

management

• 6. Specialized n

district & sub ealth specific ventions ewborn care with suscitation & Child Health specific interventions

• 7. Effective referral linkage to ensure

continuum of care – from community c

for Ending Preventable Child 35: Interventions

suscitation &

• f Chlorhexidine

steroids for labor and mother care premature/low t babies sepsis nt at PHC level d newborn care at sub-district level

continuum of care – from community c to district /tertiary hospitals

• 8. IMCI at all levels
• 9. Multi-sectoral approach to promote

exclusive BF and IYCF

• 10. Community based child drowning

prevention activities

• 11. New vaccines: pneumococcal and

rotavirus

Pathway to effe

Enabling Environment Strength of Implementation nal readiness to support NBH interventions Standards of care applied Quality NBH Care mproved sub-national anagement capacity engthened systems and structures Quality NBH Care available and accessi Systems functiona Caregivers enables seek/ practice timel care

ffective scale up

High Effective Coverage Impact at Scale re re All newborns receive timely quality care Reduced neonatal re ssible nal es to ely Families and caregivers practice recommended behaviors neonatal mortality, still births and morbidity

urrent Status of Priority Newbo angladesh

Consensus, policy tools & guidelines development Piloting in small areas, learning

ACS

born Interventions in

Several districts or facilities covered Near universal coverage, institutionalizatio n

HBB, 7.1% CHX ENC

National Roll Out of He (October 2011

Capacity building :

28,189 SBA trained

Resusc Trainin p

Helping Babies Breathe 11 – March 2014)

*Post training evaluation:

• HBB logistics ( Bag-Mask and

Sucker) available in 84% labor room/OT

• 81% Bag-mask and sucker we

found clean

17,530 scitation equipment provided 1,649 ning equipment provided provided Job aid : reprocessing

• f equipment

National roll-out of chlorhexi

(July 2015 –

85,849 service

• viders, supervisors and

anagers trained

Logistic management

• cacy and

ization meeting Capacity Building : 26,755 facility level provider, 59,094 community level provider trained

st training evaluation: % providers received orientation X available in 52% facilities % providers could demonstrate lication procedure accurately % providers used CHX in the week

IM evaluation, Aug-Sep’16, 64 dist, 1044 facilities, 3400 provider

exidine for newborn cord care:

– June 2016)

Orientation package Orientation package IEM/BCC material Job aid

ENC, CHX and HBB: (October 2016 –

evisit Package: efreshers orientation of A in 64 districts erformance review of wborn interventions cluding CHX application cluding CHX application

• gistics management

isit of all health facilities assess: R, skill retention, cility readiness, logistic anagement ction plan development

A workshop of Newbo

: Post-roll out Revisit December 2017)

Progress

• 943 newborn focal perso

identified and oriented on follow up package.

• Advocacy meetings for u
• f HBB and 7.1% CHX in

districts

• Review meeting and
• Review meeting and

refresher training of 15,89 SBAs

• Quick assessment of 4,4

facilities regarding preparedness for newborn interventions (HR, training, facility readiness, logistic availab (CHX, HBB kit)

born Focal Persons

82 66 63 91 85 61 85 69 29 49 79 42 40 50 60 70 80 90 100 %

Percentage of providers trained o

reported on the

Training status

29 10 20 30 40 50

Gyn_Obs_Ped MO_Asst.Surgeon Nurse FWV_Para SACMO DH MCWC Provider type

7.1% CHX 85 71 90 88 90 77 49 73 75 51 76 72 53 62 41 53

d on 7.1% ENC, CHX & HBB (as

he day of visit)

tus of providers

MCWC UHC UH&FWC-FP UH&FWC-H USC RD Others Total Facility type

HX HBB

Post roll out follow up visit ( Oct 2016- December 2017

100 100 91 90 84 73 89 77 77 69 56 69 54 50 50 60 70 80 90 100

Status of HBB and CHX deliver

10 20 30 40 50 Offer delivery service delivery service 77 46 87 69 65 74 47 48

X in facilities that provide ery care

N= 4,469 30 46 16 30 47 13 41 15 48 vice & HBB delivery service & 7.1% CHX

Post roll out follow up visit ( Oct 2016- December 2017)

Institutionalization

All newborn interventions incorporate National Newborn Health Program (N Dedicated budget for NNHP Procurement and distribution of comm HBB equipment, CHX Indicators included in the MIS, dashb created on DHIS 2 Monitoring and review of progress Capacity-building materials and job a SBCC and newborn health campaign Engagement of partners and stakeho ated into the (NNHP) mmodities: hboard b aids ign holders

Newborn Health Dashboard us used on DHIS 2 platform

Lessons learnt from nation

Reaching mothers who deliver at ho remains a challenge: need alternativ approaches mpact at scale” only as good as we National scale up requires commitme all sectors – public, private, NGOs Community and local government of potential local solutions to many of t bottlenecks Securing resources for all elements

ional scale up

home tive delivery weakest link tment from t offers f the ts critical

Opportunities & Challenge

Quality implementation of NNHP un HPNSP Consistency across the service deliv systems Sustainable support from partners

Way Fo

Sustainable support from partners (technical and financial) Active engagement of all stakeholde Enhanced attention to quality of car new sector program and new initiati MNH QoC

ges

under elivery

Forward

lders are in the iatives for

Thank you