In June 2016, the USAID-funded Every Preemie—SCALE project, a consortium of Project Concern International (PCI), Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and American College of Nurse-Midwives (ACNM), finalized and launched Antenatal Corticosteroids for Women at Risk of Imminent Preterm Birth in the Democratic Republic of Congo, Ethiopia, Malawi, Nigeria, Sierra Leone, Tanzania and Uganda: A Policy and Implementation Landscape Analysis. The landscape analysis was conducted on behalf of the Newborn Health Technical Resource Team under the UN Commission for Life-Saving Commodities for Women and Children (UNCoLSC).
The World Health Organization (WHO) recommends that antenatal corticosteroids (ACS) are used to promote lung development in the unborn baby and are given to women who are 24 – 34 weeks pregnant when they are suspected to be in early labor. WHO recommends ACS use only when adequate childbirth and preterm newborn care are consistently available. Given the large contribution of preterm birth to deaths among newborns and children under five years of age and the evidence that ACS can improve newborn survival when used appropriately, countries are moving forward with its use.
This new report presents elements of ACS implementation in seven UNCoLSC Pathfinder countries—the Democratic Republic of the Congo (DRC), Ethiopia, Malawi, Nigeria, Sierra Leone, Tanzania and Uganda. To inform the landscape analysis, Ministry of Health (MOH) representatives were interviewed in each country and various government documents, including maternal and newborn health treatment guidelines, were reviewed for ACS-specific content. The document provides information on the levels of care where ACS is being used, which providers are authorized to prescribe and/or administer ACS, and the availability of critical maternal and newborn health care services in each country for safe and effective use of ACS. The analysis also explores how ACS use is being tracked in each country.
On June 14, 2016, the UNCoLSC ACS Technical Working Group met in Washington, DC. Meeting participants included MOH officials from the DRC, Ethiopia, Malawi, Nigeria, Sierra Leone, and Uganda and global technical and program experts from non-governmental organizations, the UNCoLSC and USAID. Report authors Judith Robb-McCord (Every Preemie/PCI) and James A. Litch (Every Preemie/GAPPS) presented the report findings. Country representatives shared their views on lessons learned, strengths, opportunities and challenges regarding ACS implementation in their countries. They emphasized that ACS use is fairly new and that countries need support to institutionalize WHO recommendations for improved maternal and newborn health.
The ACS Policy and Implementation Landscape Analysis identifies crucial needs within health care systems for safe and effective use of ACS that must be addressed by the international community as well as by national stakeholders. The information provided in this landscape analysis can be used to advance the global and national conversation regarding the safe expansion of ACS and, ultimately, inform comprehensive programming to improve the survival of babies born too soon.
Pictured above: Ministry of Health representatives from (left to right) Dr. Philip Koroma, Sierra Leone; Eneles Kachule, Malawi; Dr. Lisanu Taddesse, Ethiopia; Dr. Bose Adeniran, Nigeria; Dr. Laetitia Mavinga, DRC and Dr. Jesca Sabiiti, Uganda participate in the UNCoLSC ACS Technical Working Group on June 14 in Washington, DC.