Preventing Newborn Deaths

“When it comes to babies and their mothers, the right care at the right time in the right place can make all the difference. Yet millions of small and sick babies and women are dying every year because they simply do not receive the quality care that is their right and our collective responsibility.”

—Omar Abdi, UNICEF Deputy Executive Director

Preventing Newborn Deaths

“When it comes to babies and their mothers, the right care at the right time in the right place can make all the difference. Yet millions of small and sick babies and women are dying every year because they simply do not receive the quality care that is their right and our collective responsibility.”

—Omar Abdi, UNICEF Deputy Executive Director

Overview

In 2017, 2.5 million newborns died from mostly preventable causes. Prematurity is the leading cause of death globally for children under five and for newborns. Each year, one in 10 babies around the world are born preterm.

Yet, evidence shows that nearly 68 percent of newborn deaths could be averted with essential newborn care such as warmth by placing the baby in skin-to-skin contact between the mother, father and other family members, breastfeeding support, and basic care for infections and breathing difficulties. But, without specialized treatment, many at-risk newborns won’t survive their first month of life. If they do survive, these babies can face chronic diseases, developmental delays, or long-term disabilities, outcomes that can be avoided with the right care in the vital moments and days after birth.

The Every Preemie—SCALE Project

Managing preterm birth calls for strong action across the spectrum of care—from prevention, to the management of immediate, quality preterm labor and postnatal care for preterm newborns. To support this effort, PCI, in partnership with the Global Alliance to Prevent Prematurity and Stillbirth and the American College of Nurse-Midwives, led Every Preemie-SCALE, a five-year, $9 million project designed to catalyze action, globally and at the country level, toward improving newborn health.

Working in 24 United States Agency for International Development (USAID) priority countries, predominantly in Africa and Asia, Every Preemie engaged with global partners, including the World Health Organization , UNICEF, and USAID, as well as leading newborn health experts to improve preterm birth, low birth weight care, and sick newborn care around the world.

PCI convened thought leadership discussions on these topics and designed and disseminated tools on early/small and sick newborn care and management.

Other program activities included:

  • Launching country profiles on preterm birth and low birth weight to promote dialogue and action in USAID’s 25 priority maternal and child health countries
  • Providing technical input on WHO standards of care for early/small and sick newborns
  • Developing and disseminating the global WHO/UNICEF document Survive & Thrive: Transforming Care for Every Small and Sick Newborn
  • Revising the global Respectful Maternity Care Charter to include newborns
  • Designing a protocol and tools for situation analysis on the care of inpatient newborns and young infants, which were used in Ghana, Rwanda, Tanzania, and Uganda
  • Development of a new model of care for small and sick newborns: Family-Led Care
  • Global engagement and collaboration

This project also supported implementation research in Bangladesh, Ethiopia, India, and Malawi in partnership with Brigham and Women’s Hospital, St. Paul’s Hospital Millennium Medical College, the Post-Graduate Institute of Medical Education and Research, and the University of Malawi College of Medicine and MaiKhanda, respectively.

In Malawi, this research laid the foundation for the innovative Family-Led Care model. This model was designed to improve health services while empowering families to care for their early/small babies in a facility and at home. The Family-Led Care model helps improve the quality of Kangaroo Mother Care provided to inpatient preterm and low birth weight newborns; strengthen post-discharge follow-up care; and extend care for preterm and low birth weight newborns at community and household levels.

Program Highlight: Global Working Group and the Do No Harm Technical Briefs

Every Preemie-SCALE convened a Global Technical Working Group focused on implementation challenges and solutions. The meetings convened more than 200 thought leaders in the field of maternal and newborn health and provided a broad, multi-disciplinary forum for emerging evidence, relevant research, and learning across the range of preterm birth and low birth weight interventions and implementation in low-income countries.

A direct outcome of the Global Technical Working Group was the development of a series of Do No Harm technical brief to highlight the safe and effective use of specific inpatient newborn care interventions. Using the guiding principle of “Do No Harm,” the briefs were designed to provide stakeholders with evidence-based information regarding safe and effective inpatient care in low-resource settings—an important step to avoid harm and improve health outcomes for newborns.

The Do No Harm technical briefs included:

  • Safe and Effective Oxygen Use for Inpatient Care of Newborns
  • Safe and Effective Infection Prevention for Inpatient Newborn Care
  • Safe and Effective Thermal Protection for Inpatient Care of Newborns
  • Prevention and Screening of Retinopathy of Prematurity
  • Family Participation in the Care of the Inpatient Newborn
  • Safe and Effective Human Milk Feeding for Small and Sick Newborns
  • Management of Newborn Infections During Inpatient Care

The briefs are available in English, Spanish and French and are available on Every Preemie’s website.

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Program Highlight: Situation Analysis of Newborns and Young Infant Inpatient Care

In 2017, Every Preemie developed protocol and tools for a situation analysis to gain a better understanding of inpatient care for small and sick newborns in low- and middle-income countries. The goal was to assess service readiness and quality of care by examining health system structures, facility processes, national policies, clinical standards, and the parent/caregiver experience during inpatient care.

In 2018 and 2019, Every Preemie program partners implemented the situation analysis and the Every Preemie team developed a multi-country overview of key findings for Ghana, Rwanda, Tanzania, and Uganda. This summary featured country demographic data; the types and numbers of facilities; available policies, guidelines, strategies and standards of care for inpatient newborns; service readiness and availability; elements of nurturing care; and data available through the Ministry of Health facility registers.

The Ministries of Health and other stakeholders planned to use these comprehensive findings to inform policy and improve service delivery and inpatient care of newborns and young infants.

Program Hilight: Family-Led Care

The Family-Led Care model was developed by Every Preemie to empower families to care for their preterm and low birth weight newborns by practicing Kangaroo Mother Care in the health facility and at home. Kangaroo Mother Care is defined as care of early and small babies carried skin-to-skin with their mother or other family members and exclusive breastfeeding or feeding with human milk.

The model—originally developed, implemented, and assessed in Balaka District, Malawi—was designed to improve the quality of Kangaroo Mother Care provided to inpatient preterm and low birth weight newborns; strengthen post-discharge follow-up care, and extend care for preterm and low birth weight newborns at community and household levels.

By developing a Family-Led Care training package, global audiences can adapt the model for use in local contexts. The content includes a trainers’ resource manual, PowerPoint presentations, pictorial counseling books and information flyers, family monitoring forms, and feeding chart forms.

Learn more about the project.

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