Newborn Health Scale Up Framework for Zambia Dr. Penelope Kalesha Child Health Specialist Ministry of Com. Dev. Mother and Child Health.

Newborn Health Scale Up Newborn Health Scale Up Framework for ZambiaFramework for Zambia

Dr. Penelope KaleshaChild Health Specialist

Ministry of Com. Dev. Mother and Child Health

Total Population 11479000

Annual Births 468000

Mothers

Maternal mortality rate (per 100,000 live births, adjusted) 750

Annual no. of maternal deaths 3510

Babies

Stillbirth rate (per 1000 deliveries) 31

Neonatal mortality rate (per 1000 live births) 37

Annual no. of neonatal deaths 18044

Percentage NMR gap between poorest and least poor 39%

Children

Under 5 mortality rate (per 1000 live births) 182

Annual no. of under 5 deaths 85176

Annual no. of postnatal deaths 67132

NMR as percentage of under 5 mortality 20%

Births and Deaths and inequity.

04/18/23Child Health Overview

140130

115

10094

88 85 85 82

222211

194

168

156 158

186194

173

0

20

40

60

80

100

120

140

160

180

200

220

240U5MR IMR

Source: World Health Chart, WHO- 2001

64

28

Projections to 2015

140130

115

10094

88 85 85 82

222211

194

168

156 158

186194

173

0

20

40

60

80

100

120

140

160

180

200

220

240U5MR IMR

Source: World Health Chart, WHO- 2001

64

28

Projections to 2015

Ra Trends of under five and infant mortality rates in Zambia

NNR

The Information Problem The Information Problem

The majority of with the minority deaths… of information

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Goal and Objectives of Goal and Objectives of

Scale UpScale Up

Goal: To accelerate the reduction of neonatal morbidity and mortality

The scale up of newborn health care will focus on 3 strategic objectives that will guide programming and selection of interventions 

Rationale for Scale UpRationale for Scale Up

•Two thirds of newborn deaths could be prevented with a higher coverage of essential maternal newborn and child health (MNCH) service packages that are already articulated within policies and plans. The strengthening of some specific newborn healthcare aspects could save a large number of newborn lives every day.

Critical time periods: •Pre-pregnancy , Pregnancy, Labour, delivery and the first 1-2 hours of life, Early neonatal period (week 1), Late neonatal period (weeks 2-4)

Newborn Health Scale up FrameworkNewborn Health Scale up Framework

• Strategic Objective 1: To strengthen capacity to improve newborn health care at all levels of the health care delivery systemo 1.1 Strengthen capacity to increase and improve essential newborn careo 1.2 Strengthen national, provincial, district and community level planning, management and

supervisiono 1.3 Strengthen Reporting, Monitoring and Evaluation

• Strategic Objective 2: To increase the availability, access and utilization of quality newborn health care services o 2.1 Improve health care facilities and service delivery siteso 2.2 Improve provision and access to quality newborn health care and services o 2.3 Strengthen referral and outreach systems o 2.4 Strengthen advocacy towards increased commitment, resources and integrated newborn

health policy and programmingo 2.5 Foster and Strengthen Partnerships

• Strategic Objective 3: To empower communities to improve community maternal and newborn health care practices, and support the continuum of care o 3.1: Influence behaviour change towards healthy newborn care practices and strengthen

community involvement and support o 3.2: Strengthen community involvement and support for the continuum of care o 3.3: Establish and strengthen Home Based Newborn Care (HBNC) o 3.4: Establish and strengthen community IMCI strategyo 3.5: Strengthen multisectoral community response to newborn health

Most important Most important

interventions?interventions?

PREVENTIVE (Skilled care at birth)• Labour, birth and 1-2 hours after birth • Monitoring progress of labour,

maternal and foetal well-being with partograph

• Social support (companion) during birth

• Immediate newborn care (resuscitation if required, thermal care, hygienic cord care, early initiation of breastfeeding)

• Emergency obstetric and newborn care for complications

• Antibiotics for preterm premature rupture of membranes

• Antenatal corticosteroids for preterm labour

• Prevention of mother-to-child transmission of HIV+

TREATMENT (Postnatal care for all newborns)

• Newborn period (after the first 1-2 hours after birth up to 1 month)

• Exclusive breastfeeding • Thermal care • Hygienic cord care • Prompt care-seeking for illness • Extra care of low-birth-weight

(LBW) infants • Immunization • Management of newborn illness • Prevention of mother-to-child

transmission of HIV+

Adapted by WHO/CAH from the Lancet Neonatal Survival series, Lancet Child Survival series

Prioritization/ Selection

of

Strategies/Interventions•Situation analysis

•Prioritizing and choosing interventions

•Intervention delivery

•Monitoring and evaluation

Opportunities for Scale-Up•Policy and Planning

•National Pre-service and In-service Training

•Promising National Interventions and Pilot Programs

•Community and Facility Based Strategies

•Key opportunities in policy and programmes to save newborn lives

•Prioritization and Selection of Strategies/Interventions

Progress to 2015- Child Health

The hours and days

of highest risk have

the lowest coverage of care

Thank you!

We can work together to make a big difference for mothers, newborns and the future?