Beruflich Dokumente
Kultur Dokumente
Global Newborn Conference April 16, 2013 By: Dr. Abeba Bekele
Outline
300
200
100
88
66
37
0 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010* 2015
1- 59 month mortality rate reducing each year at 5.5% Source: U5MR (UN): www.childinfo.org NMR (UN):year Oestergaard et al 2011 PLoS Neonatal mortality rate/ www.childmortality.org reducingand each only by 2.4% updated for 2011 data , Sept 2012
Data sources: Updated from Opportunities for Africas Newborns with UN data from www.childmortality.org. * 2010 year contains 2008 data
Source: Liu L. et al. 2012. Global, regional, and national causes of child mortality in 20002010: an updated systematic analysis. The Lancet. doi:10.1016/S0140-6736(12)60560-1.)
40
30 20 10
15
COMBINE
Objectives
Health Post
COMBINE helped to strengthen the implementation of the HEP for maternal and newborn care
Improved the HEWs ability to capture & manage cases of severe neonatal infections at community level
Counselling on benefits 2 visits by fCHP/DTL of focused ANC As soon as identified Recognition of danger 8th month of the signs pregnancy Birth plan Essential newborn care 1 visit by HEW Notification of HEW ASAP after delivery
Counselling and support for ENC Assess newborn & mother for danger signs Referral for illness Sepsis management of newborn if referral not accepted (intervention arm)
90 80
70 60 50
40 30
20 10 0
Q1
Q2
2009
Q3
Q4
Q1
Q2
2010
Q3
Q4
Q1
Q2
2011
Q3
Q4
Q1
Q2
2012
Q3
Q4
78.3 74.6
79.2 76.7
79.5 77.3
80.778.5
33.4
30 20 10 0 1st day In 2 days
36.1
36.5
37.1
In 3 days
In 7 days
fCHP/DTL or HEW
fCHP/DTL
HEW
What is Working?
High level of pregnancy Over 70% of expected deliveries identification, notification of got early PNC delivery and conduct of early home visit postnatal home visits 50% of expected Good proportion of neonatal PSBI cases id and sepsis cases identified and treated treated High levels of treatment Over 90% of completion at Health Posts those started on
antibiotics completed
What is Working?
High motivation of HEWs to provide the services
Family referral of sick neonates indicating improved awareness of neonatal danger signs
Male involvement in changing some norms through community and religious leaders.
Challenges:
Demand side Entrenched cultural practices preventing families from taking newborns out of the home early in life Poor awareness of newborn illness & its seriousness; value /belief of modern health care for newborn illness Supply side Access related barriers Human resources Logistics and supplies
Demand Home visits and counseling by HEW and HDA network leaders contribute to improve care seeking
An integral part of the continuum of care Community management of neonatal sepsis has a potential to save many newborn lives in the Ethiopian context
Thank you!
Collaborators:
Save the Children MOH UNICEF JSI Research & Training Institute Bill and Melinda Gates Foundation LSHTM JHU EPS WHO