Beruflich Dokumente
Kultur Dokumente
Dr. Purusotam Raj Shedain, Ministry of Health and Population, Nepal Leela Khanal, Project Manager, CNCP, Nepal 1
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20 1996
1991
Other 10%
Congenital Anomaly 8%
Pre term/LBW 6%
Injury 19%
Neonatal mortality61% of the under five mortality and 75% of infant mortality
Expansion of community-based neonatal care program and role of community level health workers
A simple technology with potential to prevent 500,000 global neonatal deaths annually.
Soure : Hodgins et.al(2013)
Application of 7.1% w/v chlorhexidine digluconate in freshly cut umbilical cord stump can reduce neonatal mortality by 23%
Efficacy
Low cost
Simplicity
Safety
Acceptability
Scalability
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Commercial viability
2007
Non-inferiority trial of CHX gel compared to aqueous 2008-09 Gel versus aqueous community acceptability study
2009-11
CHX international meeting at Banke, Nepalgunj Approval from MoHP for national level scale up 2009-11 Saving Lives at Birth: a Grand Challenge for Development Better Cord Care Saves Babies Lives, Three year project by JSI to support scale up CHX as a national program.
Providing technical and product support to neighboring Asian and several African countries for doing formative work and preparing to pilot 2012 Providing a learning platform to Onwards many international visitors Providing technical support to other implementing partners
Far-Western Region
Darchula
Mid-Western Region
Mugu
Bajhang
Baitadi
Doti
Achham
Western Region
Manang
Kanchanpur Jajarkot Rukum Surkhet Myagdi Salyan Baglung Rolpa Lamjung Rasuwa Banke Pyuthan Gulmi Syangha Arghakhanchi Palpa Dhading Kapilvastu Rupandehi Chitwan Makwanpur L Ramechhap Sindhuli Parsa Nawalparasi Nuwakot K B Kavre Tanahu Sindhupalchowk Dolakha Dang Kaski Gorkha
Dailekh
Kailali
Central Region
Eastern Region
Solukhumbu Sankhuwasava Taplejung
Pilot-4 districts
Okhaldhunga Khotang Bhojpur Bara Udayapur Sarlahi Mahottari Dhankuta Dhanusha Siraha Ilam Rautahat*
Saptari
Morang
Jhapa
Implementing partners NFHPII Plan Nepal UNICEF Save the Children Health Right International Care Nepal
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Strategic Approach
Community based neonatal care program
Implementation approach
Chlorhexidine orientation to stakeholders and staff of DPHO/DHO Orientation to FCHVs Availability of service at home birth
Orientation to service providers of all level FCHVs distributes CHX to pregnant mother at 8th month of pregnancy after counseling
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Grand Challenge for Development award to JSI R&T to support GoN to scale up chlorhexidine Navi Care program as a national program
3 gram of 7.1% Chlorhexidine digluconate gel tube - Nepali brand name Kawach.
Supply is ensured through the government logistics supply system. Job aid to counsel mother
Every FCHV and HF received baby doll as a IPC tool to teach mother and family about Chlorhexidine application procedure and other essential newborn care
This is being a center for attraction in some district know as Putali (doll) Program
Ensuring Sustainability
Lessons Learned
Multiple possible distribution channels for high coverage and potential for direct consumer use
Challenges
Program shifting for cord care may create confusion in service provider and even in policy makers for transition period
Product availability
Continuing impact at scale- Supply chain, HMIS (Coverage tracking, ongoing performance management (e.g. review meetings)
References:
Hodgins S, Pradhan YV, Khanal L, Upretti S, KC NP. Chlorhexidine for umbilical cord care: game-changer for newborn survival? Glob Health Sci Pract. 2013;1(1):5-10. http://dx.doi.org/10.9745/GHSP-D-12-00014
Mullany , L(2011) Chlorhexidine Cord Cleansing. Summary and Meta Analysis of South Asian Trials
Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc. 2012. Nepal Demographic and Health Survey 2011. Kathmandu, Nepal: Ministry of Health and Population, New ERA, and ICF International, Calverton, Maryland.
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Thank You
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