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EVERY NEWBORN

An Action Plan To End Preventable Deaths

Global Progress
Dr. Nabila Zaka
Senior health Adviser UNICEF HQ

#EveryNewborn

Presentation Outline
Partner coordination for ENAP
Progress on
- Advocacy
- Support to country implementation
- Data and Metrics
- EMEN QI

Opportunities for strengthening ENAP


implementation

Partner Coordination for ENAP

Country
Implementation

Advocacy
Research as cross-cutting

Data and
metrics

Support to Country Implementation


Progress tracking:

Tool developed and tested in 10 countries


Revision of tool in progress for application
to countries with highest NMR and highest
burden of neonatal deaths
Country progress updated for WHA 2015
for 28 priority countries since 2013

National Newborn action plan developed in 8/28


countries with 9 in progress
RMNCH plan sharpened in light of ENAP in 6/28
Plans costed in 8/28

Technical support
Conducted a global review to identify the implementing partners
and donors currently providing technical support to maternal and
newborn care at the time around birth.
Developed a database which lists the
organizations providing technical assistance
and the activities and initiatives that they are
involved in per country (completed for 24
countries)
Compiled a list of key organizational focal
points for future engagement (45 organizations reached)
Compiled a list of consultants for future technical support to
countries.

Advocacy for Newborns


Work plan 2015 developed: global and regional plans for Asia
and Africa
Support dissemination opportunities for the Lancet Every
Newborn Series and/or national maternal-newborn action
plans

National events in India, Nigeria, Ethiopia, South Africa

Engagement with the development of the updated


Global Strategy for Womens and Childrens Health.
Support the next development agenda, including the
Sustainable Development Goals, targets, indicators and
means of implementation to ensure inclusion of stillbirths
and newborn.
Support and promote key advocacy moments. A calendar
of upcoming events is maintained at www.everynewborn.org

1
Technical
mapping &
planning

of indicators, tools
& work in progress

2
Institutionalise

in national collection
platforms and in
global metrics
architecture, with
accountability

3
Leadership
development

to improve & use


the data for action
www.everynewborn.org

Data and Metrics


Indicators for impact, coverage, process of maternal & newborn care
Initial focus on the 4 + 1 treatment interventions

KMC (led by KMC acceleration group)


Resuscitation (UNCoLSC, USAID, SNL Bangladesh, WHO, HBB etc)
Antenatal Corticosteroids (WHO and UNCoLSC TRT etc)
Sepsis case mx (WHO, UNCoLSC etc)
CHX cord cleansing (UNCoLSC, SNL etc)

Priority research to improve the metrics for use

Birth and perinatal death certificates, coverage & quality


Develop and test Minimum Perinatal Dataset
Perinatal Mortality audit tool, linked to Maternal Mortality audit
Inputs to facility HMIS, Health Facility Assessments such as SARA,
and to household surveys

Testing in countries also linked to EMEN work


Southern institutions as centres of excellence
Integrated technical oversight especially with maternal health
User friendly formats eg score cards, links to accountability and
parent voices (eg partnerships with E4A and WRA)
#EveryNewborn

Improving, institutionalising & using ENAP metrics for action


ENAP Milestones by 2020
Count births and deaths in CRVS (women, newborns and stillbirths)
Minimum perinatal dataset & perinatal mortality audit being widely used in countries
ENAP core indicators to be defined , incorporated in national metrics platforms and widely used

2020

June 2015 - May 2018


Testing indicators and
tools in limited number
of countries
Jan- May 2015
Refining and consulting on
Dec 2014
metrics plan
Meeting
& ENAP monitoring FW
To scope
ENAP Metrics
improvement plan

World Health
Assembly

May/June 2014

June 2018 - May 2020


Wide use in many countries
CRVS, facility HMIS, surveys
linked to health systems
scale up

Structure

Framework for Quality of Care by WHO


Health system

Quality
of Care

EXPERIENCE OF CARE

Process

PROVISION OF CARE
1.

Evidence based practices for


routine care and management of
complications

2.

Actionable information systems

3.

Functional referral systems


7.

Effective communication

5.

Respect and dignity

6.

Emotional support

Competent and motivated human resources


8.

Outcome

4.

Essential physical resources available

Individual and facility-level outcomes


Coverage of key practices

People-centred outcomes

Health outcomes

Main elements of the EMEN QI


Country introduction and implementation of the certification model
will include four main components:
1. National dialogue for adoption of the standards and
implementation planning
2. Routine self-assessment of maternal-newborn care in health
facilities by health facility staff with support from the facility
committees/boards and oversight from local health authorities
3. Targeted support to low performing facilities to improve skills
and resources, including the provision of
respectful care
4. External validation of findings (certification)
by a team

Working standards
Clinical Care
Evidence-based safe antenatal care is provided.
Evidence-based safe care is provided during labor and childbirth.
Evidence-based safe postnatal care is provided for all mothers and the newborns.
Patients Rights
Human rights are observed and the experience of care is dignified and respectful for every
woman and newborn.
Crosscutting
A governance system is in place to support the provision of quality maternal and newborn care.
The physical environment of the health facility is safe for providing maternal and newborn care.
Qualified and competent staff are available in adequate numbers to provide safe, consistent and
quality maternal and newborn care.
Essential drugs, supplies and functional equipment and diagnostic services are consistently
available for maternal and newborn care.
Health information systems are in place to manage patient clinical records and service data.
Services are available to ensure continuity of care for all pregnant women, mothers and
newborns.

Next Steps
Three EMEN fore-runner countries
National support focusing on institutionalization
of EMEN QI framework
Sub-national level efforts to develop the national
EMEN QI framework
The different country models are used to find
common principles of QI that can be replicated
globally.

Opportunities for ENAP

A Promise Renewed
RMNCAH Fund
Global Financing facility
EWEC Strategy 2.0
Sustainable Development Goals

Thank you