Prevention of Pre-term Birth_10.16.13


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Prevention of Pre-term Birth_10.16.13

  1. 1. CORE GROUP FALL MEETING 2013 Prevention of Pre-term Birth Community Approaches to Underutilized and Evidence-based Interventions Carolyn Kruger, Ph.D. Sr. Advisor MNCH, PCI
  2. 2. Evidence-based PTB/LBW Interventions Use of antenatal corticosteroids (ACS) for pre-term birth Use of appropriate drug regimens for premature rupture of membranes and infectious diseases (STIs, malaria, newborn infections) Resuscitation methods to help babies breathe Kangaroo Mother Care for LBW babies Chorhexidine – cord care
  3. 3. Additional Interventions Evidence-based –applied at community level Comprehensive Antenatal Care – early and regular visits Maternal nutrition and weight gain Birth preparation and early recognition of complications Clean/Skilled care delivery Essential newborn care Home-based Life Saving Skills and HBB © 2011 Save the Children. All Rights Reserved
  4. 4. Interventions Applied at Community Level Prevention of infection – especially for PTB Domestic violence- global violence- stress Mental Health- assessment of depression Pregnancy spacing and family planning
  5. 5. Community Strategies: Newborn  Utilize existing platforms ( vulnerable groups, HIV, MCH maternal and newborn, child health) and integrate PTB evidencedbased interventions  Strengthen access, quality and equity of health services through community advocacy- tracking vulnerable groups  Build capacity of health services in emergency care, Helping Babies to Breathe and PTB
  6. 6. Community Strategies: Newborn/PPTB Ensure Essential Commodities- advocacy by community health committees Build community leadership (tribal, religious, community/civil committees) and capacity to prevent PTBs Overcome bottlenecks ( distance, referral systems, poverty)
  7. 7. Promising Practices Mother/Father Care Groups and home visits to promote early ANC, birth preparation, recognition of complications and skilled care delivery © UNICEF/NYHQ20102330/ Olivier Asselin, Mali, 2010 Bangladesh “Trio” Care Groups-Mother, Father and Grandmother influence behavior change -Fathers commit to providing food for malnourished mothers and children -Grandmothers commit to caretaking children so that mother can “rest”
  8. 8. Trio Care Groups PROSHAR TRIO CARE GROUP APPROACH Each supervisor oversees approximately three paid promoters Each paid promoter oversees approximately 10 Care Group Trios (4 supervisors total) Each Care Group Trio consists of 12 leaders each. Mother CGs meet monthly. Grandmothers & Father CGs will meet every three months with the mother CGs. (12 promoters total) Promoter Supervisor (162 Care Group Trios total) Grand mothers Mothers Fathers Promoter Promoter Each leader will meet with approximately 14 peers regularly (monthly/mothers & quarterly/fathers & grandmothers) reaching 81,648 HH decision-makers
  9. 9. Trios Care Groups BEHAVIOR CHANGE TRENDS 100 88.7 90 80 73 70 56 60 50 40 30 31.4 53 38.2 32.3 34.6 40.9 29.2 20 10 0 Exclusive Breast Early Initiation Feeding of BF Baseline 3+ ANC Visits Post Partum Vit- 3 Correct IYCF A Behaviors Sept 2012 Results
  10. 10. Promising Practices  Adolescent and mother-friendly reproductive health services- youth corners and teaching centers  School and community advocacy for prevention of early marriage and pregnancy- PTAs, teacher training, youth groups  Community referral/ transportation systems- community planned and owned  Respectful maternity care- cultural sensitivity, equity support  Economic and social empowerment groups- mothers group that include a micro-credit component that increased their sense of decision-making and household resources; WE groups – Women’s Empowerment groups  Feeding support- extra support for PTB
  11. 11. Promising Practices Kangaroo Mother Care – health facility and community outreach Maternal Waiting Homes for high-risk pregnant women Social shifting to prevent early marriage Promotion of girls’ and women’s education Community Health Committees that advocate for essential commodities at primary health clinics
  12. 12. Overcome Bottlenecks Formative research- Barrier Analysis/doer-non-doer Promote culture of respectful and equitable care Knowledge sharing among community leaders – champions Inter-family dialogues Utilize community leaders to advocate for improved care Community ownership of the problem and solution Photo property of CARE, Nov 2011
  13. 13. DISCUSSION Are you integrating prevention of PTBs? If so, HOW? What is working? And if so WHY? What are the barriers to integration? What are the facilitating factors to integration? Community ownership- ideas? Are you aware of Newborn/PTB opportunities and resources to share? Have you visited your representative lately?