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Global Newborn Action Plan_Lily Kak_4.26.13
1. CORE Spring
Meeting
25th April 2013
Lily Kak on behalf of the GNAP
team
Lily Kak, USAID (on behalf of the GNAP team)
Core Spring Meeting
April 26, 2013
2. What is the Global Newborn Action Plan?
• Global plan for country action linked to Every Woman
Every Child, and to A Promise Renewed
• Global partnership with multiple organizations
including:
– Country governments
– United Nations
– NGOs
– Universities and Professional organizations
– Donors and foundations
2
Timeline
• Global consultation (started in Johannesburg): April – October 2013
• Launch of plan: November 2013:
3. Source: Lawn J,E. et al. 2012. Newborn survival: a multi-country analysis of a decade of change. Health Policy and Planning.
27(Suppl. 3): iii6-ii28. Data sources: UNICEF 2011 www.childinfo.org , UN MMR estimates 2012
Global progress for reducing maternal, newborn and
child deaths has accelerated with the MDGs
Average rate
reduction
1990-2010
Maternal mortality ratio 4.2%
Mortality for children 1- 59
months
2.5%
Neonatal mortality (<1 month) 1.8%
3
4. 0
10
20
30
40
50
60
70
80
90
100
1990 1995 2000 2005 2010 2015 2020 2025 2030 2035
U5M current trajectory: ARR 2.5%
• MDG 4 achieved in 2035
• 4 million deaths annually in 2035
U5M ARR 5.2%
• 2 million deaths by 2035
• Every country reaches
20/1000 Many countries
below 15/1000
MDG 4
6 m deaths in 2011
The trajectory of newborn deaths is flat compared to
under-five trajectory and goal of 20/1000 by 2035
Source: UNICEF State of the World’s Children 2012; The UN Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report
2011, 2011; Team analysis from 2035 onward based on straight-line ARR reduction from UNICEF numbers 1990-2035
NMR current trajectory
of ARR 2.2%
4
Mortality rate (per
1,000 live births)
9.6 mm deaths
in 2000
5. 0
5
10
15
20
25
30
35
1990 1995 2000 2005 2010 2015 2020 2025 2030 2035
Neonatalmortalityrate(per1,000livebirths)
Year
NMR target of 10 by 2035
ARR: 3.2%
NMR target of 5 by 2035
ARR: 6.0%
Current trajectory
NMR in 2035: 13
ARR: 2.2%
We need to bend the curve to end preventable neonatal deaths by 2035
What is plausible? NMR = 5 or 7 or 9 or 10?
7. Bending the curve:
looking back, looking forward
Looking back: period of learning
• 2005: Newborn Lancet series
• January 2011: World Health Assembly Resolution
• June 2012: Child Survival Call to Action/A Promise
Renewed
• April 2013: Global Newborn Conference
Looking forward: poised for scale and impact
• Nov 2013: Global Newborn Action Plan Launch
• National rollout of newborn programs
8. 8
3 reasons why the
past does not have to
be our future for
newborn survival….
1. We know the causes
2. We have high impact
interventions that integrate
within health systems
3. We know it can be done as
some low income countries
are succeeding
Looking forward:
poised for scale and impact
1
2
3
9. 43%
We now know why newborns die
Source: Liu et al. 2012. Global, regional and national causes of child mortality in 2000-2010:. The Lancet. DOI:10.1016/SO140-60560-1.
3 million
9
Global causes of child deaths for 2010
717,200
713,000
1,077,800
Preterm
complications
Intrapartum
events
Neonatal
infection
Newborn deaths
invisible in global
estimates until 2005
– now visible
10. We can reduce the main causes of death
Newborn Survival Solutions – 3 by 2, Plus 1
Preterm birth
1. Preterm labor management including antenatal corticosteroids*
2. Care including Kangaroo mother care, essential newborn care
Birth complications (and intrapartum stillbirths)
1. Prevention with obstetric care *
2. Care - essential newborn care, resuscitation*
Neonatal infections
1. Prevention, essential care, breastfeeding, Chlorhexidine *
2. Case management of neonatal sepsis *
Keep healthy newborns healthy
1. Essential newborn care
1
2
3
* Prioritized by the UN Commission on Life Saving Commodities for Women and Children
Over two-thirds of newborn deaths preventable –
actionable now without intensive care
Plus 1
11. MDG 4 MDG 5 Neonatal mortality rate
Annual Rate of Reduction:
2000-2010
Rwanda Progressing 6.2%
Bangladesh 4.0%
Nepal 3.6%
Malawi Progressing 3.5%
Some countries are “bending the curve”
for newborn survival
Source: Newborn survival decade of change analysis: Health Policy and Planning. 27(Suppl. 3) papers 3 to 7
12. GNAP emerging themes
1. Happy Birth Day! Focus on care around birth, saving women and
stillbirths as well as newborns
2. Mother and baby belong together, and it is critical for
midwives and caregivers to be empowered to care for baby as well as
mother
3. Highly cost-effective interventions work for the 3 main
causes of newborn death and can be scaled up - some countries have
halved newborn deaths in 20 yrs
4. Quality of care matters and saves lives and reduces disability
5. Stronger health systems are crucial and saving newborn babies is
the most sensitive marker of a health system that works
6. Families and communities are key to mobilise change for
their newborns
13. Ending preventable newborn deaths:
GNAP Strategic Approaches
1. Leadership and political
commitment: country and
global
2. Focus on high impact
interventions
3. Move towards universal
coverage of essential maternal
and newborn care
4. Address the gap in quality of
care
5. Create a supportive
environment
6. Ensure mutual accountability
14. Challenge:
What game-changing action can you take?
Three actions:
1. Increase birth notification
2. Increase home-based postnatal care coverage
3. Change social norms about newborn death
Pvt. company NGO
Partnership for Three Actions
