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Global Newborn Action Plan_Lily Kak_4.26.13


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Global Newborn Action Plan_Lily Kak_4.26.13

  1. 1. CORE SpringMeeting25th April 2013Lily Kak on behalf of the GNAPteamLily Kak, USAID (on behalf of the GNAP team)Core Spring MeetingApril 26, 2013
  2. 2. What is the Global Newborn Action Plan?• Global plan for country action linked to Every WomanEvery Child, and to A Promise Renewed• Global partnership with multiple organizationsincluding:– Country governments– United Nations– NGOs– Universities and Professional organizations– Donors and foundations2Timeline• Global consultation (started in Johannesburg): April – October 2013• Launch of plan: November 2013:
  3. 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 , UN MMR estimates 2012Global progress for reducing maternal, newborn andchild deaths has accelerated with the MDGsAverage ratereduction1990-2010Maternal mortality ratio 4.2%Mortality for children 1- 59months2.5%Neonatal mortality (<1 month) 1.8%3
  4. 4. 01020304050607080901001990 1995 2000 2005 2010 2015 2020 2025 2030 2035U5M current trajectory: ARR 2.5%• MDG 4 achieved in 2035• 4 million deaths annually in 2035U5M ARR 5.2%• 2 million deaths by 2035• Every country reaches20/1000 Many countriesbelow 15/1000MDG 46 m deaths in 2011The trajectory of newborn deaths is flat compared tounder-five trajectory and goal of 20/1000 by 2035Source: UNICEF State of the World’s Children 2012; The UN Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report2011, 2011; Team analysis from 2035 onward based on straight-line ARR reduction from UNICEF numbers 1990-2035NMR current trajectoryof ARR 2.2%4Mortality rate (per1,000 live births)9.6 mm deathsin 2000
  5. 5. 051015202530351990 1995 2000 2005 2010 2015 2020 2025 2030 2035Neonatalmortalityrate(per1,000livebirths)YearNMR target of 10 by 2035ARR: 3.2%NMR target of 5 by 2035ARR: 6.0%Current trajectoryNMR in 2035: 13ARR: 2.2%We need to bend the curve to end preventable neonatal deaths by 2035What is plausible? NMR = 5 or 7 or 9 or 10?
  6. 6. BOTSWANAC.A.R.DRCERITREAETHIOPIAMADAG.MALAWIRWANDASENEGALSOMALIAS. AFRICASWAZI.TANZ.ZIMBABWEBANGLADESHBHUT.INDIANEPALPAKISTANEGYPTIRANIRAQMOROC.BOLIV.BRAZILMEXICOP.N.G.CAMBODIAINDONESIACHINADPRKLAOSPHILIPPINES VIET NAMAZERB.KYRGYZTURKUZBEKISTAN-2-101234567-1 0 1 2 3 4 5 6 7RequiredAnnualReductioninNMRtoReach10by2035Observed Annual Reduction in NMR (2011)SubSaharan AfricaSouthern AsiaMidEast/ North AfricaLACEast Asia/ PacificCentral & E.Europe/ Ind.StatesLIBERIA*Bubble size = # newborn deaths 2011Many countries need to dramatically accelerate progress to achieve 10 by 35, many others willnot be challenged by it (you’re on track if you’re on or below the line)
  7. 7. Bending the curve:looking back, looking forwardLooking back: period of learning• 2005: Newborn Lancet series• January 2011: World Health Assembly Resolution• June 2012: Child Survival Call to Action/A PromiseRenewed• April 2013: Global Newborn ConferenceLooking forward: poised for scale and impact• Nov 2013: Global Newborn Action Plan Launch• National rollout of newborn programs
  8. 8. 83 reasons why thepast does not have tobe our future fornewborn survival….1. We know the causes2. We have high impactinterventions that integratewithin health systems3. We know it can be done assome low income countriesare succeedingLooking forward:poised for scale and impact123
  9. 9. 43%We now know why newborns dieSource: Liu et al. 2012. Global, regional and national causes of child mortality in 2000-2010:. The Lancet. DOI:10.1016/SO140-60560-1.3 million9Global causes of child deaths for 2010717,200713,0001,077,800PretermcomplicationsIntrapartumeventsNeonatalinfectionNewborn deathsinvisible in globalestimates until 2005– now visible
  10. 10. We can reduce the main causes of deathNewborn Survival Solutions – 3 by 2, Plus 1Preterm birth1. Preterm labor management including antenatal corticosteroids*2. Care including Kangaroo mother care, essential newborn careBirth complications (and intrapartum stillbirths)1. Prevention with obstetric care *2. Care - essential newborn care, resuscitation*Neonatal infections1. Prevention, essential care, breastfeeding, Chlorhexidine *2. Case management of neonatal sepsis *Keep healthy newborns healthy1. Essential newborn care123* Prioritized by the UN Commission on Life Saving Commodities for Women and ChildrenOver two-thirds of newborn deaths preventable –actionable now without intensive carePlus 1
  11. 11. MDG 4 MDG 5 Neonatal mortality rateAnnual Rate of Reduction:2000-2010Rwanda  Progressing 6.2%Bangladesh   4.0%Nepal   3.6%Malawi  Progressing 3.5%Some countries are “bending the curve”for newborn survivalSource: Newborn survival decade of change analysis: Health Policy and Planning. 27(Suppl. 3) papers 3 to 7
  12. 12. GNAP emerging themes1. Happy Birth Day! Focus on care around birth, saving women andstillbirths as well as newborns2. Mother and baby belong together, and it is critical formidwives and caregivers to be empowered to care for baby as well asmother3. Highly cost-effective interventions work for the 3 maincauses of newborn death and can be scaled up - some countries havehalved newborn deaths in 20 yrs4. Quality of care matters and saves lives and reduces disability5. Stronger health systems are crucial and saving newborn babies isthe most sensitive marker of a health system that works6. Families and communities are key to mobilise change fortheir newborns
  13. 13. Ending preventable newborn deaths:GNAP Strategic Approaches1. Leadership and politicalcommitment: country andglobal2. Focus on high impactinterventions3. Move towards universalcoverage of essential maternaland newborn care4. Address the gap in quality ofcare5. Create a supportiveenvironment6. Ensure mutual accountability
  14. 14. Challenge:What game-changing action can you take?Three actions:1. Increase birth notification2. Increase home-based postnatal care coverage3. Change social norms about newborn deathPvt. company NGOPartnership for Three Actions
  15. 15. #Newborn2013 #GlobalNewbornAction