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Thinking Locally and Acting Globally to End Preventable Newborn Deaths_Joy Riggs-Perla_5.8.14


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Thinking Locally and Acting Globally to End Preventable Newborn Deaths_Joy Riggs-Perla_5.8.14

  1. 1. CORE Group Global Health Practitioner Conference May 8, 2014 Joy Riggs-Perla, Director, Saving Newborn Lives Program #EveryNewborn
  2. 2. Presentation Topics • What is ENAP and what are we trying to achieve? • ENAP targets for newborns, stillbirths and maternal mortality • Content of Action Plan • Process moving forward • Civil society contribution
  3. 3. A roadmap for change in countries… A platform for harmonized action by all partners…  Sets out a clear vision with mortality targets, strategic objectives, innovative actions within the continuum of care  Supported by new evidence to be published in The Lancet in May 2014  Plan to be launched at Partner’s Forum end of June 2014  A movement for greater action and accountability… The Every Newborn Action Plan: building a movement Photo credit: Save the Children
  4. 4. The vision for Every Newborn Action Plan A world in which there are no preventable deaths of newborns or stillbirths, where every pregnancy is wanted, every birth celebrated, and women, babies and children survive, thrive and reach their full potential. Vision statement in draft ENAP, March 2014
  5. 5. What are we aiming for? End preventable newborn deaths and stillbirths as well as maternal and child deaths Stillbirths and newborn deaths are not inevitable Women and babies deserve quality care around birth and small and sick newborns need special care Each year save the lives of 3 million newborns, stillbirths and women 1. Include newborns and stillbirths in post-2015 framework along with maternal & child health 2. Attention and funding for newborns and stillbirths within the RMNCH continuum 3. Sharpen national plans and improve demand and delivery of care at the time of birth 4. Develop and implement “Mother-Baby Friendly” package 5. Improve programmatic and impact data and use this for action in countries Long term Medium term NOW
  6. 6. 0 10 20 30 40 50 60 70 80 90 100 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 Mortalityrate(per1,000livebirths) 2000-2012 AAR = 2.7% 2000-2012 AAR = 3.8% Global U5MR Global NMR A Promise Renewed target: National U5MR of 20 or less [Global U5MR of 15] Current trends continue: U5MR AAR = 4.3% Target for ending preventable newborn deaths Current trends continue: NMR Scenario 2035 global neonatal mortality rate 2035 neonatal deaths If current trends are unchanged 13 1.8 million Every country to NMR <10 per 1000 7 0.9 million Similar to 2/3 reduction in NMR as if a continuation of MDG4 ENAP Neonatal Mortality target: National NMR of 10 or less [Global NMR of 7]
  7. 7. 0 5 10 15 20 25 1995 2000 2005 2010 2015 2020 2025 2030 2035 Globalaveragestillbirthrate (per1,000totalbirths) 2000-2009 ARR = 1.3% ARR required = 3.5% Scenario 2035 global stillbirth rate 2035 stillbirths If current trends are unchanged 15.9 2.2 million Every country reaches SBR of 10 per 1000 8.0 1.1 million Also similar to ≥2/3 reduction in stillbirth rate for every country With same time trends SBR Every Newborn target: for stillbirths National stillbirth rate of 10 or less [Global SBR of 8] Consistent with neonatal and under5 mortality targets Target for Stillbirths Country consultations requested a specific stillbirth target
  8. 8. Lancet GH Sept 2013 : The Lancet Global Health 2013; 1:e176-e177 (DOI:10.1016/S2214-109X(13)70059-7) Maternal mortality target in process of being set, coordinated by WHO and others Hope to include a target for MMR
  9. 9. Family/communityOutreach/out patient Clinical antenatal care postnatal care early postnatal home visits for mother and newborn cleaner, safer birth adolescent health at home and school child health care obstetric and childbirth care including essential newborn care emergency newborn care reproductive health care reproductive health care intersectoral Improved living and working conditions including housing, water and sanitation, and nutrition Education and empowerment emergency child care ongoing care for the child at home pregnancy home visits What to focus on? Packages within RMNCH continuum of care ChildhoodNewborn/postnatalBirthPregnancyPre-pregnancy Birth
  10. 10. What to focus on? Prevention & care for main causes of neonatal deaths (3 by 2) Preterm birth • Preterm labor management including antenatal corticosteroids* • Care including Kangaroo mother care, essential newborn care Birth complications (and intrapartum stillbirths) • Prevention with obstetric care * • Essential newborn care, and resuscitation* Neonatal infections • Prevention, essential newborn care especially breastfeeding, Chlorhexidine where appropriate* • Case management of neonatal sepsis * 1 2 * Prioritised by the UN Commission on Life Saving Commodities for Women and Children Over two-thirds of newborn deaths preventable – actionable now without intensive care 3
  11. 11. What to do differently? Every Newborn’s Five strategic objectives 1. Strengthen and invest in care during labour, birth and the first day and week of life 2. Improve the quality of maternal and newborn care 3. Reach every woman and every newborn; reduce inequities 4. Harness the power of parents, families and communities 5. Count every newborn – measurement, tracking and accountability
  12. 12. Every Newborn’s guiding principles Country leadership Good governance, community participation, partner alignment Integration Integrated service delivery, continuum of care, programme coordination Equity Universal coverage, closing the equity gap Human rights Principles, standards Accountability Transparency, oversig ht Innovation Interventions, delivery approaches, technologies
  13. 13. Health Sector Strategic & Investment Plan Integrated National RMNCH Plan Increasing access and use of Family Planning Ending preventable newborn deaths Ending preventable deaths from pneumonia and diarrhoea (GAPPD) Ending preventable maternal deaths Sharpen focus within existing national RMNCH and health strategies and plans; not a new stand alone plan
  14. 14. UMBRELLA MESSAGE In next decade, 3 million babies and women saved every year with quality care at birth Every Newborn main events 2014 February NovemberJune September LAUNCH! May Every Newborn 2014 UNGA ICM Problem identification Burden of problem Progress for newborns has fallen behind Lives saved and investment case Cost-effective and feasible solutions available Lives saved and cost Triple return on investment Post-2015 action for newborn & stillbirths Actions by all at country and global level Parent and civil society voice * Developing detailed matrix of events for more details WHA SOWM Countdown
  15. 15. Unique Civil Society Contribution • Household Level Essential Newborn Care: Drying, wrapping, delayed bathing, clean cord care including CHX, immediate/exclusive breastfeeding. • Demand and Care Seeking: Preventive care around birth, sustained demand for services and timely care seeking for mothers and newborns • Community leadership and accountability: Solve practical problems, hold health providers accountable to providing quality services, strengthen links between community and facilities, promote incentives for community health workers.
  16. 16. Unique Civil Society Contribution • Champions: Develop local champions, including parliamentarians, parent groups, professionals, community health volunteers and community leaders; engage and link champions for RMNCH+A • Adolescents: Give special attention to adolescent girls; help prevent early and unwanted pregnancies • Quality and accountability: Be a voice for change. Demand quality, affordable, accessible services. Report poor services. Change social norms regarding preventable maternal and newborn death.