CORE Group Fall Meeting 2010. WHO/UNICEF - Joint Statement Service Delivery & Program Implications, - Winnie Mwebesa & Stella Abwao, Save the Children.

1. WHO/UNICEF - Joint Statement Service Delivery & Program Implications Dr. Winnie Mwebesa Dr. Stella Abwao CORE Group Fall Meeting September 14-15, 2010

3. Rationale 1: Neonatal deaths & MDG 4 Almost 40% of under 5 deaths are neonatal – 4 million a year MDG4 can be achieved if neonatal deaths are reduced Source: Lawn JE et al Lancet 2005 0 50 100 150 Mortality per 1000 births (global av) 1960 1980 2000 2020 Year Under-5 mortality rate Late neonatal mortality Early neonatal mortality Target for MDG-4

4. Rationale 2: When do newborn deaths occur? Up to 50% of neonatal deaths are in the first 24 hours 75% of neonatal deaths are in the first week – 3 million deaths Source: Lawn JE et al Lancet 2005, Based on analysis of 47 DHS datasets (1995-2003), 10,048 neonatal deaths)

6. Direct causes of 3.72 million neonatal deaths - almost all are due to preventable conditions Source: Lawn JE, Cousens SN, Zupan J Lancet 2005. 60 to 90% of neonatal deaths are in low birth weight babies, mostly preterm Rationale 4: What causes newborn deaths?

7. Evidence of Home Visits for Newborn Care

15. Saving Newborn Lives: Home Visits Within National Delivery Platforms Bangladesh GoB and BRAC community health workers ANCC, PNC visits Pakistan GoP Lady Health Workers CM, ANCC, PNC; attendance home births (resus, LBW extra care, identify infection and begin antibiotics Nepal National Neonatal Health Strategy Female community health volunteers (FCHV) Indonesia GoI Community Midwives ( Bidan di desa ) Bidan di desas (community midwives) Malawi MOH policy; OR demonstrating “how” Health Surveillance Assistants Ethiopia National MOH standards Health Extension Workers LAC Regional Neonatal Health Strategy; OR demonstrating “how” Various cadres (CHWs, ANMs )

18. Causes of neonatal death (estimated for 2005) Source : Lawn JE et al. 2006 MALAWI: Three causes account for ~84% of neonatal deaths in Malawi

19. Coverage of key packages along the continuum of care Source: MICS 2006 Gap in coverage between poorest and least poor MALAWI:

33. Thank you!