Assessment of WHO and UNICEF’s EVERY NEWBORN: An Action Plan To End Preventable Deaths
The United Nation’s Every Woman Every Child movement has expanded their “Committing to Child Survival: A Promise Renewed” Call to Action to target the most critical and impactful period of a child’s life: the neonatal period.
The neonatal period refers to the first 28 days of a newborn’s life, a period in which 44% of under-5 deaths occur. During this time babies and mothers experience a great deal of change, leaving both vulnerable to illness and death. According to the “Every Newborn: An Action Plan To End Preventable Deaths” (ENAP) report 80% of neonatal deaths can be attributed to infection, intrapartum (delivery) complications, and prematurity.
From this, ENAP was enacted with two main goals: to end preventable newborn deaths and to end preventable still births globally by 2035.
Global highs for neonatal mortality hover around 40-50 deaths per 1000 live births (4-5%). Africa contains the the highest concentration of countries with high neonatal death rates. By comparison, most industrialized nations range from 1-3 neonatal deaths per 1000 live births (.1-.3%).
The plan recognizes the vast array of sociopolitical and cultural differences between nations and therefore focuses its plan strictly on health-based interventions. Many of the proposed actions can be related back to the idea of delivering certified, quality care. Indeed, one of the greatest differences observed between countries with low mortality rates and those with high is the implementation of practices that are customary in industrialized nations but are not yet widespread in other countries. For example, basic sanitation measures, exclusive breastfeeding and kangaroo-care are three low-cost, high-impact practices that are capable of saving thousands of infant lives.
ENAP provided readers with a hearty helping of statistics, clarifying and quantifying the neonatal problem and its importance.
ENAP lists 5 “strategic objectives” to end neonatal mortality and stillbirths by 2035. Our 2013 Children’s Prize winner, Dr. Anita Zaidi, tackles these 5 strategic objectives using evidence-based, impactful practices.
- Strengthen and invest in care during labour, birth and the first day and week of life
- In her plan, Dr. Zaidi will ensure training of 5 new community midwives, as well as the use of community health workers (CHWs) to promote exclusive breast-feeding, clean cord care, recognition of danger signs of illness, water and sanitation advice plus soap, and links to local immunization services.
- Improve the quality of maternal and newborn care
- In Karachi, Pakistan, women will have the opportunity to give birth at a USAID upgraded maternity hospital, have an increased number of well-educated health workers available to them, as well as receive immunizations and nutritional supplements as part of Dr. Zaidi’s 5-step program.
- Reach every woman and newborn to reduce inequities
- Pakistani CHWs will serve as liasions between hospitals and rural Karachi communities and will make routine home visits. Women will receive a Rs. 2000 ($20) cash transfer to help with hospital costs as well as well as complimentary emergency obstetric transport.
- Harness the power of parents, families and communities
- As part of Dr. Zaidi’s plan, CHWs will identify pregnant women in their communities, and make ante- and post- natal in-house visits. The 5 newly trained midwives will be put in contact with local businesses and families to increase awareness and extend their network.
- Count every newborn through measurement, programme-tracking and accountability
- Dr. Zaidi and CHWs will encourage pregnant women to register with the USAID hospital in order to ensure continuous monitoring of the mother and her baby once delivered.