NEWBORN 2013: GLOBAL NEWBORN HEALTH CONFERENCE

Session: Synthesis of Successful Models for Behavior Change

Part I: CORE Group Newborn Health Survey Results Part II: Around the World Marketplace

Part I:

CORE Group

Newborn Health Survey Results

C A R O LY N K R U G E R , P h . D .
SR. ADVISOR MNCH PCI

CORE GROUP CO-CHAIR: SAFE MOTHERHOOD & REPRODUCTIVE HEALTH WORKING GROUP

USAID PRIORITY COUNTRIES: SUPPORTING NEWBORN CARE

Belize Dominican Republic Guatemala Mexico Nicaragua Colombia Ecuador Peru

Ethiopia Kenya Senegal South Sudan Mali India

NEWBORN HEALTH AREAS SUPPORTED

(18 ORGANIZATIONS)
16 16 15 15 12 12 12 11 10 10 9 9 8 7 6 5 3 2 2 1

Number of organizations

CROSS-CUTTING APPROACHES
CHW capacity building - 100% Behavior change/communication - 78% Community mobilization - 70% Community health system strengthening - 70% Care groups - 50% mHealth approaches - 48% Mass communication - 42% C-IMCI/CCM - 38%

INNOVATIVE STRATEGIES CHW capacity to recognize danger signs Mobile job aids - counseling messages mHealth reminders on assessment of mothers and newborns Newborn screening on birth defects Preconception care

INNOVATIVE STRATEGIES (CONTINUED) Casa Materna birthing home model Community Kangaroo Mother CAre Involving fathers during pregnancy, delivery and PP care EBF among adolescent mothers using text messaging and support groups

HELPING BABIES BREATHE (HBB)

7 responded-involved in GDA: Helping Babies Breathe 15 involved in HBB Involvement includes: master and staff training, service delivery, and equipment Advocacy - 4 countries Research - 1 country

WHERE ARE THE GAPS & OPPORTUNITIES?

Husband and fathers involvement in newborn and child care Soothing a crying baby Hygiene and skin care Birth defects and perinatal impairments CCM for newborns Scale-up HBB Integrating ECD into ENC and C-IMCI

NEXT STEPS: SUPPORTING WIDER TOOL DISSEMINATION & COUNTRY LEVEL COORDINATION AND SCALE-UP

Part II:
USAID REDUCING MATERNAL AND NEWBORN MORTALITY

AROUND THE WORLD MARKETPLACE (POSTERS)

PVO/NGO Innovative Models

NGO/PVO Community Interventions

Build on Maternal, Newborn, Child Health platforms- promote behavior change at the community and household levels Focus on most vulnerable groups Local problem solving and solutions Creating community behavior change agents Strengthening community- district clinical relationships Strengthen community to health facility referral systems Community emergency transport systems; mobile phone referrals Peer support groups- Care Groups- father and grandmother Gender considerations- increase male involvement

WORLD VISION Mozambique/Afghanistan

Use of mobile phones to improve maternal and newborn health
Pregnancy, post-partum and newborn mPhone assessment

tools by CHWs Birth preparation-early recognition of danger signs and rapid referral

Key results: Increase in ANC (20%) High association between birth preparation and danger sign recognition and referral completion

FUTURE GENERATIONS Peru

Household monitoring of pregnant women, newborns and infants 0-2 years old
Organization of community committees for obstetric

and neonatal emergencies High quality training materials Empowerment of CHWs and community leadership to take action to protect health and nutrition of newborns

Key result: 21 communities established emergency committees

CURAMERICAS Guatemala
Community-owned Casa Materna maternity and birthing center Increased access to clean delivery and culturally acceptable environment with immediate available support Mothers and newborns remain 48 hours at the center to monitor maternal and newborn care /complications Established community emergency response plans Key Result: Neonatal mortality at 46 compared to surrounding communities with 66-81/1000

CHILD FUND Honduras

Community-based health units that provide MOH Outreach -integrated maternal and newborn services
Cost analysis study to determine service delivery costs and

out-of-pocket expenses Cost comparison of community TBA and health facility deliveries IMR reduced from 20-16/1,000

Key Result: 20% out-of pocket saving and $66,000 government annual savings due to disease prevention

PLAN Nepal
Chlorhexidrine (CHX) coverage and compliance study
Pregnant women group

approach better outcomes for neonates CHWs taught pregnant women application of CHX and served as primary channel for distribution

Key Results: 82% coverage rate; 66% right application; CHWs excellent point of distribution

WORLD RENEW Jharkland, India

Public/Private partnerships to improve communitybased maternal and newborn care practices Antenatal and newborn care delivery by trained ANMS and traditional providers Keeping newborns healthy household timed counseling, growth monitoring and nutrition by CHWs

Key Results: Increased skilled birth attendant by 10% and health facility indicators improved by 10-15%

PCI Guatemala
Community Kangaroo Mother Care
TBA post-partum home assessments of

mother and newborn Low birth weight assessments at delivery Immediate KMC positioning and wrapping; referral Recognition, early managment, referral of breathing difficulties and complications

Key Results: Early response and referral for LBW infants; family and community support for KMC

SAVE THE CHILDREN Zambia

Innovative teaming approach to increase health care coverage of children 0-59 months
Testing a teaming approach to cover skilled care

delivery and services for postnatal 24 hr visits Referrals for mothers, newborns and children Train neighborhood health committees to mobilize communities to support the teams

Key Results: 75% of TBA registered newborns received a 24hr PP visit and a 1/3 increase in health facility deliveries

WORLD VISION Senegal

Accelerating scale-up of newborn health interventions through community health huts A consortium of six NGOS implemented a network of community health huts (health posts) to increase access to care community health program that reached 9,000 people and 5,200 newborns CHWs made early home visits to assess newborns, provide essential newborn care and make referrals

Key Result: Infant mortality dropped by 49 points between 2005-2011

WORLD VISION South Sudan

Integrating newborn interventions into Community Case Management
OR study: Assessing the feasibility of integrating

newborn interventions into a CCM approach in a complex emergency environment Integrated CCM PLUS: Adaptation of IMCI, HBLSS and Helping Babies Breathe

Key Result: Content appropriate in training of illiterate community-based staff with no health background

NGO/PVO Contributions
Promising practices- operations research Community-based Models Behavior Change Agents

-Community emergency transport systems -Family birth preparation - Front-line worker referral/follow-up systems - Task-shifting- 24 hr PN maternal and newborn assessments -Home-based care- KMC, 24 hr assessments - Community Baby-friendly Initiatives - Mobile phone methodologies

Thank You!