A roadmap for change in countries…
A platform for harmonized action by all partners…
Sets out a clear vision with mortality goals, strategic objectives, innovative actions within the continuum of care
Supported by new evidence
Inputs from more than 2,000 individuals
A movement for greater action and accountability…
The Every Newborn Action Plan: building a movement
Photo credit: Save the Children
Why Every Newborn?
• Huge burden, yet huge potential for rapid change with high impact, feasible interventions
• Country demand for guidance and action to accelerate progress towards MDGs 4 and 5, universal health coverage, and towards ending preventable deaths among women and children
• For greater effectiveness we must accelerate and harmonize global response and link to existing initiatives for reproductive, maternal, child and adolescent health care.
More than 3 million babies and women could be saved each year through investing in quality care
around the time of birth.
Photo credit: Save the Children
Source: Adapted from 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 2012 www.childinfo.org , UN MMR estimates 2012* Maternal mortality ratio annual rate reduction 190-2010
We’ve made significant progress toward MDGs 4 & 5, but newborn survival is lagging behind
Average annual rate reduction 1990-2012
Maternal mortality ratio* 4.2%
Children aged 1- 59 months 3.4%
Neonatal mortality (newborn, first 4 weeks after birth)
2.1%
Stillbirths (last 3 months of pregnancy)
1.0%(1995-2009)
At least 40% slower for newborn survival and
slower still for stillbirths
4
Causes of under five deaths 44% are from neonatal causes
Data source: Cause of death - WHO. Global Health Observatory http://www.who.int/gho/child_health/en/index.html); Child deaths - UN Inter-agency Group for Child Mortality Estimates. Levels and Trends in Child Mortality. Report 2013; Stillbirths - Lawn et al The Lancet stillbirth series 2011. 377 (9775) p1448 – 1463
5
3 main killers to address:
1. Preterm birth
2. Birth complications
3. Neonatal infections
Two-thirds of neonatal deaths are preventable
We have the knowledge and tools to reduce the main causes of death
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
There are proven interventions within RMNCH continuum of care
Source: Adapted from The Lancet Every Newborn Series
Source: Special analysis detailed in The Lancet Every Newborn Series - forthcomingThe lives of more than 3 million babies and women could be saved each year with high coverage of quality care around birth and care for small and sick babies
Care around birth gives a triple return on investments by reducing maternal and newborn deaths and stillbirths
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
NEW NEONATAL MORTALITY GOALUnless we greatly accelerate newborn survival efforts, goal to end
preventable child deaths by 2035 unreachable
Source: Special analysis detailed in The Lancet Every Newborn Series based on country and official online consultations and using neonatal mortality rate data from the UN Inter-agency Group for Child Mortality Estimation 2013 .
NEW goal for stillbirths
Source: Special analysis detailed in The Lancet Every Newborn Series based on country and official online consultations and using stillbirth rate data from The Lancet Stillbirth Series (Cousens S et al Lncet 2011)
Lancet GH Sept 2013 : The Lancet Global Health 2013; 1:e176-e177 (DOI:10.1016/S2214-109X(13)70059-7)
Maternal mortality goal in process and will need to be linked with action
What to do differently?Every Newborn’s guiding principles
Country leadershipGood governance, community
participation, partner alignment
IntegrationIntegrated service delivery, continuum
of care, programme coordination
EquityUniversal coverage, closing the equity
gap
Human rightsPrinciples, standards
InnovationInterventions, delivery approaches,
technologies
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
What we aim to achieve?End preventable maternal, newborn and child
deaths and stillbirthsStillbirths and newborn deaths are not inevitable Women and babies deserve access to quality care
around the time of birth
Each year save the lives of 3 million newborns, stillbirths and women
1. Include newborn and stillbirth in post-2015 framework along with maternal and child health
2. Attention and funding to newborns and stillbirths within the context of and linking to the RMNCH continuum
3. Sharpen national plans and improve demand and delivery of care at the time of birth in countries
4. Improve the quality of care for mothers and newborns by implementing high-impact interventions , including through a “Mother-Baby Friendly” Initiative
5. More trained and equipped health workers6. Improve programmatic and impact data and use
this for action in countries
Long term
In sight
NOW
Health Sector Strategic & Investment Plan
Integrated National RMNCH Plan
Increasing access and use of FP
Ending preventable
newborn deaths
Ending preventable deaths from pneumonia and
diarrhoea (GAPPD)
Ending preventable
maternal deaths
Every Newborn prioritizes focus on birth within existing national strategies and plans; not a new stand alone plan
How will we track progress?Every Newborn milestones
Every Newborn sets out concrete and
measurable global and national level
milestones from now to 2020, coverage
targets to 2025 and mortality goals to
2035
How will we track progress?Every Newborn indicators
A clear monitoring plan is
an important milestone. ENAP proposes a core set of indicators
and maternal/newborn service delivery
packages
• Progress is possible – targets getting traction Neonatal survival unfinished agenda, stillbirths still missing,
but count for families Synergies of newborn survival with demographic transition Country consultations and ownership over 1 yr process
• Programmatic focus is clear and evidence-based Time around birth, triple return on investment Priority attention to small babies to reduce deaths, disability
and risk of non communicable diseases (NCDs) Urgent improvements for programmatic coverage data
• Partnerships and alliances UN leadership Maternal alliances especially re service delivery eg “Mother-
Baby friendly package” Civil society advocacy to change social norms
Potential for major change in countries
Movement with a planWho has been involved?
Every Newborn consultation process
Alliance: 50+ global partners on Advisory group; Steering team and management group (led by WHO & UNICF) ENAP presented and discussed at many global meetings in
2013 including Women Deliver, AU MNCH, IPA, and NYC mtg
Countries: 17 country consultations between April-September 2013 2 regional workshops Completed bottleneck analyses conducted in 10 countries
Official WHO consultation: More than 300 official comments including +40 member states,
professional associations, academics, NGOs, individuals WHO executive board and on main agenda at WHA
AU MNCH conference
April 2013 – June 2014 National and regional consultation and technical
inputs to the development of the plan
20-25 January 2014 Discussed at the WHO Executive Board
February 2014 Open consultation on draft Every Newborn by
stakeholders and inputs incorporated into final draft
May 2014 Lancet series (update from 2005 and giving the
analyses which are the basis for the Every Newborn)
Draft plan presented to the 67th World Health Assembly
June 2014 Action Plan launched at PMNCH Partners’ Forum,
Johannesburg
Every Newborn Process
Photo credit: Save the Children
We are building a movement…
BE PART OF THE ACTION
For more informationvisit www.everynewborn.org
#EveryNewborn
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