Reaching Newborns After Delivery: Lessons from Ethiopia Community-based Newborn Care Program

Session: Postnatal Care: Reaching Newborn Infants and Mothers with Preventative and Curative Care

Presenter: Lisanu Taddesse, Ministry of Health, Ethiopia
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Background: Ethiopia is the second most populous country in Africa with a population of 90.1 million.  The country achieved many MDG targets for health through institutionalization of Ethiopia’s innovative flagship Health Extension Program (HEP).  The following statistics reflect the national situation in Ethiopia:  Access to health services is >92%; under-five mortality and neonatal mortality are 64 and 28 per 1000 live births respectively; ANC1 coverage 98.1%; skill birth attendance 41%; and PNC coverage 66%. To accelerate reduction in newborn mortality and contribute to the post-MDG goals, a nine-pronged community based newborn care package (CBNC) was launched in March 2013 using the four C’s approach – contact, capture, care and completion.

Methodology:  A review of CBNC program was conducted from March 2013 to December 2014 to assess the status of implementation.   Data reviewed included results of rapid assessment, routine program data, program reports and information from the quarter performance reviews.

Results:  CBNC package was scaled up including sepsis management. Primary Health Care Unit capacity was strengthened to provide quality maternal, newborn and child health in catchment health posts. Skilled delivery, postnatal care and follow-up have significantly improved in the 7 zones. Contributing factors for increased uptake are: increased care seeking through community mobilization/sensitization using the Health Development Army; policy change for hospital stay for 24 hours post-partum; allowing birth companion and cultural ceremonies at health facilities; emergency transport/referral systems; maternity waiting homes; BeMONC, CeMONC and helping babies’ breath (HBB) strategy expansion; and cost exemption of maternal and newborn health services. Barriers identified include:  cultural belief and practice, late identification of pregnancy and lack of awareness of newborn care practices.

Conclusion:   Continued improvement of the implementation of the CBNC package using the identified facilitators of intervention uptake and addressing barriers will contribute significantly Ethiopia achieving its goal of reducing newborn mortality and morbidity.