Session: Programming for Maternal and Newborn Health during Emergencies: Lessons Learned from Epidemics and Conflict
Presenter: Mariella Castillo, UNICEF
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Super typhoon Haiyan resulted in disruption of health service delivery and infrastructure in 2013. The rapid re-establishment of essential services for mothers and children became a priority as part of the rebuilding strategy in the most devastated towns. Using a UNICEF Tool, rapid assessments of equipment and supplies, intra-partum service standards and providers skills were conducted in 59 facilities in Regions 6, 7 and 8. The assessments were followed by a training of local trainers, cascade training, evaluation and supervision visits after one month and three months. Equipping local health workers with skills on Essential Intrapartum and Newborn Care (EINC) and quality improvement was central to the approach. Rapid assessments showed lack of essential MNH commodities such as bag and mask for newborns and antenatal corticosteroids. Oxytocin was available, but magnesium sulfate was available only in 38% of facilities in Region 8, the most devastated region. Towels for drying the baby were available in less than 25% of facilities across all regions. Providers had low skills in partograph use, administering antenatal corticosteroids, and early initiation of breastfeeding. After the intervention, the availability of antenatal corticosteroids in Region 8 facilities increased from 45% to 100%, magnesium sulfate from 38% to 94%, and bag and masks from 0% to 88%-100% and were sustained at the 3-month evaluation. Capacity and quality in EINC was increased in 365 frontline workers. Improvements in service standards, such as partograph use, controlling delivery room temperature and completion of delivery records were seen. Dramatic increases in use of antenatal corticosteroids and Kangaroo Mother Care were also recorded. Lesser progress was observed for handwashing practices, companion of choice during labour, birth doses of BCG, and monitoring of postnatal care. Restoring essential maternal and newborn is disasters can be used as an opportunity to improve quality and strengthen health systems.