1 - SOUTH ASIA
Political Commitment to the Every Newborn Action Plan in South Asia
In 2014, the Government of India launched the India Newborn Action Plan – a direct response to the Global Every Newborn Action Plan, ratified at the 67th World Health Assembly in May 2014. Contributed to by UNICEF and other partners, the plan outlines a strategy to end preventable newborn deaths in India. The plan aims for equitable progress despite gender, geographical location, or wealth status.
Contextualized and costed national newborn action plans are essential for progress to reduce preventable newborn deaths. It is a priority for UNICEF regional and country offices in South Asia to technically contribute to developing these plans, and then assist governments to make sure changes really happen in an equitable way. Other countries in South Asia, including Bangladesh and Nepal, are in the process of forming their national newborn action plans, and UNICEF aims to see all countries with costed plans in 2015 and 2016.
2 - INDIA
Delivering innovative healthcare solutions in India
The issue of quality and timeliness of receiving data was identified as a problem for monitoring performance and follow up of newborns from special newborn care units - intensive care units for newborns with severe complications. To address this UNICEF supported the government to develop a real time monitoring and tracking system.
This innovation generates real time information on over 250 parameters to assist program managers to improve quality of newborn care. The system is also linked to an SMS network that sends periodic reminders to families and health care workers to follow up. This work was incorporated into the India Newborn Action Plan by the Government of India in 2014 and scaled up to cover eight states and 245 special newborn care units in the country (it was three states and 109 units in 2013).
3 - SRI LANKA
Regional consultation on newborns
UNICEF and the World Health Organization jointly led a regional specific consultation on the Every Newborn Action Plan in Colombo, Sri Lanka in November 2014.
Following the launch of the Global Every Newborn Action Plan in May 2014, South Asia was the first region to hold a regional consultation on the Every Newborn Action Plan. The meeting also included discussion of postnatal care for mothers and newborns. The meeting was inaugurated by the Minister of Health from Sri Lanka, and was well attended with about 100 delegates from ministries of health and development partners. There was a fantastic atmosphere of collaboration, learning and sharing at the consultation, as well as a highlighted need to develop, launch and cost tailored country specific newborn action plans.
4 - NEPAL BANGLADESH
Promising results in Nepal and Bangladesh
Nepal and Bangladesh have made the most progress in reducing newborn deaths since 1990. In 1990 Bangladesh had a neonatal mortality rate of about 55 per 1000 live births and in Nepal it was 53. In the 2014 data from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) which reports on 2013 data, Bangladesh had plummeted to about 24 per 1000 live births and Nepal to 23.
UNICEF advises that a skilled birth attendant should provide care during delivery, as this is an important way to reduce neonatal mortality. Yet, there are:
• Huge inequities between countries in South Asia: Almost 100% of births in Sri Lanka are attended by skilled health staff vs only 32% in Bangladesh.
• Vast disparities between rural and urban: In Nepal, only 32% of rural births are attended by a skilled provider compared to 73% in urban areas.
• Wealth and education disparities: In Bangladesh, about two thirds of the wealthiest women, or those who have completed secondary or higher education, have a medically trained provider at birth. For the poorest women, or those with no education, it is just over 10%.
Millennium Development Goal 4: Reduce Child Mortality
In 2015, countries will make a final push to achieve the MDGs. Looking ahead to the next 20 years, reducing newborn mortality is an important challenge which needs to be faced.
Progress on MDG 4 in South Asia has been steady, but improvements in infant mortality (deaths at less than 12 months) and child mortality (deaths at less than five years) have been faster than neonatal or newborn deaths (deaths at less than 28 days after birth). The need to recommit to addressing MDG 4 (and MDG 5) was reiterated in a joint UN regional statement by the Regional Directors of WHO, UNICEF and UNFPA in April 2014.
Read the full statement