If effectively administered to newborns in high-mortality countries, these highly effective and affordable products could save approximately 1,770,000 newborns yearly. But regulatory hurdles, low provider and user awareness, and insufficient training on the administration of these commodities contribute to limited use.
Pooling expertise on newborn health
The Newborn Technical Resource Team, a group of health experts from 29 organizations, has been supporting the implementation of the UN Commission’s recommendations from 2012 to 2016, working to ensure that these commodities are available in countries with a high burden of newborn morbidity and mortality, are put into the hands of skilled health workers and administered properly to save newborns. The expertise of the TRT members as well as the knowledge resources they have developed during this period are captured in the Life-Saving Commodities Practitioners’ Network.
Progress to date
Nigeria, Madagascar, the Democratic Republic of Congo (DRC), and Malawi are now scaling up chlorhexidine in national newborn care programs, and eight additional countries – Ethiopia, Liberia, Pakistan, Bangladesh, Uganda, Kenya, Haiti, and India – are introducing the product or aligning policy for its introduction. The Newborn Health Technical Resource supported these countries in developing policy, clinical guidelines and programs to introduce and scale up chlorhexidine by working with ministries of health and other stakeholders. Nepal was already scaling up the product through female community health volunteers when this initiative started.
Drugfield Pharmaceuticals Ltd, a Nigerian drug company, has been granted regulatory approval to produce chlorhexidine digluconate 7.1% gel. Chlorhexidine gel, a high impact, low-cost medicine prevents umbilical cord infections in newborns. The local production of chlorhexidine digluconate 7.1% gel, means that the gel will be more readily available, stocked, and distributed to health facilities and health workers. This nascent local market is the result of extensive market shaping activities, led by the Global Markets, Quality and Regulation Technical Resource Team and the Newborn Health Technical Resource Team and their partners.
Documentation from around the world making the case for antenatal corticosteroids, and evidence on effectiveness, coverage rates, and common barriers to uptake of ACS and their potential solutions are gathered and accessible on www.healthynewbornnet.org. Training materials on the safe use of ACS for health care providers managing women in preterm labour are available.
Dexamethasone was added to the WHO’s EML for fetal indications, an effort led by the TRT. The group also initiated the development of a WHO guideline for managing preterm birth.
The TRT also supported a policy and implementation landscape analysis on the use of ACS for women at risk of imminent preterm birth in Ethiopia, DRC, Malawi, Nigeria, Sierra Leone, Tanzania and Uganda. The full landscape analysis is available at www.everypreemie.org.
Pediatric syringes are included in the interagency list of medical devices.
A rapid assessment tool for injectable antibiotics supply ‘bottleneck analysis’ in Africa: the TRT developed and tested this tool, which is now used in four countries.
The Nigeria Federal Ministry of Health and its partners reviewed a TRT report examining the existing barriers to access and availability of antibiotics and capacity of healthcare providers to classify, refer, and manage cases of newborn sepsis. The Ministry of Health could consider alternative approaches to newborn sepsis management where hospital referral is not possible.
Bacterial testing for the resuscitation devices was completed and the results will be analyzed in 2015; these activities were included in the Assessment of Infection Prevention Practices for Resuscitation Devices in Bangladesh which will assist in developing infection prevention practice guidelines specific to Bangladesh.
A comprehensive toolkit providing access to resources for government officials, NGOs, health workers, health clinics and more will be available on this site soon. This toolkit will improve knowledge and awareness of resuscitation devices and will ensure that more babies can breathe at birth.