UNICEF and EU save new-born lives in rural Ethiopia

By Efa Workineh, CBNC Project Officer, Save the Children, Ethiopia; Tadesse Bekele, Regional Programme Manager, Save the Children, Ethiopia; Hailemariam Legesse, Health Specialist, UNICEF Ethiopia; Asheber Gaym, Health Specialist, UNICEF Ethiopia  

Ginde Beret
Elias with mother Shure after completion of his new-born sepsis treatment provided at the village health post ©SCI/2015/Efa Workineh

Abuna Gindeberet Woreda is one of the eighteen woredas (districts) found in West Shoa Zone, Oromia Regional State, 182 km west of Addis Ababa, Ethiopia’s capital.

Baby Elias Suyum Belacho was born in Guro Furto health centre in Gartoke Kebele (sub district) of Abuna Gindeberet Woreda on September 20 2015.  His mother, Shure Negasa and father, Suyum Belacho took good care of Elias, the fourth born in the family, even prior to his birth.  During her pregnancy, Shure attended three Ante Natal Care (ANC) visits at the Guro Furto health centre. Unfortunately, she had not received the required post-natal visit schedule following her delivery.

When Elias was three weeks old, he attended the routine community based new-born care assessment provided as part of the community based new-born care programme of the national Health Extension Programme (HEP) package. (The HEP is a community health programme covering the whole of Ethiopia provided by two female community health workers (health extension workers) working at rural health posts, at present over 38,000 health extension workers are providing services in over 16,000 health posts across Ethiopia. The community based new-born care programme (CBNC) is one of the key public health interventions provided by HEP through extensive partner support. UNICEF is the major supporter of CBNC scale up in Ethiopia). Emushe Abebe, the health extension worker providing CBNC noted that Elias’ respiration rate was found to be 72 breaths per minutes in two counts; much higher than the upper limit of 60 expected at his age. During the assessment, Emushe asked Shure if she has noted any other symptoms that Elias has been showing recently. Shure explained that Elias had been coughing for the last two days. Thanks to her Community Based New-born Care (CBNC) training, the health extension worker correctly diagnosed Elias’ condition as new-born sepsis; a potentially lethal advanced infection in new-borns. In addition, she found out that Elias was underweight, which was caused by not enough breastfeeding.  As per her CBNC training, she classified Elias’s condition to be very severe. Shure was not aware that she had to breastfeed at least eight times per day and because she did not realise that Elias was seriously sick, she never reached out for medical assistance.

After counselling by the health extension worker, Shure agreed to start the treatment at home immediately and to continue taking Elias to the health post. 48 hours after initiating the standardised (Chart Booklet) treatment with gentamicin and amoxicillin antibiotics, the HEW assessed the status of the child and found that he was rapidly improving. By now he was physically stable:  he showed a lower breathing rate of 48/minute and he was breastfed more than 10 times a day. Following the seven days’ full course treatment, Elias completely recovered from his illness.

Elias’ mother Shure Negasa, who was not aware of her child being in life threatening condition, has promised to seriously take care for her new-born child and other children. From now onwards she will seek health care when ever needed and she will teach her neighbour’s what she experienced.

When Ethiopia along with 196 other countries signed the Millennium Declaration in New York in 2000, maternal and child health situation was bad for the majority of the population. Under five mortality rate – number of children dying before their fifth birthday from 1000 born alive- in 1990 (the beginning of measurements for the MDGs) was 222; one of the highest in the world. Many were sceptical that the country would achieve the targeted reduction of two thirds of the 1990 levels by 2015. Against all odds, the country has achieved child health target of the millennium development goals MDG 4 three years ahead of 2015 by reducing the 1990 child mortality rate to less than 68 child deaths per 1000 live births.

Clear health policy and strong implementation supported by coordinated international partnership; a large scale community health programme targeting rural villages through the health extension programme; sustained investments in health and sustained economic growth are among the reasons for this success story.

Highly appreciable as the improvements in child health are, an under five mortality rate of 68 translates to the unacceptable number of over 200,000 child deaths annually. More than 43 per cent of these child deaths occur during the first 28 days following child birth (the neonatal period) the majority occurring in the few days following birth. Breathing difficulties; premature birth and new-born infections/sepsis are responsible for the majority of neonatal deaths and most are preventable or easily treatable with currently available medical care. Access to health care is nevertheless essential to obtain the benefits of these lifesaving interventions. For the tens of thousands of new-borns born at home and far from health facilities, accessing these lifesaving interventions have been largely impossible.

To overcome this formidable challenge to access key new-born health interventions, Ethiopia in collaboration with its major child health partners including UNICEF has adopted novel public health interventions of ICCM/CBNC (Integrated community case management of childhood illnesses/ community based new-born care). ICCM/CBNC interventions rely on task shifting of key child health interventions responsible for majority of child deaths to community health workers who receive training on detection and treatment of key childhood illnesses at home or at village clinics (health posts). They also timely refer new-borns and older children with severe illnesses to higher level care.

The EU-ESDE (European Union- Enhancing Skilled Delivery in Ethiopia) project, allocated Euro 42 million for a three-year support to maternal and new-born health to Ethiopia from 2014-2016. The EU is one of the major partners for the national scale up of ICCM/CBNC programme in Ethiopia. Since its inception in 2013, the ICCM/CBNC programme has rapidly scaled up to increase availability of CBNC services in 75 per cent of the total health posts in the country. Key interventions of the programme include training and mentoring of health extension workers on key skills of detections of new-borns and infants with illness through clear symptoms and signs and provision of essential interventions including provision of antibiotics to sick new-borns.  

Emushe Abebe, the HEW who provided the critical intervention that saved the life of Elias is one of the 2500 health extension workers who received training through EU-ESDE (European Union- Enhancing Skilled Delivery in Ethiopia) project support. She is saving lives of many children like Elias, and teaches mothers like Shure the importance of seeking health care.

Thousands more mothers, babies can be saved in Ethiopia

New Lancet Series finds major progress in improving survival for Ethiopia’s babies, but more can be done

Untitled
ADDIS ABABA: 24 November 2014: By 2025, Ethiopia could save as many as 76,800 mothers and babies each year if it continues its aggressive efforts to develop and implement effective strategies to improve maternal and newborn health. These estimates were released in Addis today at the Ethiopia launch of The Lancet Every Newborn Series 2014 and the Every Newborn Action Plan.

The authors of the Series say that while Ethiopia is one of the 10 countries with the highest numbers of neonatal deaths, it is currently ranked fifth in the world as having the greatest potential to save maternal, perinatal and neonatal lives by 2025. A systematic assessment of challenges in high-burden countries like Ethiopia, revealed that the most common barriers to improving survival were related to the health workforce, financing, and service delivery. By addressing these challenges, many lives can be saved in the next decade alone.

Yet far too many babies and mothers in Ethiopia still die from preventable causes with 84,000 babies dying before their first month, and an additional 78,400 who are stillborn. The major killers were prematurity, complications during child birth including trouble breathing, and severe infections, which together cause more than 80 percent of neonatal deaths. More than two-fifths of Ethiopia’s under-five deaths are among newborns.[1][2]

Mother feeding her child plumpy nut
Mother taking care of here baby boy. ©UNICEF Ethiopia/2006/Getachew

Birth is the riskiest time for mothers and their babies, but there is an opportunity to accelerate progress towards ending preventable newborn and maternal deaths,” said John Graham, Country Director for Save the Children. “Our five-year research known as Community-based Interventions for Newborns in Ethiopia (COMBINE) shows community-based treatment of severe neonatal infections can reduce newborn deaths after the first day of life by as much as by 30 percent. This demonstrates investment in community-based newborn health programme will reduce newborn deaths and sustain the country’s remarkable achievements in tackling child deaths.”

The Series findings present the clearest picture to date of a newborn’s chance of survival in countries around the world and highlight the steps that must be taken to end preventable infant deaths. New analyses indicate that 3 million maternal and newborn deaths and stillbirths can be prevented each year around the world with proven interventions—including the promotion of breastfeeding, neonatal resuscitation, kangaroo mother care for preterm babies, and the prevention and treatment of infections.

These interventions can be implemented for an annual cost of US$1.15 per person. Providing quality care at birth yields a quadruple return on investment—saving mothers and newborns, and preventing stillbirthsand protects babies from disability.

“Newborn survival is as attainable as child survival, we know why and when newborns are dying,” said Patrizia DiGiovanni, Representative a.i., UNICEF Ethiopia. “We also know what we need to do to reduce neonatal death. Investment on newborn survival has a promising return for future generations. The time to act is now.”2

Examination of new born at Wukro Clinic ©UNICEF Ethiopia/2009/Tuschman

Ethiopia is using the lifecycle approach to implement a number of high impact interventions to ensure newborn survival; this starts before pregnancy, through pregnancy delivery and the postnatal period. The country is currently revising the national newborn and child survival strategy taking the newborn survival agenda as central.

“There is tremendous opportunity and we know what needs to be done to ensure every Ethiopian mother and her baby have a healthy start,” said Dr. Gary L. Darmstadt, Lancet Series author and senior fellow at the Bill & Melinda Gates Foundation. “Countries that have made recent, rapid reductions in newborn and maternal deaths have done so by expanding the number of skilled health workers, rolling out innovative mechanisms to reach the most underserved families, and focusing on improving care for newborns.”2

“The success in Ethiopia is primarily due to political commitment and the introduction of our home grown innovative community health workers programme called the Health Extension Programme”, said Dr. Kesetebirhan Admasu, Minister, Federal Ministry of Health.

Health extension workers are equipped with the skills and equipment to identify pregnant mothers early, conduct focused, antenatal care, facilitate skilled birth care, conduct postnatal home visits to identify complications in both mothers and newborns and take appropriate measures, including but not limited to the treatment of newborns with severe infections by using oral and injectable antibiotics when referral is not possible or acceptable by families. The Health Development Armies are supporting the 38,000 Government funded health extension workers in mobilizing communities to promote key healthy behaviors including early care seeking for newborns, children and mothers.

[1] The Lancet Every Newborn Series

[2] United Nations Inter Agency Group for Mortality Estimate, 2014 Report

Scaling up high-impact solutions for Ethiopia’s newborn

After convening the 2013 African Leadership for Child Survival A Promise Renewed, a regional forum that called for greater accountability for Africa’s mothers and children, the Government of Ethiopia is leading by example. With support from UNICEF and other partners, the government is implementing a bold strategy that targets the country’s hardest-to-reach mothers and newborns. The three-pronged strategy is scaling up the coverage of community-based new-born care, which includes sepsis treatment; immediate essential newborn care in health centres and district hospitals; and neonatal intensive care units in hospitals.

Scaling Up High-Impact Solutions For Ethiopia’s Newborns
© UNICEF-ETHA2013_00486-Ose

The combination of innovative, evidence-based strategies and the government’s long legacy of leadership on maternal, newborn and child survival is yielding impressive results. Ethiopia achieved MDG 4 three years ahead of schedule by cutting under-five mortality from 205 per 1,000 live births in 1990 to 68 per 1,000 in 2012. Ethiopia’s progress illustrates that countries can achieve dramatic declines in child mortality, despite constrained resources. It puts Ethiopia on a trajectory to bend the curve and achieve a major goal of A Promise Renewed — 20 under-five deaths per 1,000 live births by 2035.

For more information read the story on http://apromiserenewed.org/Ethiopia.html

 

 

Despite dramatic progress on child survival, 1 million children die during their first day of life from mostly preventable causes

Analysis points to health system failures at critical time around birth as a significant contributing factor to these needless deaths

New York, 16 September 2014 – Child survival rates have increased dramatically since 1990, during which time the absolute number of under-five deaths has been slashed in half from 12.7 million to 6.3 million, according to a report released today by UNICEF.
The 2014 Committing to Child Survival: A Promise Renewed progress report, indicates that the first 28 days of a newborn’s life are the most vulnerable with almost 2.8 million babies dying each year during this period. One million of them don’t even live to see their second day of life.

Many of these deaths could be easily prevented with simple, cost-effective interventions before, during and immediately after birth.

Analysis points to failures in the health system during the critical time around delivery as a significant contributing factor to these unnecessary deaths. It also shows that there is considerable variation – from country to country and between rich and poor – in the take-up and quality of health services available to pregnant women and their babies.

Key findings in this study include:

  • Around half of all women do not receive the recommended minimum of four antenatal care visits during their pregnancy.
  • Complications during labour and delivery are responsible for around one quarter of all neonatal deaths worldwide. In 2012, 1 in 3 babies (approximately 44 million) entered the world without adequate medical support.
  • Evidence shows that initiating breastfeeding within one hour of birth reduces the risk of neonatal death by 44 per cent, yet less than half of all newborns worldwide receive the benefits of immediate breastfeeding.
  • Quality of care is grossly lacking even for mothers and babies who have contact with the health system. A UNICEF analysis of 10 high mortality countries indicates that less than 10 percent of babies delivered by a skilled birth attendant went on to receive the seven required post-natal interventions, including early initiation of breastfeeding. Similarly, less than 10 per cent of mothers who saw a health worker during pregnancy received a core set of eight prenatal interventions.
  • Those countries with some of the highest number of neonatal deaths also have a low coverage of postnatal care for mothers. Ethiopia (84,000 deaths; 7 per cent coverage); Bangladesh (77,000; 27 per cent); Nigeria (262,000; 38 per cent); Kenya (40,000; 42 per cent).
  • Babies born to mothers under the age of 20 and over the age of 40 have higher mortality rates.

Additionally, the report shows that the education level and age of the mother has a significant bearing on the chances of her baby’s survival. Neonatal mortality rates among mothers with no education are nearly twice as high for those with secondary schooling and above.

“The data clearly demonstrate that an infant’s chances of survival increase dramatically when their mother has sustained access to quality health care during pregnancy and delivery,” said Geeta Rao Gupta, UNICEF Deputy Executive Director. “We need to make sure that these services, where they exist, are fully utilised and that every contact between a mother and her health worker really counts. Special efforts must also be made to ensure that the most vulnerable are reached.”
Inequality, particularly in health care access, remains high in the least developed countries: women from the richest households are almost three times as likely as those from the poorest to deliver their baby with a skilled birth attendant. Despite this, the report suggests that the equity gap in under-5 child mortality is steadily reducing. In every region, except sub-Saharan Africa, the proportion of under-five mortality among the poorest sections of society is declining faster than in the richest. More significantly, worldwide, the poor are registering greater absolute gains in child survival than their wealthier compatriots. “It is deeply heartening that the equity gap in child survival is continuing to narrow,” said Rao Gupta. “We need to harness this momentum and use it to drive forward programmes that focus resources on the poorest and marginalised households; a strategy which has the potential to save the largest number of children’s lives.”

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Note to editors:

About A Promise Renewed

A Promise Renewed is a global movement that seeks to advance Every Woman Every Child – a strategy launched by United Nations Secretary-General Ban Ki-moon to mobilize and intensify global action to improve the health of women and children around – through action and advocacy to accelerate reductions in preventable maternal, newborn and child deaths.

The movement emerged from the Child Survival Call to Action convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF, to examine ways to spur progress on child survival. It is based on the ethos that child survival is a shared responsibility and everyone – governments, civil society, the private sector and individuals – has a vital contribution to make.

Since June 2012, 178 governments and many civil society organizations, private sector organizations and individuals have signed a pledge to redouble their efforts, and are turning these commitments into action and advocacy. More details on A Promise Renewed are available at www.apromiserenewed.org.

About Committing to Child Survival: A Promise Renewed 2014 Progress Report

This year’s annual report focuses on newborn survival. This report not only presents levels and trends in under-five and neonatal mortality since 1990, but also provides analysis on key interventions for mother and newborn.

About UNICEF UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit: http://www.unicef.org/

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For further information please contact: Rita Ann Wallace, UNICEF New York, +1 917 213-4034; rwallace@unicef.org  Melanie Sharpe, UNICEF New York, +1 917-485-3344, msharpe@unicef.org Najwa Mekki, UNICEF New York, nmekki@unicef.org, +1917 209 1804

 

A Day in the Life of a Well-fed Child: Ethiopia

By Frehiwot Yilma

AMHARA REGION, 05 June 2014 – Kossoye Ambaras is a small lush green village within Wogrea woreda in northern Gondar where it is relatively cold. Amarech Ashager, a 28 years old mother of two, is used to the weather as she lived her whole life here. At the top of her daily agenda is making sure that her family, especially her youngest son, Metages Birhanu of 9 months, is well fed.

Like many of the residents, Amerech does not rise out of bed before 7 a.m., as it is too cold to leave the house. She begins her day by breastfeeding Metages and cooking breakfast for the rest of the household. Her husband, Birhanu Tagel, is a businessman and her eldest son, Muluken, 10, is a third grader. After saying ‘good day’ to Birihanu and Muluken, Amarech will cook breakfast for Metages. Since he was introduced to solid food only three months ago, Metages eats exclusively porridge. Preparing highly nutritious porridge for a child is a technique that Amarech has recently learnt. The base of the porridge, the flour, contains various grains and legumes. For breakfast the added ingredient besides the flour is an egg and minced cabbage. As well as cooking the food, feeding the child to achieve best results is also a discipline. Amarech has learnt to feed her child while also playing and talking to him to keep him engaged.

It takes a village to raise a child

Health Extension workers in Amhara region provide preventive and curative health service to the community
Health Extension workers in Amhara region provide preventive and curative health service to the community ©UNICEF Ethiopia/2014

Amarech and other mothers in the village get support from Health Extension Workers (HEWs) on how to properly raise their children. Today, HEWs Habtam Dese and Yeshiwork Tesfahun are weighing the children in the village to monitor their health and development. They too receive assistance from Gebeyaw Alamerew, the woreda Nutrition and Child Health Officer. In a typical session with a HEW, a six-month-old child will receive a vitamin A supplement, while those aged above one year will additionally receive deworming tablets. With the support of UNICEF, this has become a routine service in the woreda.

Out of 18 children weighed by the HEWs , 16 are in the average weight range. Amarech is one of the happy mothers to learn that her son, Metages, weighs 8.6 kilograms, well in the range of a healthy baby’s weight. “I am so happy that he has gained a few more grams since last time,” she says, smiling. After weighing babies in the community, Habtam and Yeshiwork demonstrate how to make a child’s diet balanced and about the importance of using iodised salt. As the child-friendly food preparation simmers over a fire, the two mothers, whose children’s weight was under the average limit, get counselling on how to improve their baby’s weight. Gebeyaw believes the woreda has come a long way. “In previous years, there were up to eight children per month in Kossoye suffering from Severe Acute Malnutrition (SAM), but this year there have been no cases,” he says. “This is because we monitor the children’s growth and give counselling and other packages of support to the mothers at the earliest stage possible, as we did with the two mothers today.” When the food has finished cooking, Habtam and Yeshiwork let the mothers feed the warm nutritious preparation to their children.

Bridging the nutrition gap before sunset

Amarech Ashager breast feeds Metages Birhanu, 9 months old
Amarech Ashager breast feeds Metages Birhanu, 9 months old © UNICEF Ethiopia/2014

The afternoons in Kossye Ambaras are usually foggy this time of the season. Amarech has subsequently decided to do her laundry the following day and so turns to preparing dinner as well as other domestic chores. For Metages, she has a new menu in mind: adding mashed potatoes and carrots to the porridge. She says she will also never forget adding iodised salt to the food. “Habtam has told us that iodised salt is key to a child’s mental growth. She also told us that we have to put in the salt after the food is cooked and out of the oven so that the iodine does not evaporate with the heat,” she says.

Habtam is one of 38,000 government salaried HEWs currently providing nutritional and other support to mothers and children across all regions of Ethiopia. Development partners such as UNICEF are committed to support this initiative. “Nations will face critical bottlenecks to economic growth if a large proportion of their working-age people’s IQ and productivity are limited by under-nutrition,” says Dr Peter Salama, UNICEF representative in Ethiopia.

As the day draws to an end, Amarech’s house becomes lively as the family come together and discuss their experiences. While breastfeeding Metages, Amarech tells her husband about the importance of investing in their children’s diet to ensure their healthy future. “I will feed my children a variety of foods so that they will have a bright mind,” she says with confidence. “And I will be happy if Metages becomes a doctor.”

On the recent Micronutrient Global Conference (June 2-6, 2014), researchers, policy-makers, program implementers, and the private sector has been discussing ways of overcoming micronutrient malnutrition. The forum has been held under the theme of “Building Bridges”, thus emphasising scientific advances and multi-sectoral programming on adequate micronutrient intake. Read more

In Ethiopia, the most common cause of death for children under five years of age is new-born death

Mother breastfeeding her new born for the first time
A mother breast feeds for the first time her new-born at Shire Clinic, Ethiopia ©UNICEF Ethiopia/2009/Tuschman

New York/Addis Ababa, 22 May 2014 – A ground-breaking series of papers released by The Lancet at UNICEF Headquarters today shows that the majority of the almost 3 million children who die before they turn one month old could be saved if they received quality care around the time of birth – with a particular focus on the most vulnerable and under-served.

New-born deaths account for a staggering 44 per cent of total mortality among children under five, and represent a larger proportion of under-five deaths now than they did in 1990. These deaths tend to be among the poorest and most disadvantaged populations.

“We have seen tremendous progress in saving children under five, but where the world has stumbled is with the very youngest, most vulnerable children,” said Dr Mickey Chopra, head of UNICEF’s global health programmes. “This group of children needs attention and resources. Focusing on the crucial period between labour and the first hours of life can exponentially increase the chances of survival for both mother and child.”

According to UNICEF, 2.9 million babies die each year within their first 28 days. An additional 2.6 million babies are still-born, and 1.2 million of those deaths occur when the baby’s heart stops during labour. The first 24 hours after birth are the most dangerous for both child and mother – almost half of maternal and new-born deaths occur then.

The Lancet’s Every Newborn Series identifies the most effective interventions in saving new-borns, including breastfeeding; new-born resuscitation; ‘kangaroo care’ for premature babies – that is, prolonged skin-to-skin contact with the mother; and preventing and treating infections. More funding and adequate equipment are also vital.

Countries that have made the most progress in saving new-born lives have paid specific attention to this group as part of the overall care extended to mothers and under-fives. Rwanda – alone among sub-Saharan African countries – halved the number of new-born deaths since 2000. Some low and middle-income countries are making remarkable progress by, among other methods, training midwifes and nurses to reach the poorest families with higher quality care at birth, especially for small or ill new-borns.

In Ethiopia, Neonatal Mortality Rate (NMR) has reduced from 54 in 1990 to 29 (per 1000 deaths) in 2012 according to the Inter-agency Group of Child Mortality Estimation 2013.

“Despite progress in child survival, the single most important remaining cause of death among children less than five years of age is new-born deaths – deaths within the first 28 days of life,” said Dr Peter Salama, UNICEF Representative to Ethiopia. “The government of Ethiopia is rapidly expanding access to basic health services to communities to prevent maternal and new-born deaths. With the strong commitment of the government and the sustained support of all our partners, we can speed up the reduction of maternal and newborn death even further.”

New Born baby taken care off by his nurse
A nurse takes care of a newborn baby at Shire Clinic, Ethiopia ©UNICEF Ethiopia/2009/Tuschman

To increase access, the Federal Ministry of Health has committed to the improvement of services based on the Health Sector Development Programme (HSDP) including the construction of 800 district hospitals (one per each woreda (district)). At present, over 120 hospitals are providing comprehensive emergency obstetric and neonatal care (CEmONC) services including caesarean sections, blood transfusions and emergency laparotomy for the entire population of the country.

A survey of 51 countries with the highest burden of new-born deaths found that if the quality of care received by the richest were to become universal, there would be 600,000 fewer deaths per year – an almost 20 per cent reduction.

The highest numbers of new-born deaths per year are in South Asia and sub-Saharan Africa, with India (779,000), Nigeria (267,000) and Pakistan (202,400) leading. For the highest burden countries, every $1 invested in a mother’s or baby’s health gives a nine-fold return on investment in social and economic benefit.

UNICEF and World Health Organization will roll out next month the Every Newborn Action Plan which aims to end preventable maternal and child deaths by 2035.

Lancet’s Every Newborn Series is co-authored by experts from UNICEF, the London School of Hygiene and Tropical Medicine, and the Agha Khan University, Pakistan, among others.

Find the press release here

Materials from the Lancet Every Newborn series launch are available at: http://www.thelancet.com/series/everynewborn

Video makes Community Based New-born Care (CBNC) training more productive

By Hailemariam Legesse

The Community Based New-born Care (CBNC) initiative was launched in March 2013, following the national policy breakthrough of allowing Health Extension Workers (HEWs) to treat new-born sepsis. The programme is supporting four agrarian regions: Amhara, Tigray, Southern Nations Nationalities and Peoples’ Region (SNNPR) and Oromia.

One of the methods and tools used during the four day CBNC training in Ethiopia is a training video produced in English, Amharic and Oromiffa. The video helps to make CBNC training more productive through presentation of communication skills and specific technics and procedures performed by Health Extension Workers in a rural setting of Ethiopia.

Though, first and foremost produced to support the four-day standard training on CBNC, the individual components of the video can be used also to support specific separate skill’s training like; Measuring Temperature; Weighing the Baby; Hand Washing; Essential New-born Care; and Expressing Breastmilk.

The video demonstrates components designed to follow the principles of continuum of care for mothers and new-born.             

  1. Registering women in childbearing age by HEW
  2. Communication skills during antenatal care follow up
  3. Filling the birth preparedness plan
  4. Measuring temperature of the new-born
  5. Weighing the baby
  6. Postnatal care visit (PNC) for the mother and new-born
  7. Hand washing
  8. PNC visit for the sick new-born
  9. Essential new-born care
  10. Ikram case study
  11. Expressing breast milk

Federal Ministry of Health led the production of the video with the financial and technical support from UNICEF and WHO and help of CBNC partners through the National Technical Working Group.6