Every Newborn: health-systems bottlenecks and strategies to accelerate scale-up in countries

Dickson, Kim; Simen-Kapeu, Aline; Kinney, Mary; Huicho, Luis; Vesel, Linda; Lackritz, Eve; Johnson, Joseph D.; Xylander, Severin von; Rafique, Nuzhat; Sylla, Mariame; Mwansambo, Charles; Daelmans, Bernadette; Lawn, Joy E

doi:10.1016/s0140-6736(14)60582-1

Cited by 283 publications

(314 citation statements)

References 57 publications

Supporting

Mentioning

291

Contrasting

Unclassified

Order By: Relevance

“…In this regard, although the global community has tended to shift its attention toward neonatal mortality reduction [21,50–54], the focus should still be on the leading infectious causes of post-neonatal mortality in many countries, especially in west and central African countries, for child survival efforts. This is warranted because the substantial contribution of one or a few cause-specific reductions may mask unsuccessful performance in other areas of cause-specific child mortality reduction.…”

Section: Discussionmentioning

confidence: 99%

Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Jin

Mankadi

Rigotti

et al. 2018

Global Health Action

View full text Add to dashboard Cite

Background: During the Millennium Development Goal (MDG) era, impressive reductions in the under-5 mortality rate (U5MR) have been observed, although the MDG 4 target was not met. So far, cause-specific progress in child mortality has been analyzed and discussed mainly at the global and regional levels. Objectives: We aimed to explore annual changes in cause-specific mortality at the country level, assess which causes contributed the most to child mortality reduction in 2000–2015, and estimate how many child lives were saved. Methods: We used the cause-specific child mortality estimates published by Liu and colleagues. We derived average annual changes in cause-specific child mortality rates and cause-specific contribution to overall child mortality in 2000–2015. We estimated the number of cause-specific child deaths averted during the MDG era, assuming that cause-specific child mortality remained the same as in 2000. We targeted the 75 Countdown countries where 95% of maternal and child deaths occurred during the MDG era. Results: Wide disparities existed across causes within countries, both in neonatal and post-neonatal mortality reduction, except for a few countries such as China, Rwanda, and Cambodia. In 20 of the 45 sub-Saharan African countries, malaria was the main contributor to post-neonatal mortality reduction, and pneumonia was the main contributor in only six countries. A single disease often contributed to a substantial proportion of the child mortality reduction, particularly in west and central African countries. Diarrhea-specific post-neonatal child mortality reduction accounted for 7.1 million averted child deaths (24.5%), while pneumonia accounted for another 6.7 million averted child deaths (23%). Conclusions: This study demonstrates country-specific characteristics with regards to cause-wise child mortality that could not be identified by global or regional analyses. These findings provide the global community with evidence for formulating national policies and strategies to achieve the Sustainable Development Goals in child mortality reduction.

show abstract

Section: Discussionmentioning

confidence: 99%

Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Jin

Mankadi

Rigotti

et al. 2018

Global Health Action

View full text Add to dashboard Cite

show abstract

“…Maternal and newborn care is high on many policy agendas and a conscious change is needed for a shift in political will [3] and public policy to create the right environment for scale up [48]. Leadership amongst local policy makers provides the impetus for involving government partners [3].…”

Section: A Policy Environment Leading To Commitmentmentioning

confidence: 99%

“…Maternal and newborn outcomes driving the need for the programme may exist because of a poorly functioning system, a factor that can increase the costs of scale. There may also be more bottlenecks to overcome [48]. For example, the underutilisation of existing health services by the target population is a potential indicator of poorer quality of care [52].…”

Section: Health-systems Strengtheningmentioning

confidence: 99%

What is needed for taking emergency obstetric and neonatal programmes to scale?

Bergh

Allanson

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

View full text Add to dashboard Cite

Scaling up an emergency obstetric and neonatal care (EmONC) programme entails reaching a larger number of people in a potentially broader geographical area. Multiple strategies requiring simultaneous attention should be deployed. This paper provides a framework for understanding the implementation, scale up and sustainability of such programmes. We reviewed existing literature and drew on our experience in scaling up the Essential Steps in the Management of Obstetric Emergencies (ESMOE) programme in South Africa. We explore the non-linear change process and conditions to be met for taking an existing EmONC programme to scale. Important concepts cutting across all components of a programme are equity, quality and leadership. Conditions to be met include appropriate awareness across the board and a policy environment that leads to: commitment, healthsystems-strengthening actions, allocation of resources (human, financial, capital/material), dissemination and training, supportive supervision, and monitoring and evaluation.

show abstract

“…Four of 5 newborn deaths result from 3 preventable or treatable conditions: (1) complications from prematurity and low birth weight; (2) complications during childbirth (including birth asphyxia); and (3) infection. 3,4 Proven, low-cost interventions, health commodities, and medicines can prevent more than two-thirds of newborn deaths. Gaps in coverage, equity, and quality of care around birth and postnatal care for small and ill newborn infants exist in health facilities in many low-and middleincome countries.…”

Section: Column Editormentioning

confidence: 99%

“…Practical, competencybased training for providers, and implementation of quality improvement mechanisms for clinical services can help address these barriers to optimal care and thus to child survival. 4 Maternal nutrition before and during pregnancy, tobacco smoke exposure, and other factors also contribute to a healthy birth weight, a strong indicator of a newborn's chances for survival and healthy development. Engagement and investment of national private and public sector stakeholders, in collaboration with technical experts and global stakeholders, can help ensure that sustainable interventions become incorporated into country health care systems.…”

Section: Column Editormentioning

confidence: 99%