Mazia: How Has the LAC Neonatal Alliance Contributed to Scale-Up of Newborn Interventions at Country Level in the Region

7/28/2019 Mazia: How Has the LAC Neonatal Alliance Contributed to Scale-Up of Newborn Interventions at Country Level in the Region

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How has the LAC Neonatal Alliance

contributed to scale-up of newborn

interventions at country level in the region?

Goldy Mazia, MD, MPHCoordinator - LAC Neonatal Alliance

Newborn Health Advisor - MCHIP/PATHGlobal Newborn Health Conference

J ohannesburg, South AfricaApril 15th, 2013


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37 37 37

2726 26

2524 24

22

19 19 1918 18

1716

15

1110

9

76

4

HAI

BOL

GUY

BRA

PER

DOR

NIC

SUR

PAR

HON

JAM

ECU

COL

BLZ

ELS

MEX

ARG

VEN

URU

COR

CHI

CUB

USA

CAN

Variations in NMR in LAC

0

10

20

30

40

NMR

(per1,00

00LB)

Source: Levels and Trends in Child Mortality Report 2012 (UNICEF, WHO, World Bank, UN)

21-30 10-20


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66 66

5957 57

56 56 5655

50 5048

4746 46

45

42 4241

40

3736

32 32

22

ELS

PERMEXEC

UCUB

BLZ

BRADO

RUR

UHO

NAR

GNICVEN

GUAPA

RCHI

COL

JAM

BOL

CRODO

MPA

NGUY

HAIT&T

NMR Reduction Estimates 1990-2011

Source: Levels and Trends in Child Mortality Report 2012 (UNICEF, WHO, World Bank, UN)

0

20

40

60

80

PercentageNMR

rediuction

NMR

37

NMR

37

NMR

37

NMR23

NMR

19


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Disparities in Neonatal Mortality in LAC

The LAC region is diverse (20countries/391 ethnic groups)

Average indicators HIDEDISPARITIES between and within

countries (i.e. Cuba and Chiles NMRis 5/1000 LB; Haits NMR is 31 andBolivias is 27/ 1000 LB)

Limited access to health services byrural, displaced, and indigenouspopulations contributes to inequities(i.e. in Bolivia: Potoss NMR is 52,while Santa Cruzs is 17/1000 LB)

NMR in the poorest quintiles isdouble than in richest


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Causes of Mortality in Children

under 5 in the Americas - 2010

5Source: WHO, Lancet May 2012

2nd cause of death

In children under 5


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Proportion of premature births

in the Americas

6

9.6

7.58.8

12.5

8.19.1

10.6

7.96.7

0

2

4

6

8

10

12

14

Total Moredeveloped

Developed Lessdeveloped

LAC CentralAmerica

NorthAmerica

SouthAmerica

Caribbean

Source: P Duran, PAHO/WHO, 2012

6.1%

33-36 w


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Source: WHO estimates 2000

Skilled Birth Attendants and NMR

0

10

20

30

40

50

0

20

40

60

80

100

Africa Asia Latin America& the

Caribbean

Moredeveloped

regions

Neonataldeathsper1000

livebirths

Skilledattenda

ntat

delivery(%

)Skilled attendant at delivery Neonatal deaths

Country NMR MMR SBA

Haiti 31 523 26

Chile 5 12 99.9

Dom Rep* 23 159 98


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Breastfeeding in the Americas

Source: Fort A., Macro International,

2007

62.8

53.6

46.7

40.7

36

30.6

29.7

24

12

7.8

0 10 20 30 40 50 60 70

Per 2004-2006

Bolivia 2003

Colombia 2005

Hait 2005

MUNDO EN DESARROLLO 2006 (UNICEF)

Nicaragua 2006-2007

Honduras 2005

El Salvador 2002-2003

EEUU 2005*

Repblica Dominicana 2007

Lactancia Exclusiva < 6 meses

Exclusive breastfeeding 0-1 m: 20%!!

Exclusive breastfeeding < 6 months


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The burden of fetal deaths

9

Stillbirths are commonly not counted in national

information systems, and are often misclassified

It is estimated that there were 97,000 stillbirths in

LAC in 2009 (8,7/1000 LB)


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10

The LAC Neonatal Alliance


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Mission of the Alliance

To promote neonatal health in LAC within the

continuum of reproductive, maternal, and child

health, through inter-agency efforts

To promote policies and programs based on

scientific evidence, with a specific focus on the

most vulnerable populations


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Members of the LAC Neonatal Alliance
http://www.feppen.net/logo.gif


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Strategic Areas

Create a favorable environment

Strengthen health systems and

improve access to health services for

the mother, the newborn, and the child

Promote community-based

interventions

Develop and strengthen surveillance,

monitoring, and evaluation systems toassess progress

MOU i h i l f i l i i (S b


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MOU with regional professional associations (September

2009), and increasing memberships

Shared annual work plan and budget with clear

responsibilities for each member

National Alliances Sub-Regional Forums

(Nicaragua/Paraguay; Peru/Barbados)

Positive PAHO mid-term evaluation of Regional Strategy

and Action Plan (March 2013)

Highlights


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Achievements

Regional Strategy and Action Plan- ResolutionCD48.R4 of PAHOs Directing Council

Website to share information and experiences onevidence-based interventions(www.alianzaneonatal.org)

Neonatal health indicators through an expertconsultative process

Member of the Commission on Information andAccountability for Women and Childrens Health(WHO/PAHO) and the UN Commission on

Commodities for Neonatal Resuscitation andChlorhexidine

Technical assistance to countries for developmentand implementation of newborn work plans andstrengthening of National Alliances
http://www.alianzaneonatal.org/http://www.alianzaneonatal.org/


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HBB Scale-up in LAC through Alliance efforts

- Mxico and Central America (El

Salvador, Honduras, Nicaragua,

Guatemala)- South America: Colombia (national-

integrated with IMNCI), Ecuador, Per

- Caribbean: English- speaking

Caribbean, and Dominican Republic

(national)

- Muchos otros


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LAC KMC Network

Created in December 2011 in the

Dominican Republic (1st regional

meeting)

Supported by the Neonatal Allianceand the Colombian KMC Foundation

10 countries: Paraguay, Bolivia, Ecuador, Per,

Colombia, El Salvador, Honduras, Guatemala,

Nicaragua, Dominican Republic Community of practice

Second regional meeting planned for June 2013

17


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Challenges

Small and decreasing funding for the region

Newborn health again disappearing from

regional agenda

Funding for national alliances

Limited national budgets for newborn health

18


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www.alianzaneonatal.org

(healthynewbornnetwork.org)

Many thanks
http://www.alianzaneonatal.org/http://www.alianzaneonatal.org/

Documents

Mazia: How Has the LAC Neonatal Alliance Contributed to Scale-Up of Newborn Interventions at Country Level in the Region