RCM IDM May 5 th, 2015 Edinburgh 1 |1 | Every Newborn Action Plan Midwives for a better tomorrow Fran McConville, RCM IDM, Edinburgh May 5 th 2015 Every

RCM IDM May 5th, 2015 Edinburgh1 |

Every Newborn Action Plan

Midwives for a better tomorrow

Fran McConville, RCM IDM , Edinburgh May 5th 2015

Every Newborn Action Plan

Midwives for a better tomorrow

Fran McConville, RCM IDM , Edinburgh May 5th 2015

RCM IDM May 5th, 2015 Edinburgh2 |www.everynewborn.org #EveryNewborn

Main funders: Bill & Melinda Gates Foundation, USAID, Children’s Investment Fund Foundation

Every Newborn SeriesEvery Newborn Series

5 papers, 6 comments

55 authors from 18+ countries

60+ partner organizations

Published May 2014

Every Newborn Action PlanBased on the evidence from the Series

Co-led by UNICEF & WHO

World Health Assembly 2014 resolution

Over 300 experts consulted 60 +partner organization

Launched 30th June 2014

40 +commitments to EWEC

From evidence to action


Causes of under five deaths 44% are from neonatal causes

Data source: Cause of death - WHO. Global Health Observatory

http://www.who.int/gho/child_health/en/index.html

); Child deaths - UN Inter-agency Group for Child Mortality Estimates. Levels and Trends in Child Mortality. Report 2013; Stillbirths - Lawn et al The Lancet stillbirth series 2011. 377 (9775) p1448 – 1463

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3 main killers to address :

.1Preterm birth

.2Birth complications

.3Neonatal infections

Two-thirds of neonatal deaths are preventable




When are mothers and newborns dying?Source: Lancet newborn series

When are mothers and newborns dying?Source: Lancet newborn series


What is the coverage of PNC services? Source Countdown 2013 Update

What is the coverage of PNC services? Source Countdown 2013 Update


We have the knowledge and tools to reduce the main causes of death

Preterm birth

• Preterm labor management including antenatal corticosteroids*

• Care including Kangaroo mother care, essential newborn care

Birth complications

(and intrapartum stillbirths)

• Prevention with essential obstetric care *• Essential newborn care, and resuscitation*

Neonatal infections

• Prevention, essential newborn care especially breastfeeding, Chlorhexidine where appropriate*

• Case management of neonatal sepsis *

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*Prioritised by the UN Commission on Life Saving Commodities for Women and Children

Over two-thirds of newborn deaths preventable – actionable now without intensive care

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Source: Special analysis detailed in The Lancet Every Newborn Series - forthcomingThe lives of more than 3 million babies and women could be saved each year with high coverage of quality care around birth and care for small and sick babies

Care around birth gives a triple return on investments by reducing maternal and newborn deaths and stillbirths

Care around birth gives a triple return on investments by reducing maternal and newborn deaths and stillbirths


What do we need to do differently for newborns? ENAP 5 Strategic Objectives - midwifery!

What do we need to do differently for newborns? ENAP 5 Strategic Objectives - midwifery!

Strengthen and invest in care during labour, birth and the first day and week of life

Improve the quality of maternal and newborn care:

Reach every woman and every newborn; reduce inequities

Harness the power of parents, families and communities

Count every newborn – measurement, tracking and accountability


The critical role of nursing and midwifery for maternal and newborn care

The critical role of nursing and midwifery for maternal and newborn care

1. Invest in education of midwives to international standards – they provide the essential interventions to save women's and children's lives

2. Invest in health facilities – so they are well equipped and organized to enable staff to provide quality care

3. Collect more and better data on births, deaths and numbers of midwives – information is critical to have the right staff, in the right place, at the right time


The critical role of nursing and midwifery personnel for maternal and newborn careThe critical role of nursing and midwifery personnel for maternal and newborn care

4. Legislation and regulation – is essential to protect women and newborns, as well as nurses and midwives

5. Fight gender discrimination – essential for women to be empowered to seek quality care, and for nurses and midwives to work under acceptable conditions

6- midwifery will free up doctors and other medical staff and is the pathway towards universal humanized care for women and newborns


Number and timing of postnatal contactsNumber and timing of postnatal contacts

What is recommended?

– For facility births: postnatal care for at least 24 hours.

– For is at home births: first postnatal contact as early as possible within 24 hours.

– At least 3 additional postnatal contacts for all mothers and newborns, on day 3 (48-72 hours) and between day 7-14 after birth, and 6 weeks after birth.

Special circumstances: stay in facility probably needs to be longer after Caesarean sections, for single mothers, first time mothers, adolescent mothers, complicated deliveries, small /preterm infants.

What has changed? Harmonization between post-partum and postnatal care


NEW GLOBAL TARGETS : Ending preventable newborn mortality (EPMN) and stillbirths

Every Newborn Action Plan goal :

National NMR of 10 or less in 2035National NMR of 12 or less in 2030

Global average NMR of 9 by 2030


Ending preventable maternal mortality is within reach! Ending preventable maternal mortality is within reach!

Global MMR of less than 70 per 100.000 live births by 2030


NEW! Strategies toward ending preventable maternal mortality (EPMM)

NEW! Strategies toward ending preventable maternal mortality (EPMM)

Stakeholder and Member States consultation was conducted in August 2014

First references to the evidence in Lancet Special Series on Midwifery


NEW ! alignment of ENAP + EPMM NEW ! alignment of ENAP + EPMM

1. Engage in data-driven country analysis to effectively address all causes of death, morbidities, disability and foster country leadership

2. Strengthen and invest in care during pregnancy, labour, birth and the first day and week of life, ensuring full integration of maternal and newborn care

3. Focus on improving quality of care

4. Strengthen health systems — health work force, commodities, innovation

5. Reach every women and every newborn and address inequities in the context of a human rights approach

6. Harness power of parents, families and communities and engage with civil society

7. Count every woman, newborn and stillbirth: strengthen measurement capacity and improve data quality to drive improvement and accountability


FIRST DRAFT HIGHLIGHTSMAY 2015

Global Strategy for Women’s, Children’s and Adolescents’ Health


Draft Outline: post 2015 Global StrategyDraft Outline: post 2015 Global StrategyI. EVERY WOMAN, CHILD AND

ADOLESCENT EVERYWHERE: A HISTORIC JOURNEY AND OPPORTUNITY

II. BIG RETURNS TO INVESTING IN WOMEN’S, CHILDREN’S AND ADOLESCENTS’ HEALTH

III. WHAT IS NEEDED: DEFINING GOALS, OVERCOMING CHALLENGES

IV. HOW TO ACHIEVE THE GOALS: 7 TRANSFORMATIVE ACTIONS

V. WE ALL HAVE A ROLE TO PLAY


Next steps to finalize the new Global Strategy 2015

Next steps to finalize the new Global Strategy 2015

5th May: First draft for EWEC public consultation– 6-7th May: EWEC South Africa consultation meeting– 14th May: Greentree high-level retreat with UNSG – 18th May: World Health Assembly high-level session

5th June: EWEC consultation concludes– 12th June: PMNCH synthesis report

18th July: Addis meeting, Strategy and Coordination Group– Sign-off and send to UNSG for endorsement– Translation and publication of the Strategy

September: UN General Assembly launch alongside the SDGs


THANK YOU ! THANK YOU !

“We need more midwives, we need more midwives, we need more midwives!!!”

State of World’s Midwifery Report event, Geneva, 23rd February 2015

Documents

RCM IDM May 5 th, 2015 Edinburgh 1 |1 | Every Newborn Action Plan Midwives for a better tomorrow Fran McConville, RCM IDM, Edinburgh May 5 th 2015 Every