The ‘Every Newborn’ Maternal – Newborn Bottleneck Analysis Tool

The Every Newborn BNA Tool • Standardized questionnaire to assess barriers and identify

solutions to scale-up newborn care+++

• Divided into 2 sections:Section I includes questions to assess bottlenecks to scale-up newborn health programmes in generalSection II is sub-divided into 9 sub-sections. Each section includes questions to assess bottlenecks to scale-up each critical maternal and newborn interventions, in particular

• Each section includes a chapter on solutions and strategies to address identified challenges/barriers

The Every Newborn BNA Tool Section I includes questions related to newborn health programmes in general and is organized into health system building blocks as follows:

1. Leadership and governance (enabling environment) 2. Health financing (enabling environment)3. Health work force (supply)4. Essential medical products and technologies (supply)5. Health services (supply, quality)6. Health information systems (quality)7. Community ownership and participation (demand)

The Every Newborn BNA Tool • Section II is sub-divided into 9 sub-sections

representing critical newborn interventions

• These are considered as “tracer interventions” and most likely appropriate to be used as “proxy” to get an understanding of challenges related to key newborn interventions delivered through a similar platform

• The questionnaire focuses on interventions around the 24 hours of birth; labour, child birth and immediate postnatal care

The Every Newborn BNA Tool Section II selected interventions are:

1. Management of pre-term birth - focus on antenatal corticosteroids

2. Skilled care at birth - focus on the use of the partograph3. Basic Emergency Obstetric Care - focus on assisted

vaginal delivery4. Comprehensive Emergency Obstetric Care - focus on

caesarean section5. Basic Newborn Care - focus on cleanliness including cord

care, warmth, and feeding

The Every Newborn BNA Tool

5. Neonatal resuscitation

6. Kangaroo mother care - focus on skin to skin, breastfeeding and feeding support for premature and small babies

7. Treatment of severe infections - focus on using injectable antibiotics

8. Inpatient supportive care for sick and small newborns - focus on IV fluids/feeding support and safe oxygen

The Every Newborn BNA Tool

• Each section (Section I, sub-sections of section II) has a chapter on the identification of potential strategies and solutions to address the priority bottlenecks according to the health systems building blocks

The Every Newborn BNA Tool Group Work on the BNA

Objectives• Become familiar with the questionnaire • Analyze challenges to scale-up newborn care (“Kick – off” session)• Identify solutions to address the barriers• Provide feedback/inputs (formulation of the questions, clarification on contents, etc)

to improve the tool

Participatory process: Each country should assess the bottlenecks and identify practical and realistic solutions to address the challenges/ bottlenecks. Each country will focus on: • Section I: Newborn care in general (Day 1 -afternoon)• Section II: Two interventions randomly assigned- see guidelines (Day 2- morning)

Feedback: Formal feedback on group work will be provided by each country in a plenary session