Dr Hanifah Sengendo

Imperial Royale Hotel, Kampala26 June 2013

Session 1: Newborn Survival and Health

within Global Initiatives

OutlineWhy focus on newborn?

What are some of the linked RMNCH global initiatives?Every Woman Every ChildBorn Too SoonA Promise RenewedUN Commission on Life Saving CommoditiesFamily Planning 2020Commission on Information & AccountabilityCountdown to 2015 for MNCH

Where does the EVERY NEWBORN action plan fit in?

What does this mean for Uganda?

No baby stillborn

Uganda’s delivery goal

No newborn

born to die

88,000 die4,700 die 38,00 die

No child stunted or dying

43,000 die

33,000 within a few days of birth (intrapartum stillbirths and first day neonatal deaths)

147,000 deaths each year

Source: Mbonye et al, 2012. Lawn J,E. et al. 2012. Decade of change for Newborn Health in Uganda. Health Policy and Planning. 27(Suppl. 3). Data sources: UNICEF 2011 www.childinfo.org , UN MMR estimates 2012

Progress for reducing maternal, newborn and child deaths in Uganda has accelerated with the MDGs

Average rate reduction 2000-2010

Maternal mortality ratio 5.2%

Children aged 1- 59 months 4.1%

Neonatal mortality (newborn, first 4 weeks after birth)

2.2%

Stillbirths (global)(last 3 months of pregnancy)

1.0%(1995-2009)

At least 30% slower for

newborn survival

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Strong link between maternal and newborn: essential interventions

The UN Secretary-General's Global Strategy for Women's and Children's Health is the first comprehensive roadmap to accelerate progress, deliver results, and ensure accountability for women's and children's health by:

• Galvanizing commitments and action from partners• Prioritizing women’s and children’s health in national health plans• Ensuring access to a comprehensive, integrated package of essential

services and interventions• Addressing critical health system gaps, including human resources• Holding ourselves accountable for results • Addressing social determinants

The Global Action Report on

Preterm Birth

Born Too Soon

• 4 lead organizations, 50 partner organizations

• 45 authors from 11 countries • Linked to Every Woman Every

Child• Action agenda for professionals,

policymakers and parents• Uganda is a champion

country for preterm birth care

1. Evidence-based country plansParticipating governments will lead the effort to sharpen country plans. Milestones for maternal, newborn and child survival will be identified to track and hasten declines in child mortality.

2. Transparency and mutual accountabilityGovernments and partners from civil society, the U.N. and the private sector will track and report the global progress of child survival strategies.

2035 target for U5MR for all countries: 20 deaths per 1000 live births.

3. Global communication and social mobilizationSocial media, publications, and other communication channels will be used to sustain the focus on and generate momentum for the goal to end preventable deaths.

Uganda’s launch of A Promise Renewed: comprehensive RMNCH plan with Presidential commitment planned for August 2013

UN Commission on Life-Saving Commodities • Shaping global markets• Shaping local delivery markets• Innovative financing• Strengthening quality• Making regulation efficient

• Female condoms• Implants• Emergency contraception• Oxytocin• Misoprostol• Magnesium sulphate

• Increasing supply and awareness• Increasing demand and utilisation• Reaching the poorest• Improving performance• Prioritizing and funding innovation

10 recommendations

• Injectable antibiotics• Antenatal Corticosteroids• Chlorhexidine• Resuscitation equipment• Amoxicillin• Oral Rehydration Salts • Zinc

13 commodities

Family Planning 2020• FP2020 builds on the partnerships launched at the

London Summit on Family Planning in June 2012 where global leaders committed to provide 120 million women in the world's poorest countries with access to contraceptives by 2020

• It will sustain the momentum from London and ensure all partners are working together to achieve and support the goals and commitments announced at the Summit

• In Uganda, the President has pledged to provide an additional US$5m annually for reproductive health supplies

UN Commission on Information and Accountability

Launched in 2011, the Commission sets out a framework for global reporting and oversight on women’s and children’s health.

There are 10 recommendations for strengthening accountability and reporting mechanisms at country levelIn May 2013, one page MNCH accountability data profiles were released linked to Countdown to 2015 for MNCH.

• Countdown to 2015 tracks coverage of health interventions proven to reduce maternal, newborn and child mortality.

• Calls on governments and development partners to be accountable, identifies knowledge gaps, and proposes new actions to reach MDG 4 and 5.

• District-level Countdown being phased in for priority districts in Uganda linked to the Commission on Information & Accountability

Family Planning Summit Every Newborn A Promise

Renewed

Country leadership & Implementation

Global action plans: scaling up nutrition, global action plan for pneumonia & diarrhea, Born Too Soon,

WASH for all

www.everywomaneverychild.org

Key catalytic initiatives in support of Every Woman Every Child

Commission on Live-saving Commodities

‘Every Newborn’ supports existing global initiatives

Commission of Information and Accountability Recommendations

10-part framework for global reporting, oversight and accountability on women's and children's health

Reviewing progress on the Global Strategy and the Commission’s recommendations

Independent Expert Review Group

Who? Global mechanisms for coordinated action and advocacy Some examples:

• Country demand for guidance and action

• Large problem but huge potential for rapid change since we know what to do and can develop clear context specific guidance on HOW

• Harmonize global response which so far has been slow and needs to link to many existing initiatives for reproductive, maternal, child and adolescent health care, scaling up global attention and action

Why Every Newborn?

Every Newborn Bottleneck Analysis Process

• Stimulate national dialogue and action to accelerate progress for newborn health and stillbirth reduction by all key country stakeholders

• Systematically assess status for high impact interventions and plan how to overcome bottlenecks for scale-up and ensure reflected in government plans with adequate funding

• Linked to RAIC and district bottleneck process with a specific focus on barriers to scaling up newborn care

Health Sector Strategic Plan

RMNCH Strategic Plan - APR

Increased access and use of FP

Ending preventable newborn deaths

Ending preventable child deaths

Ending preventable maternal deathsCOMMODITIES, HUMAN RESOURCES etc.

How it all fits together

Who is involved to build this movement?• Global plan for country action linked to Every Woman

Every Child, and to A Promise Renewed, following Born Too Soon report and World Prematurity Day movement

• Global partnership with multiple organizations including:– Country governments and parliamentarians– United Nations – NGOs– Universities and Professional organizations– Donors and foundations– All the PMNCH 500+ constituencies

NATIONAL action by professionals, policymakers and parents = ALL OF US !!

Global launch May 2014 linked to the World Health AssemblyCountry consultations and global communities

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