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Helping Babies Breathe annual meeting . Prof Bogale Worku Washington DC July 17/ 2012 . 3. Ethiopia’s Progress to meet MDG 4. According to 2008 National EmONC assessment, 66 % of HCs did not have a resuscitation bag and mask. .

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Helping babies breathe annual meeting
Helping Babies Breathe annual meeting

Prof Bogale Worku

Washington DC

July 17/ 2012

3


Ethiopia s progress to meet mdg 4
Ethiopia’s Progress to meet MDG 4.

According to 2008 National EmONC assessment, 66 % of HCs did not have a resuscitation bag and mask.

Data sources: Updated from Opportunities for Africa’s Newborns with UN data from www.childmortality.org. * 2010 year contains 2008 data


National scale up strategy of hbb in ethiopia
National scale up strategy of HBB in Ethiopia

  • Govt ownershipwith extensive collaboration among all maternal, newborn and child health partners

  • HBB is integrated in existing and new trainings and programs:

    • NBC training /Newborn corner ,

    • NICU nurse training ,

    • CEmONC / BEmONC,

    • PMTCT,

    • ICCM, New IMNCI

    • Pre-service training for midwifes

    • Others


National scale up strategy cont
National scale up strategy cont.

  • Rollout strategy for Ethiopia

    • Champions and high level advocacy

    • Government coordination with all MNCH partners

    • Master level TOT for trainers and supervisors of existing MNCH training programs

    • UNICEF making available resuscitation equipment and for both training and service

    • No specific budget needed as the program is rolled out through integration though existing programs




Evaluation newborn c orner
Evaluation - Newborn Corner

  • The newborn corner is an initiative to address gaps in preventing newborn morbidity and mortality by ensuring standard newborn care immediately after birth in health facilities.

  • Piloting in 100 facilities by EPS in collaboration with FMoH and UNICEF

  • 354 HW including MDs, HOs, midwifes and clinical nurses

  • 3 days on ENC, HBB, KMC and sepsis management

  • providing supplies and clinical mentoring post training.


The newborn corner
The newborn corner

  • Trained personnel to care for the baby

  • A warm and clean surface

  • Essential newborn resuscitation equipments


Evaluation results
Evaluation - Results

  • Baseline and end line assessment in 60 facilities looking at knowledge, skills and availability of basic resuscitation equipment



C omparison health workers skill on neonatal resuscitation on base line and end line survey
Comparison % health workers skill on neonatal resuscitation on base line and end line survey


Number of newborn with asphyxia one month in 60 health facilities
Number of newborn with asphyxia(one month in 60 health facilities )


Results to date in ethiopia
Results to date in Ethiopia

  • Carders trained on HBB by 31 June 2012

    Health workers 7 295

    HEWs 20 050

    Total 27 345

  • Bag and mask distributed by 31 April 2012

    Health centers 354

    Hospitals 50

    Total 404 out of 3000 HF (13,5%)

    • Resuscitation equipment available 8 000, plus an additional 10 000 to arrive shortly in Ethiopia. In addition 2 000 NeoNatalie training dolls are available in Ethiopia for HBB training.


Quality improvement process
Quality improvement process

  • Neonatal registration book in place

  • Supportivesupervision and clinicalmentoring post-training

  • Guidelines and protocols for newborn resuscitation is being under development

  • Quarterly / annual review meetings planned


Lessons learned
Lessons learned

  • Integration has been a successful way to quickly train and orient a large number of health workers and community health workers (HEWs) on HBB in Ethiopia.

  • Having a strong governmental leadership with close collaboration among partners is the only way to make changes to newborn survival in a large country with limited funding sources.

  • Making training material and resuscitation equipment available has helped the HBB rollout.

  • Early data shows that the training on HBB among HWs has improved their skills.


However
However…

  • Still only around 10% of deliveries are conducted in health facilities, and only 1% of the HEW have the opportunity to conduct deliveries.

  • Data on newborns not yet systematically collected as current HMIS does not fully address NB issues


Acknowledgements
Acknowledgements

  • FMoH

  • UNICEF

  • WHO

  • ICAP – Ethiopia



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