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BRAC. Community Based Newborn Care. Partnership approach to achieve the MDGs in Bangladesh. PRESENTATION OUTLINE. Maternal and Child Health Scenario in Bangladesh. BRAC MNCH Programme. Service Delivery. Service provider. Intervention areas. ANC, PNC. Essential Newborn Care.

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Community based newborn care

BRAC

Community Based Newborn Care

Partnership approach to achieve the MDGs in Bangladesh


Community based newborn care

PRESENTATION OUTLINE

Maternal and Child Health Scenario in Bangladesh

BRAC MNCH Programme

Service Delivery

Service provider

Intervention areas

ANC, PNC

Essential Newborn Care

Reduction of NMR

Challenges addressed, Lessons learned


Community based newborn care

Maternal and Child Health Scenario in Bangladesh

A reduction from 12,000 maternal deaths per year in 2001 to about 7,300 in 2010

An increase in hospital birth from 9.2% to 23% and skilled attendance at delivery from 12.2% to 26.5% in three years

Of 250,000 annual under-five deaths, over half die in their first month

At least two-thirds of these deaths could be averted by ensuring appropriate care

Source : BMMS 2010, BDHS 2007


Community based newborn care

BRAC MNCH PROGRAMME


Community based newborn care

BRAC MNCH PROGRAMME IMPLEMENTATION AREAS

19

million rural populations


Community based newborn care

5. Linkage between community and

public/private health facilities

4. Timely Referral of emergency

cases

p

2. Community empowerment

1. Capacity development of HR

3. Services rendered at community,

households and facilities

NHW

SS

SK

CSBA

Midwife

Staff

OPERATIONAL STRATEGIES


Community based newborn care

SERVICE PROVIDER AT COMMUNITY LEVEL

  • Selected from localities

  • Age 25-45 years

  • Married

  • Willingness to work

  • Community acceptability

  • Selected from localities

  • Age 25-45 years

  • Married

  • Willingness to work

  • Community acceptability

  • Selected from localities

  • Age 20-35 years

  • Married

  • Minimum SSC

  • Willingness to work

  • Community acceptability


Community based newborn care

SERVICE DELIVERY

  • Maternal Care

  • Identification of pregnancy

  • Ante, intra & post natal care

  • Referral of maternal complications

  • Family planning

  • Post-abortion care

  • Neonatal Care

  • Essential Newborn care

  • Special care for LBW babies

  • Management of birth asphyxia

  • Detection and referral of Neonatal sepsis

  • Referral of complications

  • Child Care

  • Exclusive breast feeding and complementary feeding

  • Immunization and Vitamin A intake

  • Community case management of ARI and diarrhea

  • Referral of complications


Community based newborn care

REFERRAL SYSTEM

Referral Hub


Community based newborn care

UTILIZATION OF ANTENATALAND POSTNATAL CARE

Baseline



Community based newborn care

ESSENTIAL Hospitals NEWBORN CARE

Increasing coverage of essential newborn care


Community based newborn care

LOW BIRTH WEIGHT DETECTION AND HospitalsSPECIAL CARE



Community based newborn care

REDUCTION OF HospitalsNEONATAL MORTALITY

* BDHS 2007; BRAC MIS


Community based newborn care

CHALLENGES HospitalsADDRESSED

Changes in behavior and practices

Community health worker’s adoption of new knowledge and practices

Lack of competence among health providers to manage neonatal sepsis

Lack of services in referral facilities for managing newborn complications


Community based newborn care

LESSONS HospitalsLEARNED

  • Community health workers can perform if properly trained and supervised

  • Support of skill mix team

  • Postnatal home visit

  • Performance based incentives

  • Community support network

  • Referral support network


Community based newborn care

THE HospitalsEND

THANK YOU