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The problem

The problem. Close to 4 million deaths occur in the first 28 days of life (the neonatal or newborn period) in the world each year ; 40% of all under-five deaths – most within 7 days of birth;

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The problem

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  1. The problem • Close to 4 milliondeaths occur in the first 28 days of life (the neonatal or newborn period) in the world each year; • 40% of all under-five deaths – most within 7 days of birth; • Three main causes – infections, asphyxia, and preterm birth – account for nearly 80% of these deaths.

  2. Deaths that could be prevented • Up to two thirds of newborn deaths could be prevented if known, effective health measures were provided at birth and during the first week of life; • Yet 47% of all mothers and newborns in developing countries do not receive skilled care during and immediately after birth, and 72% of all babies born outside the hospital do not receive any postnatal care.

  3. Home visits for newborn care by a trained health worker can save lives

  4. Effectiveness of home visits for newborn care

  5. Recommendation:Home care visits on days one and three of a newborn's life, and if possible, a third visit on day seven. Health workers should: • Promote early and exclusive breastfeeding; • Help keep the newborn warm; • Promote hygienic umbilical cord and skin care; • Assess the baby for signs of problems - seek prompt medical care if so • Promote birth registration and timely vaccination; • Identify and support additional care to low-birth-weight, sick newborns or those who have an HIV-infected mother; and • Ask and counsel the mother about her own health.

  6. Examples of workers in existing government programmes • Community midwives in Indonesia • Community workers of the Integrated Management of Neonatal and Childhood Illness (IMNCI) programme in India • Female community health volunteers in Nepal • Health Surveillance Assistants (HSAs) in Malawi • Health extension workers in Ethiopia

  7. Recommendations for countries • All newborns should receive appropriate care especially in the first hours and week of life when they are most vulnerable; • Each country should analyse the current policies and practices to provide such care; • A home visitation programme is recommended where access to facility-based skilled care is limited; • Home visits should be initiated as soon as possible after birth or after returning home; and • Postnatal home care by community health workers should be linked to the health system and the full continuum of care.

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