The Every Newborn Action plan (ENAP) was launched in 2015. It set bold global targets to reduce neonatal mortality and Stillbirths to below 12/1000 births by 2030. Five years later how are we progressing?
The past 30 years have seen remarkable progress in child survival and newborn health in all regions of the world. The global Newborn Mortality Rate declined by more than half between 1990 and 2018, from 37 deaths per 1000 live births to 18 deaths per 1000 live births. Yet, the fact remains, the risk of dying is highest in the time around birth and the first month of life. Newborn deaths represent 47% of all under-5 child mortality, accounting for 2.5 million deaths in 2018. This is 7000 newborn deaths each day. Ninety-eight per cent of newborn mortality occurs in low- and middle income countries (LMICs) and 78% occur in sub-Saharan Africa and Asia.
Moving faster to end preventable newborn deaths and stillbirths by 2030 was launched on 3 September 2020. This includes a report on progress up to the end of 2019 and an Update to ENAP to include coverage targets. It was really great to see our COINN President endorsing the Report during the launch-giving visibility to and reinforcing the importance of neonatal nurses at this very high global level.
These targets include:
- 90% global coverage of four or more antenatal care contacts
- 90% global average coverage of births attended by skilled health personnel
- 80% global coverage of early (within 2 days) routine postnatal care
- 80% of countries have a national implementation plan that is being implemented in at least half the country, with an appropriate number of functional level-2 inpatient units linked to level-1 units to care for small and sick newborns, with family-centred care.
It is exciting to see international reports and recommendations moving from just calling for skilled attendance at birth (the role of midwives) and basic newborn to now acknowledging the need for more advanced care for sick and small neonates in neonatal units.
In the Survive and Thrive report (as discussed in our recent newsletter) there is now a clear recommendation for countries to create a specialised cadre of nurses to care for sick and small neonates (See page 67). This may give support for our lobbying with SANC for specialised Neonatal Nurse training!
The Quality Standards for Sick and small newborns provide a very comprehensive road map of what is required to deliver excellent neonatal care to to improve neonatal outcomes. It was very pleasing to see the central role parents have been given in this document. It will be worthwhile to review your facility polices / audit tools to ensure they are aligned with the standards set forth in this document.
The necessary elements to improve standards of care include ensuring the availability of essential medicines and commodities; compliance with evidenced-based clinical interventions and practice; an adequate hygiene infrastructure; competent and motivated staff; as well as solid documentation and use of information. In summary, it requires an intensive effort that will transform care at a critical time in the life-cycle. Taking action will have a powerful positive impact on the health and life opportunities of future generations.
Global actions now will determine the course of maternal and newborn health for the next decade and the health and lives of future generations. Essential health services, including high-quality maternal and newborn health care must be sustained and further strengthened to withstand shocks like COVID-19, in order to protect the lives and health of women and children and make progress towards the SDGs.
Links to these reports can be found below: