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Community Based Newborn Care

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

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  1. BRAC Community Based Newborn Care Partnership approach to achieve the MDGs in Bangladesh

  2. 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

  3. 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

  4. BRAC MNCH PROGRAMME

  5. BRAC MNCH PROGRAMME IMPLEMENTATION AREAS 19 million rural populations

  6. 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

  7. 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

  8. 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

  9. REFERRAL SYSTEM Referral Hub

  10. UTILIZATION OF ANTENATALAND POSTNATAL CARE Baseline

  11. A major shift is observed in place of birth from home to Hospitals TREND IN PLACE OF BIRTH

  12. ESSENTIAL NEWBORN CARE Increasing coverage of essential newborn care

  13. LOW BIRTH WEIGHT DETECTION AND SPECIAL CARE

  14. Sick Newborn Case Management

  15. REDUCTION OF NEONATAL MORTALITY * BDHS 2007; BRAC MIS

  16. CHALLENGES ADDRESSED 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

  17. LESSONS LEARNED • 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

  18. THE END THANK YOU

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