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Country Team Action Plan Scaling-Up Management of Neonatal Sepsis in Indonesia

Country Team Action Plan Scaling-Up Management of Neonatal Sepsis in Indonesia. Background. NMR: 19/1000 (57% of IMR) ; Neonatal Infection is the 3rd major killer ~ 54% home delivery, low access of newborn care, cultural & geographical barrier

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Country Team Action Plan Scaling-Up Management of Neonatal Sepsis in Indonesia

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  1. Country Team Action PlanScaling-Up Management of Neonatal Sepsis in Indonesia

  2. Background • NMR: 19/1000 (57% of IMR) ; Neonatal Infection is the 3rd major killer • ~ 54% home delivery, low access of newborn care, cultural & geographical barrier • Midwives are the front line health providers at community (55%) • IMCI algorithm adopted & implemented, • Health center with BEONC & hospital with CEONC implemented as referral services • Completed Manual of Pediatric Service in Hospital • Schedule for postnatal visit: NV1 (6-48 hours), NV2 (3-7 days) & NV3 (8-28 days) • Decentralized health system at district (489 districts)

  3. Intervention • Improving case management of neonatal sepsis at community level through home visits • Midwives • Nurses • Community health cadre

  4. Evidence of effectiveness community based newborn care • Global evidence in India, Nepal, Bangladesh, and Pakistan of community based newborn care • Joint statement WHO/UNICEF on community-based newborn care • Management of birth asphyxia by community midwives in Cirebon, West Java (SNL) • Indonesia IMCI (include diarrhea & pneumonia)

  5. Stakeholders involve in scaling up • MoH, Provincial & District Health Office • Professional organizations (Pediatrician, Obgyn, Medical, Perinatologist, Midwive, Nurse, Public Health, Nutritionist) • Institutional academics • National Family Planning Board, Ministry of Internal Affairs, Ministry of Women Empowerment & Children Protection, Ministry of Education, Ministry of Religion) • Local NGOs • International agencies (Unicef, USAID, WHO, World Bank, ADB, GTZ, AusAID, JHPIEGO, Mercy Corps, WVI, Save the Children, etc) • Media

  6. Policy Implication • Task shifting: review role of nurses & midwives, community health cadres, and TBAs to identify and manage neonatal sepsis • Legal authority: delegation of authority from and among professional organizations • Funding resources:to provide operational cost for home visits from central, provincial, & district/municipalities budget • Logistic issue of supply chain management of antibiotic • Trainings: pre- & in-service for health providers • Community mobilization to increase demand for newborn care

  7. Pilot Project Area Suggested criteria of choosing pilot project area: • Public health development index, child health & nutrition problem • Financial capacity • Geographical • Health workers availability: health staff -midwives, nurses- or non-health staff/cadres, FP workers • Possible resources: budget, human resource in health, supervisions. • Local government leadership • Urban/rural considerations

  8. Piloting Project Areas Scenario for intervention, different areas: • Availability of midwives &/ nurses • No midwives but nurses available • No midwives and no nurses available, CHWs exist • Possible areas: • Serang – West Java (Java) • Bireun – Aceh (Sumatera) • Kutai Timur – East Kalimantan (Kalimantan)

  9. Monitoring & Evaluation • Using MNCH local area monitoring system (LAMAT) • Robust and regular M&E • Good documentation

  10. Action Steps

  11. Terima kasih

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