|© UNICEF video|
|A new training curriculum will help to strengthen the integration of maternal, newborn and child health at the community level in Africa.|
By Victor Chinyama
NAIROBI, Kenya, 26 June 2007 – Twenty-year-old Evelyn Katunge doesn’t know what killed her babies. In April 2005, with the help of birth attendants in her Majengo home, a sprawling slum near downtown Nairobi, she gave birth to twins, a boy and a girl. Her joy, however, was cruelly shattered when her first baby died within hours, soon followed by her other baby. Devastated, Evelyn blamed the two birth attendants but couldn’t be too sure as she had no facts to back it up.
All across Africa, every day, Evelyn’s misfortune is multiplied 3,000 times over. More than 1 million babies die every year within the first month of life, the causes attributed to infections such as pneumonia, birth asphyxia, premature birth and low birth weight. These conditions are not necessarily fatal, but the majority of mothers in Africa deliver their babies at home, without skilled medical help. The results in terms of newborn lives lost are catastrophic.
Learning the lessons
Evelyn’s babies and those of millions of other women in Africa could be saved using simple, proven and cost-effective methods. In November 2006, UNICEF sponsored key decision-makers from Ethiopia, Kenya, Uganda, Zambia, Malawi, Mozambique and Madagascar to travel to Gadchiroli District in Maharastra State, western India, where they studied Dr. Abhay Bang’s pioneering work on newborn care.
Through the NGO he founded, the Society for Education, Action and Research in Community Health (SEARCH), Dr. Bang has successfully reduced by two-thirds the number of newborn babies dying within the first month of life in 40 poor, rural communities in Gadchiroli. His model is hailed as a feasible and cost-effective strategy for poor communities in Africa.
The programme provides basic health care to babies who are delivered at home. Village health workers are trained to diagnose complications such as pneumonia, pre-term and birth asphyxia, and are equipped with a basic $60 medical kit consisting of a baby sleeping sack, a bag and mask for resuscitation, and antibiotics.
In late June, UNICEF brought together 30 master trainers from 10 African countries for an eight-day training on community-based newborn care. The training is a major milestone in UNICEF’s efforts to help governments introduce newborn care using community health workers, health extension workers and other frontline staff.
Participants included senior paediatricians, health trainers and managers of maternal, newborn and child health programmes.
The training is intended to help strengthen the integration of newborn care with other maternal and child health programmes at the community level. The curriculum developed by UNICEF is an adaptation of the one used by SEARCH in India. Communication materials have been adapted from Bolivia.
“This training is exactly what we need to support the introduction of community-based newborn care,” said Dr. Mary Ngoma, a Consultant Pediatrician at the University Teaching Hospital in Zambia. The Ministry of Health in Zambia has plans to introduce community-based newborn care in two districts. Community health workers will be trained to identify and manage infections in newborns at home.
Mark Tomlinson, a health systems researcher at the Medical Research Council in Cape Town, South Africa, said the curriculum would be used to develop a manual on community-based newborn care. “Now we can just adapt the UNICEF training curriculum instead of inventing a new wheel,” he noted.
UNICEF Regional Director Per Engebak said there was no excuse for inaction on newborn care, as the knowledge, evidence, and tools are readily available. “All we need now is to begin rolling out and scaling up our interventions, as Malawi and Ethiopia are already doing,” he said. “We have a duty to give newborns a chance to live.”