EVERY NEWBORN An Action Plan To End Preventable

EVERY NEWBORN An Action Plan To End Preventable Deaths EVERY NEWBORN UPDATE 3 December 2014 #Every. Newborn

Agenda § Current status • History, structure, activities § Working group updates • Country Implementation • Metrics • Advocacy § Moving forward • Next steps and roles of partners § Questions and discussion www. everynewborn. org #Every. Newborn

Building a movement tion c a y r t Coun for alth n he r o b w ne World Health Assembly x The end of MDGs brings new clarity about what is left behind on the agenda – newborns, stillbirths, adolescents www. everynewborn. org #Every. Newborn

Building from evidence to action Every Newborn Series 5 papers, 6 comments 55 authors from 18+ countries 60+ partner organizations Published May 2014 www. thelancet. com/series/everynewborn Main funders: Bill & Melinda Gates Foundation, USAID, Children’s Investment Fund Foundation Every Newborn Action Plan Based on the evidence from the Series Co-led by UNICEF & WHO World Health Assembly 2014 resolution Over 300 experts consulted 60+ partner organization Launched 30 th June 2014 40+ commitments to EWEC www. everynewborn. org #Every. Newborn

Graça Machel and other world leaders launched the Every Newborn action plan Partners Forum, South Africa, June 2014 Progress is still too slow, especially for newborns. Today we launch the Every to speed up our response and save more lives. - Ban Ki-Moon, UN Secretary General Our efforts have meaning only if those who are born today can enjoy them. - Cyril Ramaphosa, Deputy Vice President of South Africa Newborn was a gap. The World Health Assembly agreed and passed ENAP. - Margaret Chan, World Health Organization This plan demonstrates that together we can achieve the vision of This is where we get the biggest a world in which there bang for our buck. are no preventable deaths of newborns - Kim Dixon, Co-Chair ENAP, or stillbirths, where every pregnancy is wanted, every birth UNICEF celebrated, and women, babies and children survive, thrive and reach their full potential – Graça Machel www. everynewborn. org #Every. Newborn

EVERY NEWBORN Commitments World Health Assembly Resolution 194 member states endorsed the Every Newborn Action Plan in May 2014 Now 40 new commitments, largest collection since launch of Every Woman, Every Child in 2010 #Every. Newborn www. lancet/series/everynewborn www. everynewborn. org

Every Newborn priority activities The partnerships forged during the development process for ENAP will work together on three main streams of activities: 1. Country implementation: to identify and respond to technical support needs to ensure that the proposed strategies and evidence are translated into action 2. Data and metrics: to improve and institutionalize metrics to track coverage and impact based on the goals and targets of the ENAP and the five strategic objectives 3. Advocacy: to strengthen and track maternal and newborn health advocacy efforts globally and in countries. Research www. everynewborn. org #Every. Newborn

New ENAP structure § New management structure set up to strengthen the support to the three main streams of activities § Members include: • Three working groups co-leads: WHO, UNICEF, LSHTM, UN Foundation, PMNCH, Save the Children • Chairs: WHO and UNICEF • Other core partners: BMGF, UNFPA, MHTF, USAID § Channels of communication for wider group of stakeholders: • Participation in one or more of the work streams either as core member or wider group member • Regular updates from ENAP management team though different outreach mechanisms e. g. email updates, discussion fora, webinars, global and national meetings. www. everynewborn. org #Every. Newborn

EVERY NEWBORN An Action Plan To End Preventable Deaths ENAP COUNTRY IMPLEMENTATION GROUP Kim Dickson and Bernadette Daelmans on behalf of team #Every. Newborn www. lancet. com/series/everynewborn #Every. Newborn

Country Implementation Group Purpose: § To identify and respond to technical support needs to ensure that the proposed strategies and evidence are translated into action Goals: 1. To strengthen technical support coordination 2. To strengthen monitoring of country implementation and track progress 3. To provide technical assistance for EMEN development, implementation and assessment Team § Leads: WHO (Bernadette Daelmans) and UNICEF (Kim Dickson) § Core partners: UNICEF, Save the Children, CIFF, BMGF, USAID www. everynewborn. org #Every. Newborn

Country Implementation Group Activity 1. To orient and support action in countries by providing technical country support and facilitate coordination including mapping partners activities, available tools and engagement of partners as well as support in the development and launch of national action plans and capacity building for effective interventions • Mapping of technical assistance currently available within countries underway and development of a repository of TA. • Inter-country meetings on Every Newborn e. g. Sri Lanka WHO/UNICEF regional meeting held in November 2014 www. everynewborn. org #Every. Newborn

Country Implementation Group Activity 2. Monitor and track progress of country implementation • Progress tracking tool has been shared by facilitating partners in many countries and countries have started returning completed tools. Data analysis to be completed by end December 2014 3. Develop, implement and evaluate the Every Mother Every Newborn Quality Improvement Initiative • Literature review of accreditation programmes, country quality improvement activities and incentives programmes underway www. everynewborn. org #Every. Newborn

Country Implementation Group Next steps/plan § Development of pre-term guidelines (for 2015) and guidelines for the management of possible severe bacterial infection (for 2015) § Progress report on newborn health to be prepared next year § Eastern Mediterranean Region meetings planned for Q 1 2015 § Stakeholders meeting on EMEN – date TBC www. everynewborn. org #Every. Newborn

EVERY NEWBORN An Action Plan To End Preventable Deaths ENAP METRICS GROUP Matthews Mathai and Joy Lawn on behalf of team #Every. Newborn www. lancet. com/series/everynewborn #Every. Newborn

Improving, institutionalising & using ENAP metrics for action ENAP Milestones by 2020 • Count births and deaths in CVRS (women, newborns and stillbirths) • Minimum perinatal dataset & perinatal mortality audit being widely used in countries • ENAP core indicators to be defined , incorporated in national metrics platforms and widely used ries t n u in co ability e s u nt nd u a o c g c n esti nt and a t s c i Metr proveme e im m m gra ro for p June 2015 - May 2018 Testing indicators and tools in limited number of countries Jan- May 2015 Refining and consulting on Dec 2014 metrics plan Meeting & ENAP monitoring FW To scope ENAP Metrics improvement plan x World Health Assembly May/June 2014 2020 June 2018 - May 2020 Wide use in many countries CVRS, facility HMIS, surveys

Every Newborn action plan core indicators Core ENAP Indicators 1. Maternal Mortality Ratio 2. Stillbirth Rate 3. Neonatal Mortality Rate Impact Coverage: Care for all mothers and newborns Additional Indicators Intrapartum Stillbirth Rate Low birth weight rate Preterm birth rate Small for gestational age Neonatal morbidity rates , eg infection Disability after neonatal conditions 4. Skilled attendant at birth 5. Early postnatal care for mothers and babies Immediate breastfeeding 6. Exclusive breast feeding to 6 months 7. Antenatal corticosteroid use Caesarean section rate Coverage: 8. Newborn resuscitation Complications and 9. Kangaroo mother care, feeding support extra care 10. Treatment of neonatal sepsis Chlorhexidine cord cleansing Counting Birth registration Death registration, cause of death "Mother. Baby" high quality care at birth ENAP service delivery packages Care of small and sick newborn Shaded = not currently routinely tracked. Bold = indicator requiring additional evaluation for consistent measurement All indicators to be tracked so that they can be broken down to assess equity, e. g. urban/rural, regional, wealth quintile Source: Every Newborn: From evidence to action to deliver a healthy start for the next generation. Mason E. , Mc. Dougall L, Lawn JE, Gupta G, Claeson M, Pillay Y, Presern C, Baye Lukong, M, Mann, G, Wijnroks M, Azad K, Taylor K, Beattie A, Bhutta ZA, Chopra M for the Lancet Every Newborn Study Group. Lancet 2014.

Every newborn management including ENAP Metrics Every Newborn Steering Group Every Newborn Management team work streams 1. Country Implementation UNICEF & WHO 2. ENAP Metrics group WHO & LSHTM 3. Advocacy & mobilisation UNF/PMNCH & Save the Children Research working group (Cross cutting) Light touch secretariat ENAP Metrics group: CO CHAIRS WHO: Matthews Mathai LSHTM: Joy Lawn COORDINATION GROUP UNICEF: Holly Newby plus alternate (purpose to link to existing UNFPA: Sennen Hounton metrics work, and SNL/NBITWG: Lara Vaz institutionalise) CIFF: Suzanne Fournier Gates: John Grove USAID: Allisyn Moran TASK TEAMS Task teams (working on specific Initial focus on the 4+1 specific metrics, linked with newborn care interventions existing initiatives) WIDER INTEREST GROUP >100 people drawn from wider Very inclusive metrics community including Newborn indicators technical working group INSTITUTIONAL PARTNERS Aim to have 2 -4 academic to build capacity especially institutional partners in high burden Africa & Asia countries linked to EMEN pilot sites (Ghana, Tz, Bangladesh, Kenya)

Three tracks of work for ENAP metrics 1 Technical mapping & planning of indicators, tools & work in progress 2 Improve & institutionalise tools in national data collection platforms & global metrics architecture, accountability 3 Capacity development to improve & use the data for action Initial focus on testing 4 + 1 priority treatment interventions 1. 2. 3. 4. 5. KMC (coordinated with KMC acceleration gp and LSHTM with SNL) Resuscitation (USAID/MCS, SNL Bangladesh, WHO, HBB, UNCo. LSC, etc) Antenatal Corticosteroids (WHO and UNCo. LSC TRT etc) Sepsis case mx (WHO, UNCo. LSC etc) CHX cord cleansing (UNCo. LSC, SNL etc) • Coverage/ content maternal & newborn care (with NBITWG & ICM) • Impact indicators including disability (LSHTM & WHO) • Priority research agenda for HMIS, surveys, and related tools, work in progress and gaps (LSHTM & WHO) • Birth and perinatal death certificates, coverage & quality • Develop and test Minimum Perinatal Dataset • Perinatal Mortality audit tool, to link to maternal death surveillance and response, led by WHO • Household surveys modules and Verbal autopsy tools (eg birth/pregnancy history, improved birthweight and GA assessment) • Standard data collection in facility HMIS and facility assessments (eg SPA, SARA) • Improving birthweight and GA assessment tools • User friendly formats, intentional links to accountability and parent voices (eg partnerships with E 4 A and WRA) • Testing linked to EMEN work (~4 countries) • Southern institutions & INDEPTH as centres of excellence • Integrated l oversight especially with maternal community

EVERY NEWBORN An Action Plan To End Preventable Deaths ENAP ADVOCACY GROUP Anita Sharma, Lori Mc. Dougall, Mike Kiernan on behalf of team #Every. Newborn www. lancet. com/series/everynewborn #Every. Newborn

Advocacy Group Purpose: § To strengthen the linkages and track maternal and newborn health advocacy efforts globally and in countries. Goals: 1. Under the Every Woman Every Child umbrella support national coalitions advocating for maternal-newborn health 2. Maintain and strengthen global and regional commitments building on growing ENAP support at country level 3. Ensure strong accountability for commitments made to ENAP 4. Continue to raise awareness and bring new partners on-board with a special focus on strengthening integration of MNCH Team: § § Leads: UN Foundation, Save the Children, PMNCH Core partners: BMGF, UNICEF, World Vision, March of Dimes, Save the Children, FCI, Johnson & Johnson, White Ribbon Alliance, Mama. Ye, Well Being Foundation and others www. everynewborn. org #Every. Newborn

Our Operating Principles • Focus on country progress • Lead from behind (ENAP is a goal, not a brand) • Build on existing networks, coalitions at country level • Leverage global efforts to deepen, sharpen country commitments (EG: World Prematurity Day) • Use evidence to guide policy, practice (EG: Lancet Every Newborn launches in country) • Support integration of maternal-newborn health www. everynewborn. org #Every. Newborn

Priorities for advocacy § Work plan 2015 currently under development § Support dissemination opportunities for the Lancet Every Newborn Series and/or national maternal-newborn action plans § Engagement with the development of the updated Global Strategy for Women’s and Children’s Health. § Support the next development agenda, including the Sustainable Development Goals, targets, indicators and means of implementation to ensure inclusion of stillbirths and newborn. § Support and promote key advocacy moments. A calendar of upcoming events is maintained at www. everynewborn. org #Every. Newborn

EVERY NEWBORN An Action Plan To End Preventable Deaths MOVING FORWARD Kim Dickson and Rajiv Bahl on behalf of team #Every. Newborn www. lancet. com/series/everynewborn #Every. Newborn

Next steps Every Newborn opportunities for action § Country launch events for the Lancet Every Newborn Series and/or national maternal-newborn action plans § Implementation of national action plans with an emphasis on saving both mothers and newborns § Global and national tracking of benchmarks, milestones and outcomes with a special focus on identifying significant progress in specific countries or regions § Annual reporting to World Health Assembly § Engagement with the development of the updated Global Strategy for Women’s and Children’s Health and the next development agenda § Support and promote key maternal and newborn resources and events. Information available at www. everynewborn. org #Every. Newborn

Actions of all stakeholders § Every stakeholder has committed to the actions in the ENAP § We would love to hear what are you doing and how can we work better together to deliver for every newborn? § Open to discussion www. everynewborn. org #Every. Newborn

We are still building a movement… EVERY NEWBORN An Action Plan To End Preventable Deaths BE PART OF THE ACTION For more information visit www. everynewborn. org www. lancet. com/series/everynewborn #Every. Newborn