WAHO_LawnBegkoyianFikree

WAHO_LawnBegkoyianFikree - Newborn health and survival:...

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Unformatted text preview: Newborn health and survival: Delivering the future From Dr. Joy Lawn, Saving Newborn Lives/ Save the Children-US Funded by the Bill & Melinda Gates Foundation & Dr. Genevive Begkoyian , UNICEF WCARO Presented by Dr. Fariyal Fikree, Population Reference Bureau WAHO meeting, Accra, June www.dcp2.org 1. Progress for child & newborn survival 2. Newborn deaths Where? When? Why? 3. Packages of interventions, lives saved and costs 4. Priorities for implementation and research Outline Almost 40% of under-5 deaths are neonatal 4 million deaths each year Newborn survival is key for MDG 4 progress Progress to MDG 4 for child survival 28 76 50 100 150 200 250 1960 1970 1980 1990 2000 2010 Mortality rate per 1000 births Global mean neonatal mortality rate Global mean under 5 mortality rate Target for MDG-4 32 Source: Lawn JE et al 4 million neonatal deaths- where? When? Why? Lancet 2005. Data updated 2007 for progress until 2005 28 24 25 9 6 4 8 12 16 1 1 2 29 35 44 1 1 5 10 20 30 40 50 60 70 80 90 1980 1995 2000 1980 1995 2000 Postneonatal period Late neonatal period Early neonatal period Source: Disease Control Priorities in Developing Countries, second edition, 2006, Figure 27.2 Low- and Middle-Income Countries High-Income Countries Mortality rate per 1,000 live births Reducing infant deaths (1980 to 2000): The poor-rich gap is widening especially for the first week of life Beyond survival. newborn heath is fundamental for a nations future ?? babies with major neonatal morbidity 3.72 million neonatal deaths 3.2 million stillbirths. ?? Children with poor development or disability due to fetal/neonatal ill-health (birth asphyxia, preterm birth, infections) Inappropriate feeding and other missed prevention opportunities (eg low HIV prevention) related to opportunities missed in the neonatal period 20 million LBW babies Source: Adapted from Lawn JE, Kerber K eds. Opportunities for Africas Newborns. 4 million neonatal deaths: Where? Newborn deaths uncounted and not counting in society Most die at home - unnamed and uncounted Retrospective surveys undercount newborn deaths especially on day 1 (probably 10 to 30% undercount) Traditional taboos prevent access to care and promote acceptance of newborn deaths 4 million newborn deaths - Where? Source: Lawn JE et al Lancet 2005 4 million newborn deaths - Where? Source: Lawn JE et al Lancet 2005 44% of neonatal deaths 32% of neonatal deaths and most of the countries with very high NMR Neonatal deaths WHERE in reality? In sub Saharan Africa and South Asia more than half of neonatal deaths are at HOME Delay in recognition and decision making In general neonatal illness presents less obviously and progresses more quickly than in older infants Beliefs and cultural taboos Financial limitations Delay in transportation to facility In Uganda IMCI study less then 10% of newborns referred from the first level facility actually went Delay in receiving appropriate care once in the facility Neonatal deaths WHERE in reality?Neonatal deaths WHERE in reality?...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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WAHO_LawnBegkoyianFikree - Newborn health and survival:...

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