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September/October 2015 (Issue 8)
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Stronger Health Systems, Healthier Newborns and Children
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The greatest gift of all: a healthy child.
More children are reaching their fifth birthdays than ever before. Global under-five mortality has dropped by more than 50 percent, from 90 to 43 deaths per 1000 live births, between 1990 and 2015. The United Nations calls the dramatic child mortality decline over the past twenty-five years “one of most significant achievements in human history”.
Since 2000, 48 million children’s lives have been saved. Approximately one-third of countries (62 of 195) -- including 24 low- and middle-income countries -- achieved MDG 4 to reduce by two-thirds the under-five mortality rate.
It’s not enough.
Every day, 16,000 children under five die -- most from preventable and treatable causes. Every minute, 11 children do not reach their fifth birthday. Among under-five deaths, forty-five percent occur among newborns in the first 28 days. In sub-Saharan Africa, 1 in 12 children do not reach his or her fifth birthday.
We know how to prevent child deaths with proven, simple, low-cost measures. Among these measures are community-based health systems: well-trained, well-supported community health workers who can identify and treat common causes of child death through integrated community case management of malaria, diarrhea and pneumonia. Management Sciences for Health (MSH) helped develop some of these community-based efforts with a basic package of health services in places like Afghanistan.
For neonatal care, a suite of proven interventions exists which make the greatest impact, and another set of innovative interventions are being tested. In Democratic Republic of the Congo (DRC), over 440,000 newborns received basic newborn care. A sub-set of newborns received the benefits of Helping Babies Breathe; and low-birth or premature babies received Kangaroo Mother Care.
All moms, newborns, and children must have access to essential medicines and commodities.
The last 25 years have produced incredible achievements in child health. To reach the targets for health in the Sustainable Development Goals, the global community will need to focus the next twenty years on accelerating these improvements in child health, ensuring that newborn health gets the attention it deserves, and that financing mechanisms ensure access and use of quality health services for women, newborns, and young children.
Since our inception over forty years ago, MSH has been working in places like Afghanistan, Nigeria, and Rwanda to ensure communities have the greatest gift of all: healthy children. You will see some of these examples in this newsletter, from places like DRC, Uganda, Madagascar, Lesotho, and Ethiopia.
MSH redoubles our commitment to ensure that the poorest and most vulnerable have the opportunity for a healthy life -- from birth, through the first 28 days, their fifth birthday, and beyond.
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~ Katherine Wright, MPH, Technical Advisor, Maternal, Newborn and Child Health; and Luis Tam, MD, DrPh, Global Technical Lead, Maternal, Newborn and Child Health
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Integrated Health Project, Democratic Republic of the Congo
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In DRC, MSH and partners, through the US Agency for International Development (USAID)-funded Integrated Health Project (IHP), provide approximately 12 million inhabitants (1/6 of the country) with an integrated package of essential health services, delivered through a network of thousands of community health workers, 1,700 health centers and more than 70 general referral hospitals. These services, focused on maternal, newborn and child health, HIV, and family planning, are the foundation of the government’s strategy to achieve universal health coverage.
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Preliminary indications from an evaluation study in seven health zones suggest that using artesunate suppositories in children under five is not only effective as a pre-referral first-line treatment for severe malaria, but also well accepted by parents.
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IHP trainers teach 30 frontline health workers -- who happen to be illiterate -- how to resuscitate a newborn who isn’t breathing, and Kangaroo Mother Care for premature and other low-birth-weight newborns.
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VIDEO: Helping Babies Breathe
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“I am grateful to the Integrated Health Project for training me to know how to revive infants, and how to care for mothers after they give birth,” says Judith Kambuyi, head nurse, Luiza Maternity, DRC. “Now, in our maternity, everyone knows the techniques to resuscitate a newborn.”
// WATCH VIDEO >>
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VIDEO: Kangaroo Mother Care
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Kangaroo Mother Care helped save baby Mardochée, born prematurely in the DRC, but stabilized through immediate and continuous skin-to-skin contact with his mother.
// Watch video >>
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Narcisse Naia Embeke (pictured with his wife and children), 41, comes from a small community in South Ubangi in northwestern DRC. “My mother taught me that I had to help others, because many children my age were dying,” Embeke remembers. Embeke now works as the child health senior technical advisor for the Integrated Health Project.
// MORE >>
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by Cyrille Massamba and Suzanne Diarra
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The USAID-funded, MSH-led Systems for Improved Access to Pharmaceuticals and Services Program (SIAPS) is helping DRC accurately quantify their country's needs for the 13 lifesaving medicines for women and children.
// More >>
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Democratic Republic of the Congo | Medicines
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Rose was five months pregnant with twins when she visited a hospital in Eastern Uganda for a routine antenatal visit, and learned she was HIV positive. MSH and partner efforts have greatly reduced mother-to-child transmission of HIV in the Eastern region since the country formally adopted Option B+ as a national strategy for prevention of mother-to-child transmission (PMTCT) in 2012.
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Uganda | HIV & AIDS | Prevention of mother-to-child transmission (PMTCT)
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The Help Ethiopia Address Low TB Performance (HEAL TB) project, a USAID-funded project led by MSH in the Amhara and Oromia regions of Ethiopia, is making childhood tuberculosis (TB) a priority, including working to improve the diagnosis and management of TB in children -- HEAL TB has trained more than 470 district TB focal persons on identification and management of TB in children -- and helping to establish a national childhood TB task force.
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Photo: Berhan Teklehaimanot/MSH
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by Nathene Morley and Moroesi Makhetha
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A pilot project in Lesotho is reinforcing the lesson that engaging local leaders and caregivers can galvanize an entire community to invest in the future of their children.
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Lesotho | Child health, nutrition, and education
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A recent outbreak in Madagascar has prompted the USAID Mikolo Project, led by MSH, to actively engage in the global fight to eradicate polio.
// MORE >>
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MSH Delegates to Present at Global Maternal Newborn Health Conference
The Secretariat of Health of Mexico, together with convening partners, will host the Global Maternal Newborn Health Conference (Global MNH 2015) in Mexico City from October 18 to 21, 2015. Global MNH 2015 attendees will discuss strategies for reaching every mother and newborn with high-quality health care, achieving health targets in the new sustainable development goals, and translating commitments and expertise into action and results.
MSH's presence will include a delegation of 13 staff, representing 6 countries across Africa, Asia, and Latin America.
MSH delegates will make 6 oral and 2 poster presentations, providing results of our work improving community level health services in Madagascar and results of an early breastfeeding initiative in DRC, among other work.
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Stronger health systems. Greater health impact.
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