The links between Neonatal Care and achieving national targets for Infant Mortality Rates in PICs

Rufina LatuWHO Country Office, Port Vila, Vanuatu

10th July, Apia, Samoa

1

The faces behind the statistics

Many newborns die from preventable causes

Reproductive AgeAntenatal

period

Adolescent

School age

Preschool

Continuum of the Life Cycle

Intra-partumDeliveryImmediate Newborn•First Embrace•Care for LBW/Preterm•Care for Sick Newborn

Postneonatal

Lateneonatal

NEONATAL DEATHS

Neonatal death = within first 28days of lifeEarly Neonatal death = first 7 days

What do the statistics show?- Global - Pacific countries

MDG 4: reduce under-5 mortality by 2/3

Target Indicators

• Under-five mortality rate

• Infant mortality rate

• Neonatal mortality rate

Causes of Deaths: under-5

Western Pacific Region, 2010

Neonatal mortality as % of under-5 mortality

REGION Proportion due to Neonatal mortality

Global 41%

Western Pacific Region 54%

Pacific Island countries 48%

Neonatal, Infant and Child Mortality- contribution to under-5 mortality

8

Neonatal deaths

48%infant deaths

24%

1-5 yrs

28%

DHS in 7 Pacific Is countries: 2006-2009

Causes of Neonatal Deaths

Preterm38%

Birth As-

phyxia26%

Severe Infection19%

Congenital Anomalies

9%

Others7%

Neonatal Tetanus1%

WHO Report

Up to 50% of neonatal

deaths occur in1 st 24 hrs

75% of neonatal deaths - first week

Age at death for NeonatesAge at death for Neonates

Interventions affect the rest of their lives

1990 1994 1999 2004 2006 2007 20150

20

40

60

80

100

120

4840 38

31 3025

16

62

5048

38 36

30

20

Infant and Under-5 Mortality (Vanuatu)

U5MR

IMR

Accelerated Action

Source: MICS 2007, UNICEF, MOH

16

We can prevent newborn deaths

Reduce Neonatal deaths - through continuum of care at all levels

Antenatal

7– 14%reduction of NMR

Intrapartum

19 – 34%reduction of NMR

Postnatal 10 – 27%reduction of NMR

Communitybased care

14 - 32% reduction of NMR

Primary Health Care

10 - 30%reduction of NMR

Secondary Care - hosp

26- 51%reduction of NMR

Neonatal care – moving forward

3. Document progress

2. Specific Interventions- eg perinatal mortality review

1. Review current practices

14

Let’s not allow missed opportunities for saving newborns

Reaching remote communities

1