15-18 Nov 2011Regional CH PM Meeting, Nepal1 Improving Neonatal & Child Health and Development along the continuum of care in South-East Asia Region: A Strategic Framework (Draft) UNICEF WHO

15-18 Nov 2011Regional CH PM Meeting, Nepal2 Need of the Strategic Framework SEAR is unlikely to achieve the MDG4 target despite good progress The coverage of well-known life saving interventions remains low in member countries There are large disparities signifying health inequity for child health in the Region Rapid scale-up while maintaining quality and equality is essential to accelerate progress in achieving MDG4

15-18 Nov 2011Regional CH PM Meeting, Nepal3 The Framework presents: Analysis of coverage levels of the existing interventions and identify opportunities to strengthen health system Analysis of the broader determinants such as safe drinking water, sanitation and hygiene, education, gender etc Set of parameters that characterize the health systems that would be useful for member states to decide their national and sub-national priorities and revise national and sub-national plans accordingly Importance of strong information system and ongoing research

15-18 Nov 2011Regional CH PM Meeting, Nepal4 Member States Bangladesh: UNICEF ROSA Bhutan: UNICEF ROSA DPR Korea:UNICEF EAPRO India: UNICEF ROSA Indonesia:UNICEF EAPRO Nepal: UNICEF ROSA Maldives: UNICEF ROSA Myanmar: UNICEF EAPRO Sri Lanka: UNICEF ROSA Thailand: UNICEF EAPRO Timor Leste: UNICEF EAPRO

15-18 Nov 2011Regional CH PM Meeting, Nepal5 Target audience Primarily, governments of member countries Policy makers at national and sub-national level International agencies and NGOs Intended to be the basis for subsequent joint WHO-UNICEF country support for the member states in the WHO SEAR for newborn and child health and development

15-18 Nov 2011Regional CH PM Meeting, Nepal6 Main Sections of the Document Executive Summary (2 pages) Introduction (2 pages) Situation analysis ( 12 pages) Improving Neonatal & Child Health and Development along the continuum of care in South-East Asia Region: A Strategic framework (24 pages) Roles and responsibilities (2 pages) Conclusions References Annexes

15-18 Nov 2011Regional CH PM Meeting, Nepal7 Section 2 Situation Analysis in South- East Asia Region

15-18 Nov 2011Regional CH PM Meeting, Nepal8 Section 2

15-18 Nov 2011Regional CH PM Meeting, Nepal9 Section 3 Improving Neonatal & Child Health and Development along the continuum of care in South-East Asia Region: A Strategic framework

15-18 Nov 2011Regional CH PM Meeting, Nepal10 Section 3

15-18 Nov 2011Regional CH PM Meeting, Nepal11 Goal of the Strategic Framework The overarching goal of the Strategic Framework is to guide and assist member countries to, within overall national health plans, develop or strengthen their national strategies and plans to improve newborn and child survival, reduce the burden of child morbidity and disability and promote child health and development.

15-18 Nov 2011Regional CH PM Meeting, Nepal12 Objectives of the Strategic Framework Implement and scale up evidence-based cost- effective interventions through effective service delivery strategies throughout the continuum of care. Establish effective health systems to ensure equitable access of all mothers, newborns and children to good quality health care services, with particular attention to the poorest and discriminated population groups. Promote development and application of multi- sector approaches to address the determinants of maternal, newborn and child health.

15-18 Nov 2011Regional CH PM Meeting, Nepal13 Objectives of the Strategic Framework Incorporate a child development perspective into policies and actions within and beyond the health system, and use all contact opportunities with families and communities to promote early childhood development. Mainstream child health and development into national development agendas and recognize the responsibility to ensure a healthy start to the children as part of the commitment to childs rights and as a pillar of their social and economic development policies.

15-18 Nov 2011Regional CH PM Meeting, Nepal14 Guiding Principles Life-cycle approach Equity Child Rights Health System Approach Regulation and integration of the private sector Integration and Convergence among all components of the health system and between health services Multi-sector action and cross- sector collaboration Partnerships Community Ownership and Participation

15-18 Nov 2011Regional CH PM Meeting, Nepal15 Actions at 3 levels 1.Action within the health system to implement effective service delivery strategies for the prioritized interventions along the continuum of care 2.Action within the health system to strengthen all health system components 3.Action beyond the health system to address the key determinants of maternal and child health, nutrition and development and address disparities across population groups

15-18 Nov 2011Regional CH PM Meeting, Nepal16 Continua of care Life cycle: which includes adolescence, the preconception period, pregnancy, childbirth, postnatal period and childhood, thereby taking advantage of natural interactions. Across different levels of health care delivery: Home/community, first level health centre, and referral hospital for functional continuity Comprehensive health care: Interventions in health promotion; disease prevention and control, treatment; rehabilitation and reintegration into society

15-18 Nov 2011Regional CH PM Meeting, Nepal17 Organization of Services for maternal, newborn and child health Family-oriented community based services Population-oriented scheduled services First level individually oriented clinical services Referral level clinical services Strengthen referral systems and referral linkages

15-18 Nov 2011Regional CH PM Meeting, Nepal18 Health System Approach Leadership and governance Financing Health workforce Infrastructure and supply system Health Information System Health Service Delivery

15-18 Nov 2011Regional CH PM Meeting, Nepal19 Strategic Directions 1.Action to improve service delivery - universal coverage: Strengthening Implementation along the continuum of care 2.Action to strengthen the Health System to ensure delivery of equitable and quality health services 3.Achieving equity 4.Improving and maintaining quality of services 5.Private sector participation 6.Action beyond Health Sector: Actions to address determinants of maternal, newborn, child health and development

15-18 Nov 2011Regional CH PM Meeting, Nepal20 Strategic directions to national / sub-national plans 1.Establishment of a national technical working group (TWG) 2.National Coordination mechanism 3.Monitoring and Evaluation mechanism 4.Develop and implement a communication strategy 5.Action to engage families and communities 6.Phased implementation approach: Scenario based approach for prioritizing policy actions and interventions

15-18 Nov 2011Regional CH PM Meeting, Nepal21 Scenario building for phased implementation

15-18 Nov 2011Regional CH PM Meeting, Nepal22 Package of services for different scenarios Key Interventions by Service Delivery Mode E = essential care to be ensured universally; S= situational, depending on epidemiological context; A = advanced care, based on Health System capacity

15-18 Nov 2011Regional CH PM Meeting, Nepal23 Package of services for Different scenarios InterventionsHome / Community Based Services Individual oriented clinical services Individual oriented clin services Family Oriented community services Population oriented schedulable services First level health facility based services Referral level services Infancy and childhood care Excl breastfeeding for infants up to 6 mo EEEE Advise on stimulation and play (CCD) EEEE Immunizations basic schedule EEEE Immunizations (Newer vaccines) AAA HIV early detection and treatment SE

15-18 Nov 2011Regional CH PM Meeting, Nepal24 Section 4. Roles and Responsibilities Member Countries – Policy review, development and monitoring –Resource allocation and –Partnership development –Capacity Building –Ensuring communication and social mobilization –Developing a framework for monitoring and evaluation –Organizing operational research

15-18 Nov 2011Regional CH PM Meeting, Nepal25 Section 4. Roles and Responsibilities WHO, UNICEF and other international partners –Provide technical support –Support and strengthen institutional capacity –Support country efforts to improve data collection and analysis –Support the generation of evidence through operational research –Advocate for mobilization of adequate resources –Improve the targeting of donor funding for equity focus

15-18 Nov 2011Regional CH PM Meeting, Nepal26 Conclusions Guidance to Member States for accelerating progress towards MDG4 A comprehensive policy approach with a focus on equity Adopting appropriate cross sector policies Fostering health system developments Improving service delivery to scale up evidence based interventions across continuum of care Strengthening monitoring and evaluation Extended partnerships within countries, including with the private sector Co-operation and support from WHO, UNICEF, and other UN Agencies and international partners

15-18 Nov 2011Regional CH PM Meeting, Nepal27 Your suggestions are indispensible for strengthening the Framework