AMTSL and the newborn DRCongo AXxe's experienceRDC

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Presentation transcript:

AMTSL and the newborn DRCongo AXxe's experienceRDC Project AXxes AMTSL and the newborn DRCongo AXxe's experienceRDC Michel MPUNGA MD MPH Newborn health program officer Axxes POPPHI’s Meeting Washington 20 novembre 09

I. Le projet AXxes Global Assitance package to health zones Covers over 8 million persons Reproductive health is given a prominent place

Alarming situation of mother and newborn in the DRC According to the national health survey (EDS 2007: Maternal Mortality: 549 for 100 000 live births Neonatal Mortality: 42 for 1000 live births

Reproductive Health Package (AXxes) Antenatal Care Assisted Birth Care of the newborn Post natal care Family planning Management of STIs Repair of vaginal fistulas GBV

Essential Components of Maternal and NewBorn Care Care of the mother during pregnancy, delivery, and postpartum at the service delivery point with focus on avoidance/management of post partum hemorrhage (AMTSL) Essential care of the newborn at the level of the service deliver point including newborn resuscitation, treatment of infections, and administration of the first doses of antibiotics before transfer. Promotion of essential care of mother and newborn at the community level including the early recognition of signs of danger and care seeking behavior

Integrated care of mother and newborn Start of a national workshops to evaluate issue mai-juin 07 Consensus of the strategies to undertake for integrated maternal-newborn care october 07 : MOH USAID AXxes BASICS POPPHI UNICEF OMS UNFPA….

Procurement of equipment for training, newborn kit and oxytocine Mannequin for AMSTL ,ENC and equipment for baby resuscitation and newborn kit

ELABORATION, PRODUCTION and DIFFUSION of WORK MATERIAL FOR PROMOTING MATERNAL-NEWBORN HEALTH AND Training Kits -Reference Manuals -Guide for the facilitator -Notebook for the participant -Register for clinical experiences -Guide for trainers for rural health promoters on disseminating messages related to care of mother and newborn

Demonstration: Resuscitation TRAINING OF 27 NATIONAL TRAINERS , 97 PROVINCIAL TRAINERS , 370 PRESTATAIRES Demonstration: AMTSL Demonstration: Resuscitation 43 ZS & 218 MATERNITES TRAINING OF 591 VILLAGE HEALTH PROMOTERS FROM 17 HEALTH ZONES IN SOUTH KIVU & KATANGA

ASSISTED BIRTH GENERAL TENDANCE OF RATES & by project year

AMTSL

LESSONS LEARNED Avantages: Consistent with the integrated care vision of the MOH for SMNE covering two essential problems and two significant causes of mortality in the DRC Funds can be shared between two domains. Training, Supervision et Monitoring integrated (efficient use of time and resources)

LECONS APPRISES Avantages: Training of clinical workers in essential maternal care and ensuring the availability of oxytocin plays a key role in the application of AMSTL Sensitizing households by community workers trained in newborn and maternal care and accompanying midwives during labor in health facilities promotes both assisted and safe delivery.

LECONS APPRISES Difficultés: Laborious process for obtaining consensus during the intervention. Long delays for obtaining training material Consensus around the adaptation and adoption of training material Putting program in action takes more time and resources than planned.

LECONS APPRISES Difficultés: Documents are voluminous Several messages taught If there is a shortage of trained personnel this could limit the application of these new concepts in maternal and newborn care.

Challenges : Consensus for the integration of information on SENN and GATPA in the Registers of Routine Care Long distances, inaccessibility of certain health zones, and necessity of traveling by airplane make supervision visits by national structures less frequent. The adoption of strategies by provincial health authorities and those in the health zones constitute a gauge for the continuity of these interventions.

Thank you for your kind attention