Basic Newborn Care & Resuscitation

Common Bottlenecks & Solutions for Basic Newborn Care Community health worker: unclear role, training and job description Postnatal visits: culture, timing, coverage, in home and facility Chlorhexidine in countries > NMR 30: policy, supply. Community health worker: standard package, job description, guidelines, job aids Postnatal: policy and job description needed, PPPs, supervision, accountability: who, where, content of package needs more clarity CHX: need policy, need to be integrated in package of basic NB care, supply, job description, training. BCC: massive campaign needed

Unique Bottleneck and solutions for BNC Distribution of CHX by FCHVs and misoprostol in Nepal because of increasing facility delivery. Many missed opportunities among women who do not go to facility for delivery Need a clearer guidance to FCHVs Overarching solution from successful countries: integrate policy, implementation, incentivization, training, etc. into the health system.

Resuscitation Bottlenecks and Solutions Institutional readiness is poor: training, supplies, skills retention. Poor access in remote areas: unclear how to reach babies in home deliveries where SBA access is poor Organizational structure: No clarity on where resus belongs: CH Dept or MH Dept? Private sector: guidelines lacking Capacity building: SBA package, integrated training, simulation, on- site coaching, algorithms, job-aids. No rapid solution in settings with high prevalence of home delivery Physical set-up: newborn corner Successful countries: resus is part of an integrated program Equipment should be included in Govt budget and plan Policy advocacy at all levels: dynamic TWG, global alliance,

Unique Bottlenecks/Solutions for Resuscitation Afghanistan has no clear guidelines or SOPs on resuscitation for all levels of care FCHV skills and implementation in Nepal was not successful for ventilation