Version April 2014

A roadmap for change in countries… A platform for harmonized action by all partners…  Sets out a clear vision with mortality goals, strategic objectives, innovative actions within the continuum of care  Supported by new evidence  Inputs from more than 2,000 individuals  A movement for greater action and accountability… The Every Newborn Action Plan: building a movement Photo credit: Save the Children

Why Every Newborn? Huge burden, yet huge potential for rapid change with high impact, feasible interventions Country demand for guidance and action to accelerate progress towards MDGs 4 and 5, universal health coverage, and towards ending preventable deaths among women and children For greater effectiveness we must accelerate and harmonize global response and link to existing initiatives for reproductive, maternal, child and adolescent health care. More than 3 million babies and women could be saved each year through investing in quality care around the time of birth. Photo credit: Save the Children

Source: Adapted from Lawn J,E. et al Newborn survival: a multi-country analysis of a decade of change. Health Policy and Planning. 27(Suppl. 3): iii6-ii28. Data sources: UNICEF UN MMR estimates 2012www.childinfo.org * Maternal mortality ratio annual rate reduction We’ve made significant progress toward MDGs 4 & 5, but newborn survival is lagging behind Average annual rate reduction Maternal mortality ratio*4.2% Children aged months3.4% Neonatal mortality (newborn, first 4 weeks after birth) 2.1% Stillbirths (last 3 months of pregnancy) 1.0% ( ) At least 40% slower for newborn survival and slower still for stillbirths 4

Causes of under five deaths 44% are from neonatal causes Data source: Cause of death - WHO. Global Health Observatory dex.html); Child deaths - UN Inter-agency Group for Child Mortality Estimates. Levels and Trends in Child Mortality. Report 2013; Stillbirths - Lawn et al The Lancet stillbirth series (9775) p1448 – dex.html 5 3 main killers to address: 1.Preterm birth 2.Birth complications 3.Neonatal infections 3 main killers to address: 1.Preterm birth 2.Birth complications 3.Neonatal infections Two-thirds of neonatal deaths are preventable Two-thirds of neonatal deaths are preventable

We have the knowledge and tools to reduce the main causes of death Preterm birth Preterm labor management including antenatal corticosteroids* Care including Kangaroo mother care, essential newborn care Birth complications (and intrapartum stillbirths) Prevention with obstetric care * Essential newborn care, and resuscitation* Neonatal infections Prevention, essential newborn care especially breastfeeding, Chlorhexidine where appropriate* Case management of neonatal sepsis * 1 2 * Prioritised by the UN Commission on Life Saving Commodities for Women and Children Over two-thirds of newborn deaths preventable – actionable now without intensive care 3

There are proven interventions within RMNCH continuum of care Source: Adapted from The Lancet Every Newborn Series

Source: Special analysis detailed in The Lancet Every Newborn Series - forthcoming The lives of more than 3 million babies and women could be saved each year with high coverage of quality care around birth and care for small and sick babies Care around birth gives a triple return on investments by reducing maternal and newborn deaths and stillbirths

The vision for Every Newborn Action Plan A world in which there are no preventable deaths of newborns or stillbirths, where every pregnancy is wanted, every birth celebrated, and women, babies and children survive, thrive and reach their full potential. Vision statement in draft ENAP, March 2014

NEW NEONATAL MORTALITY GOAL Unless we greatly accelerate newborn survival efforts, goal to end preventable child deaths by 2035 unreachable Source: Special analysis detailed in The Lancet Every Newborn Series based on country and official online consultations and using neonatal mortality rate data from the UN Inter-agency Group for Child Mortality Estimation 2013.

NEW goal for stillbirths Source: Special analysis detailed in The Lancet Every Newborn Series based on country and official online consultations and using stillbirth rate data from The Lancet Stillbirth Series (Cousens S et al Lncet 2011)

Lancet GH Sept 2013 : The Lancet Global Health 2013; 1:e176-e177 (DOI: /S X(13) )The Lancet Global Health 2013; 1:e176-e177 Maternal mortality goal in process and will need to be linked with action

What to do differently? Every Newborn’s guiding principles Country leadership Good governance, community participation, partner alignment Integration Integrated service delivery, continuum of care, programme coordination Equity Universal coverage, closing the equity gap Human rights Principles, standards Accountability Transparency, oversight Innovation Interventions, delivery approaches, technologies

What to do differently? Every Newborn’s Five strategic objectives 1.Strengthen and invest in care during labour, birth and the first day and week of life 2.Improve the quality of maternal and newborn care 3.Reach every woman and every newborn; reduce inequities 4.Harness the power of parents, families and communities 5.Count every newborn – measurement, tracking and accountability

What we aim to achieve? End preventable maternal, newborn and child deaths and stillbirths Stillbirths and newborn deaths are not inevitable Women and babies deserve access to quality care around the time of birth Each year save the lives of 3 million newborns, stillbirths and women 1.Include newborn and stillbirth in post-2015 framework along with maternal and child health 2.Attention and funding to newborns and stillbirths within the context of and linking to the RMNCH continuum 3.Sharpen national plans and improve demand and delivery of care at the time of birth in countries 4.Improve the quality of care for mothers and newborns by implementing high-impact interventions, including through a “Mother-Baby Friendly” Initiative 5.More trained and equipped health workers 6.Improve programmatic and impact data and use this for action in countries Long term In sight NOW

Health Sector Strategic & Investment Plan Integrated National RMNCH Plan Increasing access and use of FP Ending preventable newborn deaths Ending preventable deaths from pneumonia and diarrhoea (GAPPD) Ending preventable maternal deaths Every Newborn prioritizes focus on birth within existing national strategies and plans; not a new stand alone plan

Every Newborn’s impact framework

How will we track progress? Every Newborn milestones Every Newborn sets out concrete and measurable global and national level milestones from now to 2020, coverage targets to 2025 and mortality goals to 2035

How will we track progress? Every Newborn indicators A clear monitoring plan is an important milestone. ENAP proposes a core set of indicators and maternal/newbor n service delivery packages

Progress is possible – targets getting traction  Neonatal survival unfinished agenda, stillbirths still missing, but count for families  Synergies of newborn survival with demographic transition  Country consultations and ownership over 1 yr process Programmatic focus is clear and evidence-based  Time around birth, triple return on investment  Priority attention to small babies to reduce deaths, disability and risk of non communicable diseases (NCDs)  Urgent improvements for programmatic coverage data Partnerships and alliances  UN leadership  Maternal alliances especially re service delivery eg “Mother- Baby friendly package”  Civil society advocacy to change social norms Potential for major change in countries

Movement with a plan Who has been involved? Every Newborn consultation process  Alliance:  50+ global partners on Advisory group;  Steering team and management group (led by WHO & UNICF)  ENAP presented and discussed at many global meetings in 2013 including Women Deliver, AU MNCH, IPA, and NYC mtg  Countries:  17 country consultations between April-September 2013  2 regional workshops  Completed bottleneck analyses conducted in 10 countries  Official WHO consultation:  More than 300 official comments including +40 member states, professional associations, academics, NGOs, individuals  WHO executive board and on main agenda at WHA AU MNCH conference

April 2013 – June 2014  National and regional consultation and technical inputs to the development of the plan January 2014  Discussed at the WHO Executive Board February 2014  Open consultation on draft Every Newborn by stakeholders and inputs incorporated into final draft May 2014  Lancet series (update from 2005 and giving the analyses which are the basis for the Every Newborn)  Draft plan presented to the 67 th World Health Assembly June 2014  Action Plan launched at PMNCH Partners’ Forum, Johannesburg Every Newborn Process Photo credit: Save the Children

We are building a movement… BE PART OF THE ACTION For more information visit #EveryNewborn

We can bend the curve: proof of impact at scale even in low income countries MDG 4MDG 5 Neonatal mortality rate Av annual change Rwanda Progressing6.2% Bangladesh 4.0% Nepal 3.6% Malawi Progressing3.5% Source: Newborn survival decade of change analysis: Health Policy and Planning. 27(Suppl. 3) papers 3 to 7 Over the last decade, 77 countries reduced NMR by >25%, including at least 13 low income countries: Bangladesh, Bolivia, Eritrea, Guatemala, Indonesia, Nepal, Madagascar, Malawi, Morocco, Senegal, Rwanda, Tanzania, Vietnam Over the last decade, 77 countries reduced NMR by >25%, including at least 13 low income countries: Bangladesh, Bolivia, Eritrea, Guatemala, Indonesia, Nepal, Madagascar, Malawi, Morocco, Senegal, Rwanda, Tanzania, Vietnam

 Countries, donors, civil society groups, professionals, and businesses are leading this effort in support of Every Woman Every Child. Every Newborn builds on key platforms like FP2020, A Promise Renewed, the Commodities Commission, and Commission on Information and Accountability.  A comprehensive consultation process whereby all stakeholders are given an opportunity to feed into the plan and countries identify specific bottlenecks and solutions All stakeholders have a role to play Photo credit: Save the Children