For more details on this analysis, see notes to the data in Section V. Calculating plan costs and filling the resource gap Countries that calculate the costs of specific NMES programs and then compare those costs with an estimated saved lives have longer chances of seeing more resources invested in MNCH. In addition, building consensus around an operational plan that has associated costs between sicontributes to enhancing government leadership and harmonizing partners with each other.
If all the resources of partners in a given country were harmonized or combined, thus allowing investments in MNCH and donors to respect the priorities of those countries, the progress would be TABLE IV.1 Ideas for phasing strategies in agreement with the reference TMNs and withMost occurred at home (33%) Moderate coverage (average 66%) Average 41% (20%)
Very limited services
Very low coverage Initiate systematic plans to increase the coverage of specialized assistance. The aim is to improve priority behaviors for families and coverage of local services., clean birth practices, demand health care & optimal newborn care practices. Consider providing additional care for LBP with routine postnatal home visits. Consider providing clean birth kits for home births.
- Increase vaccination coverage with tetanus toxoid (at least two vaccinations during pregnancy), ANC, birth space interventions , IMCI, and routine Postnatal Control. Initiate systematic plans to increase
- coverage of specialized personnel, COE, and neonatal care, at least in hospitals. Create an implementation plan for human resources, including assignment of tasks if appropriate,
- finances, and materials and products to increase the coverage of specialized assistance, proximity services and assistance to families.
Improve the links between communities and services and promote their participation. Basic coverage of essential interventions increased by 20%. About 171,000 newborn lives were saved in 13 sub-Saharan African countries. delivery (Average% of partosnos services) * Pre-NatalAssistência specialized control childbirth
(Coberturamédia of ATP) * & neonatal obstetric care deemergênciaControlo After NatalPrincípios to dasmetas ofaseamento coberturapara of the próximos2-3 anosFamília eComunidade -examples of deintrodução maisrápida melhoriasServiços of saúdede proximidadee basic level -examples of faster introduction of improvements24-hour clinical and hospital assistance
Examples of faster introduction
of improvementsPrinciples for the medium termLives saved in the 12 countries with very high TMN (> 45) that progress through 4 phases of reducing TMNM with increasing coverage of essential packages Coverage and functions of the system Priorities introducing improvements in the first 2-3 years Medium-term investments Saved livesDefinition of mortality TMN> 45
which generated additional funding from several donors afterwards costs have been calculated (See Box IV.3). In the programs, several instruments are used (see Box IV.2), some of them for the calculation of costs, others for carrying out programmatic planning more minimized and some others that calculate the costs and impacts on maternal, newborn and child health of some simulated coverage scenarios through different forms of service provision.26
- Opportunities for newborns in Africa 163IV designed to save the lives of newborns using existing programs, of capacity and the health systemCombination home / health service (48%) Moderate to high coverage (average 77%) Medium 50% (ATP
- 18%) Moderate coverage, scarce access and unaffordable costsLow coverageAiming for faster increases in specialized care coverage.Continue to increase the coverage of services
- for the modification of family behaviors and proximity services
Promote the demand for specialized care and optimal neonatal care practices. Considering additional care for infants with LBW through routine postnatal home consultationsIncreasing coverage and quality of CPN, IMCI and routine Postnatal ControlIncreasing the number of specialized birth attendance, COEfunctional and neonatal care in district and sub-district hospitalsImplementar plans to increase coverage of specialized personnel, especially in places where it is difficult to work.
Draw up guidelines, provide training, supervise and create Monitoring and Evaluation instruments 20% increase in coverage of essential interventions Approximately 280,000 newborn lives savedMost in a health service (65%) High coverage, but there are inequalities (average 82%) Average 85% ( ATP 9%) Moderate to high coverage, variable quality, inequalities remain Moderate coverageAiming for universal coverage of services for the modification of family behavior, proximity services and specialized assistance
Promoting healthy home behaviors
Democratic Republic of Congo, Gambia, Guinea-Bissau, Lesotho, Liberia, Mali, Nigeria, Sierra Leone and Somalia.164 Opportunities for African infants much faster, and that would be in line with the founding principle of the Partnership for Maternal, Newborn and Child Health. An example of efficiency is the essential health package and the Malawi Roadmap,
and the desire to seek health careAiming for universal coverage of high CPN quality, for IMCI and for quality Post-Natal Control Ensuring universal coverage of specialized childbirth care, COE, and neonatal care in peripheral servicesImprove the quality of obstetric and neonatal care and carry out audits on maternal and newborn deaths, and on stillbirths.Resolve residual inequalities (socioeconomic, geographic, rural / tribal, etc.).
- Prepare services for full coverage of neonatal intensive care 20% increase in coverage of essential interventions About 355,000 lives of newborns saved Almost exclusively in a health service (98%)
- High coverage (average 98%) Average 98% (NA) Universal coverageHigh coverageEnsure equality and promote better quality
- health carePromote healthy home behaviors and the desire to seek health careAim for universal coverage of high quality
ANC, and for routine Postnatal Control Ensuring universal coverage of specialized birth care, COE, and neonatal carePonder creation of a regionalized referral systemProvide long-term follow-up assistance to babies with serious complications 90% increase in coverage of essential interventionsAbout 409,000 newborn lives savedTMN 30-44 TMN 15-29 TMN> 15Source:
Adapté des références23; 26 * Based on IDS analyzes as described and in reference23. For details on the lives saved, see Section V for notes on data contained in an analysis of Sub-Saharan Africa that used the hypotheses and models described in the series by The Lancet magazine on newborn survival24; 27. 12 countries in Africa with a TMN greater than 45 per 1,000 live births are Angola, Central African Republic,