SMNI data for policy dialogue, programming and advocacy are contained in the 46 country profiles presented at the end of this publication.causing regular revenues from fees previously charged to be lost. Therefore, careful assessment and a phased strategy of abolishing the fees are required.10 Some African countries have recently abolished moderating rates or modified policies to try to lessen their effect on the poor.
In addition, applying models that provide data on economic losses due to morbidity and mortality, such as PowerPoint presentations on the protection of maternal health (REDUCE) and newborn health (ALIVE!), Can help to relate these events to general national development.BOX IV.4 Assessment of neonatal health status in the context of MNCH Task 1: describe the state of neonatal health in the context of MNCH
Report on the fundamental outcomes
MNCH, such as Maternal Mortality Rates-TMM , the Mortality Rates of Children under 5 years-TMCM5, and the Neonatal Mortality Rates-TMN, rates of stillbirths, and the rates of low birth weight (LBW). Disaggregate key indicators of results by geographic region, ethnic group and income quintile to determine which populations are under-served Task 2: analyze the coverage and quality of essential interventions
- Coverage of MNCH packages, essential interventions and the quality of health care Cheers. Disaggregate fundamental indicators of results by geographic region, ethnic group and income quintile to determine which are
- the poorly served populations Integration between different health service delivery sites or programs. Domestic behaviors and cultural practices • Continue to
- analyze the reasons for low coverage (supply and demand) 1.Evaluate the obstacles that hamper the provision of health services
Access (long distances, limited transport, geographical issues of the land) – Human resources (lack of qualified personnel due to brain drain and / or absenteeism) – Materials and products (poor supply chain management, break in the cold chain), – Quality of health care provided (lack of standards or lack of knowledge of standards, or low motivation) 2.Assess the obstacles that hinder the search for health care- Knowledge of the danger signs of newborn illnesses, or maternal complications
Degree of ac eitability (compare the profiles of users and non-users, considering distance and cultural and other barriers) – Accessibility in terms of costs (moderating fees, ineffective exemptions, hidden or “under the table” costs) Task 3: Review policies, current commitment and opportunities • Plans and objectives of relevance to policies, such as the Roadmap, the Child Survival framework, health sector reform
Current expenditure on health
government and key partners in interventions essentials of SMNIT Task 4: Synthesize the strengths and weaknesses of the health system • Possibilities to save children in good time • Important gaps in the provision of services related to certain packages, or to certain ethnic or socio-economic groupsSource: Adapted from reference18On the other hand, identify and working with them to convey MNCH messages and data can help accelerate the introduction of and changes.
In West Africa, the First Ladies (the women of the presidents) have been very active supporters of the struggle to improve maternal and neonatal health.17 In Mauritania, the First Lady used data and information generated by the REDUCE model to promote causes to sensitize policy makers, community leaders and general population for the magnitude of maternal and neonatal mortality. This attitude has intensified the actions of the government and civil society to improve MNCH in the country.
- In Burkina Faso, the promotion of this cause at a high level resulted in increased funding for MNCH and reduced the value of moderating fees for cesarean sections (see
- Box IV.3). As soon as a situation analysis is completed (Box IV.4 ) it is important to define or review national level targets for neonatal health.
To achieve the 4th MDG objective, it makes more sense, from the point of view of programs and policies, to analyze TMCM5 and TMN than to analyze TMCM5 and the infant mortality rate. (TMI). Data availability is the same and there are generally few differences in trends or solutions for TMCM5 and TMI, whereas TMCM5 and TMN tend to differ in the rate of change and potential solutions, as stated in Section I.
For newborns in Africa
1612th Step. Create, adopt and finance an IV national plan inserted in existing policiesCreate an integrated operational plan focused on filling the gaps in ongoing health care Often, strategies to solve the problem of newborn deaths already exist in multiple maternal and child health plans and programs , as described in Section II, and the programs and packages covered in Section III.
- It is possible that countries already have multiple operational plans in place; in Tanzania, for example, there is a strategy for health sector reform, the Roadmap, the
- MNCH plan and a Sector Plan for Poverty Alleviation, as well as specific plans such as the Program Extended Vaccination (VAP), and the prevention of malaria and HIV,
- all of them interconnected with MNCH. A fragmented strategic plan aimed only at newborn health workers would consume the time and energy needed for action.
Therefore, what is needed is to create practical operational links between existing plans and the activities to be carried out (for example, health sector reform, the Roadmap, and the MNCH) to accelerate progress towards improving high-impact interventions, with phased targets. coverage and ensuring continuous health care without gaps. Identifying and correcting the problem of missed opportunities in the health system As has been pointed out throughout this publication,
there are many possibilities to reduce the number of newborn deaths through continuing health care programs and packages. therefore, by adding, adapting or improving interventions connected with an existing package, relatively high coverage will be achieved quickly. Notable examples include adapting the IMCI to include assistance to sick newborns in the first week of life and ensuring that all