The first three days of life are the most critical in ensuring the survival of new born babies. And although there have been significant improvements in maternal and child health in the last two decades in Mongolia, survival rates of new-born babies are not improving as fast as they must.
Forty-two per cent of the 2,000 deaths annually of children under the age of five in this land-locked and sparsely populated country occur during a child’s first 28 days of life. Even though today nearly 98% of all births in Mongolia take place in health facilities, even here there is room for real improvements in the quality of care and adoption of best care practices by health workers.
So it was with great delight and much optimism that UNICEF and our partners welcomed the Government of Mongolia’s declaration that 2014 will be “the year of Maternal and Child Health”. The declaration came in the lead up to special expert meeting aimed at improving newborn health care, organized by the Mongolian Ministry of Health, WHO and UNICEF, and it added weight and additional urgency to this important meeting.
Reflecting the Government’s determination to use 2014 to make changes to save infant lives, at the opening session, Mongolia’s Minister for Health Dr.Udval called on the participants to come up with creative and home grown solutions to improve the health system and engage communities.
My colleague from the World Health Organization Regional Office, Dr. Howard Sobel, and I shared our experiences of how things are working in other countries in the region, and a new research report on maternal and neonatal health in Mongolia, supported by UNICEF, provided evidence about the household practices and perceptions around care of the newborn and quality of services at health facilities. This helped us understand the kind of changes that are most likely to be effective, and the best way to introduce them.
A whole range of health-care partners from national and sub-national levels participated in discussions, and the back and forth about prioritization of activities was quite intense. But we are confident the outcome – a firm commitment to new long-term plan (based on the joint Regional Action Plan by WHO and UNICEF for Healthy Newborns 2014-2020) will save children’s lives.
A detailed and costed implementation plan is now being prepared to kick start the establishment of a centre of excellence to train health workers to look after newborns using team-based learning approaches, and to ensure supportive supervision that fosters best practices. UNICEF and WHO will work with Government and other partners to update the clinical guidelines and put these into comprehensive facility packages, which will also seek to guarantee financial protection for poorest families and ensure health facilities receive sustainable levels of essential supplies.
Because the first three days are the most critical in saving the life a newborn, the action plan focuses on “early essential newborn care.” Simple practices like immediate drying, delayed cord clamping, skin-to-skin contact and early exclusive breast feeding for all newborns can help avoid many life-threatening complications.
|Group work sessions were intense debates especially for the prioritization of the activities.
© UNICEF/Nabila Zaka
Using Kangaroo Mother Care – a method of care for stable pre-term and low-birth weight babies that involves infants being carried, usually by the mother, with skin-to-skin contact – can limit reliance on expensive newborn intensive care units and make more space in these facilities for babies in greater need of help.
Maternal and newborn health is inseparable. Attention to quality intra-partum care, cutting down on un-necessary C-sections and timely management of prolonged and obstructed labour are an integral part of the plan.
“This newborn action plan is the best gift for children of Mongolia in this year” remarked Mohamed Malick Fall, UNICEF’s Representative in Mongolia, and he promised full support for the development and implementation of the action plan.
* The author: Nabila Zaka is Maternal and Child Health Specialist for UNICEF East Asia and Pacific.