The birth of a baby is a cause for much hope and joy for families across this Region. However, for far too many, the happiness is short-lived as a newborn infant dies every two minutes in the Region. While there has been steady progress in the past two decades, much remains to be done to lower the number of deaths among newborn children.
“We are literally talking about the future of the Region,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific, “No expensive high-tech solutions are needed. We can save 50 000 newborn lives every year by simply changing basic practices.”
In Lao PDR, newborn deaths continue to account for 40% of all deaths under the age of five. The goal is to reduce the newborn mortality by 50%. In response to this call, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have released the Action Plan for Healthy Newborn Infants in the Western Pacific Region (2014–2020).
This pioneering document presents crucial interventions focusing on the first three days of a newborn’s life. At its heart is the “First Embrace” – a call for a return to basics.
The “First Embrace” between mother and child aims to provide a healthy start for every newborn baby in the Region and includes immediate and thorough drying followed by sustained skin-to-skin contact; appropriately timed cord clamping with a sterile instrument; and early initiation of exclusive breastfeeding.
“After thorough research, including collaboration with pediatricians, obstetricians, midwives and other health-care providers, we have observed that each of these four steps under the “First Embrace” has a major impact on improving the survival and health of newborn babies,” noted Dr Howard Sobel, Team Leader for Maternal, Child Health and Nutrition at the WHO Regional Office for the Western Pacific. “Putting these steps together only multiplies their benefits.”
Lao PDR developed its National EENC Strategy and Action Plan last year incorporating the four steps. The action plan is part of a broader push by WHO and UNICEF for early essential newborn care (EENC) that seeks to eliminate harmful and outdated practices, and focus only on evidence-based practices.
The actions and recommendations were the result of intensive consultations with technical experts and country teams that included ministries of health and academics, as well as representatives from nongovernmental organizations (NGOs), WHO and UNICEF.
For the first time, this set of recommendations is being presented on a large scale across the Region. It is a call for governments and the public to champion newborn health. The “First Embrace” in particular seeks to modify decades of routine post-natal practice – such as unnecessary suctioning, delayed drying, separation from the mother immediately after birth and delayed breastfeeding. Significant behavioral change will be required by health-care practitioners and parents alike for the action plan to be successfully adopted region-wide.
This is also part of a broader global momentum around newborn health capitalizing on “A Promise Renewed” – a commitment by governments across the world to reduce preventable child deaths by 2035.
The plan identifies five strategic actions toward this goal: ensure consistent adoption and implementation of EENC; improve political and social support to secure an enabling environment for EENC; ensure availability, access and use of skilled birth attendants and essential maternal and newborn commodities in a safe environment; engage and mobilize families and communities to increase demand for these approaches; and improve the quality and availability of perinatal information.
WHO has begun a facility strengthening process with two central hospitals, Mahosot and Mother & Child Hospital in Vientiane by organizing on-site coaching for health practitioners. The process will be further scaled up to include the other two central hospitals at a later stage. The provincial scale-up is planned for early 2015.
WHO will also assist the government on promoting this EENC initiative and breastfeeding promotion through social marketing that is planned for later this year. WHO together with UNICEF will continue our effort to strengthen and monitor the Code of Marketing of Breast Milk Substitutes in partnership with an international non-governmental organization, Save the Children International.
In Lao PDR, the EENC initiative is led by the Vice Minister of Health, Associate Professor Dr Bounkong Sihavong, who said that “We can make a difference in saving the lives of newborns using this simple but effective intervention. We should focus on providing a healthy start for every mother and their newborn infant with this EENC initiative. This will support the MDG 4 and 5 in view of the coming deadline of MDG next year.”