Latin America and Caribbean
Newborn Health Alliance
Reduce Newborn Mortality by 2015
Jonathan Hubschman for Save the Children
Cover photo: Michael Bisceglie for Save the Children
Newborn Alliance Mission
Promote Newborn Health in Latin America and the Caribbean within
the continuum of Reproductive, Maternal, and Child Health, through
interagency efforts. Promote evidence-based policies and programming with a specific focus on the most vulnerable populations.
Let’s Get There! Reduce Newborn Mortality by 2015
Each year twelve million mothers eagerly await the first cries of their newborns
in the LAC region, but almost 200,000 of these newborn lives end within 28
days of their first breath.
However, statistics show that while the infant mortality rate has been falling
in the region in recent years, the newborn mortality rate has remained almost
unaltered over the last 10 years. The neonatal mortality ratio in the region is
double for the poorest quintile than for the richest.
Common direct causes that contribute to newborn death include neonatal
infections, birth asphyxia and complications of prematurity. Most of the deaths
due to these causes are preventable. Low birth weight newborns are especially
vulnerable, comprising 60-90% of newborn deaths. Many newborn deaths
are related to conditions of the mother such as education, status, young age,
older age, malnutrition, short birth interval, sexually transmitted infections, along
with complications of pregnancy. Lack of quality health care for mothers and
newborns—focused antenatal care, skilled birth attendance, and early postnatal
care—is a major contributor to newborn deaths, especially in low-resourced
areas.
Jonathan Hubschman for Save the Children
While simple but effective strategies exist to address the specific causes of
newborn death, policies and programs in the LAC region still fail to provide
proven interventions to save newborn lives. To address this gap, the Latin America
and Caribbean Newborn Health Alliance was created as an interagency group
to promote newborn health within a Reproductive, Maternal and Child Health
continuum. The group promotes evidence-based policies and programmatic
interventions at the facility and community levels. The Alliance was formed in
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Latin America and Caribbean Newborn Health Alliance
2005 as a partnership between international agencies and programs working
to reduce newborn mortality in the LAC region. It includes experts from the
Pan American Health Organization (PAHO), the United States Agency for
International Development (USAID), UNICEF (the United Nations Childhood
Fund), Save the Children/Saving Newborn Lives (SNL), the USAID-funded
projects: ACCESS (Access to Clinical and Community Maternal, Neonatal, and
Women’s Health Services); BASICS (Basic Support for Institutionalizing Child
Survival); MCHIP (Maternal and Child Health Integrated Program); and HCI
(Health Care Improvement Project), as well as Plan USA, the CORE group and
other interested partners.
The LAC Alliance supports countries in their efforts to reduce newborn
morbidity and mortality in the LAC region by promoting the sharing of
information and experiences at the local, national and regional levels;
supporting the dissemination of cost-effective, evidence-based interventions;
providing technical support for the region; and advocating for the newborn and
the mother by actively participating in regional and international meetings and
forums.
What has been accomplished
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Michael Bisceglie for Save the Children
Jonathan Hubschman
The LAC Alliance was directly involved in the development of two key
documents: (1) Reducing Neonatal Mortality and Morbidity in Latin America
and the Caribbean, and (2) Regional Strategy and Plan of Action for Neonatal
Health. The process of developing these documents was a collaborative effort
and demonstrates the Alliance’s ability and future potential to disseminate and
diffuse information in the region to promote neonatal mortality reduction.
Let’s Get There! Reduce Newborn Mortality by 2015
Michael Bisceglie for Save the Children
The Millennium Development Goals
The Millennium Development Goals (MDGs) are eight goals to be achieved by
2015 that respond to the world’s main development challenges. The MDGs are
drawn from the actions and targets contained in the Millennium Declaration that
was adopted by 189 nations-and signed by 147 heads of state and governments
during the UN Millennium Summit in September 2000. The eight MDGs break
down into 21 quantifiable targets that are measured by 60 indicators.
Goal 1: Eradicate extreme poverty and hunger
Goal 2: Achieve universal primary education
Goal 3: Promote gender equality and empower women
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other diseases
Goal 7: Ensure environmental sustainability
Goal 8: Develop a Global Partnership for Development
www.alianzaneonatal.org
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Latin America and Caribbean Newborn Health Alliance
The first regional neonatal consensus document,
“Reducing Neonatal Mortality and Morbidity in Latin
America and the Caribbean: An Interagency Strategic
Consensus” was born out of a collaborative effort
that began on World Health Day in 2005. This was
followed by a regional workshop that brought together
technical experts from international organizations,
non-governmental and professional associations,
and Ministries of Health from 16 different countries
in the LAC region. The fact that a consensus was
achieved among such a large group bodes well for
the implementation of next steps.
OPS/FCH/CH/09-01.I
regional strategy and plan of action
for neonatal health within the continuum
of maternal, newborn, and child care
48th Directing Council of the Pan American Health Organization
60th Session of the Regional Committee
Washington, D.C., USA, 29 September-3 October 2008
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The neonatal strategic consensus document served
as a basis for the creation of neonatal health
resolution CD47.R19: “Neonatal health in the health
care context of the mother, of the newborn, and of
the child to fulfill the Millennium Development Goals
of United Nations”, which was approved by the
Directing Council in 2006. This resolution called for
PAHO, along with other experts, to develop a second
neonatal document entitled “Regional Strategy
and Plan of Action for Neonatal Health within the
Continuum of Maternal, Newborn, and Child Care”.
Alliance members played a leadership role in its
development and provided technical inputs of the
document along with the Ministries of Health during
a second meeting in 2007 in Paraguay.
The document “Regional Strategy and Plan of Action for Neonatal Health
within the Continuum of Maternal, Newborn, and Child Care” was approved
by the Pan American Health Organization’s 48th Directing Council in October
2008. Its accompanying resolution recommends that Member States
1) support the reduction of maternal and neonatal mortality as a priority within
health programs by expanding, strengthening or sustaining the implementation
of the Strategy and Regional Plan of Action; 2) consider the Regional Plan of
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Michael Bisceglie for Save the Children
Let’s Get There! Reduce Newborn Mortality by 2015
Statistics show that while the infant mortality rate has been falling
in the region in recent years, the newborn mortality rate has remained
almost unaltered over the last 10 years.
Let’s Get There! Reduce Noweborn Mortality by 2015
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Latin America and Caribbean Newborn Health Alliance
Action when formulating national plans; 3) consider undertaking, facilitating,
and supporting national activities that promote universal access to health care
for mothers, newborns, and children; 4) forge partnerships and associations;
and 5) consider strengthening national frameworks that protect mothers,
newborns, and children, along with several other important recommendations
aimed at achieving Millennium Development Goal-4.
The Plan of Action covers four interdependent strategic areas deemed
necessary to provide comprehensive care for mothers and their newborns:
i Create a favorable environment—Plans, programs, policies, standards
and protocols for neonatal health must be publicly visible and understood
by society and by regional and national leaders and stakeholders.
i Strengthen health systems and improve access to health services
for the mother, newborn and child—Focus on providing universal
access to health care for newborns, mothers, boys and girls, improving
attitudes and competencies of health service providers, strengthening preservice training, and improving the quality of care for newborns.
i Promote community-based interventions—Strengthen the capacity
of community health workers, traditional birth attendants and community
members to promote healthy practices for mothers and their newborns and
support community mobilization.
i Develop and strengthen surveillance, monitoring and evaluation
systems to assess progress—Strengthen health information systems in
order to effectively monitor progress toward program goals and monitor a
set of standard indicators at the national, regional, and program levels.
Michael Bisceglie for Save the Children
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Michael Bisceglie for Save the Children
Let’s Get There! Reduce Noweborn Mortality by 2015
What is being done
One of the main goals of the LAC Alliance is to catalyze and strengthen crosscutting activities and interventions at the local, national and regional levels
targeting specifically the newborn period, a point which tends to be less visible
in the continuum of maternal and child health. By leveraging their respective
technical, financial, and human resources, Alliance members are able to go
further to address newborn issues in LAC.
To further the aims of the LAC Newborn Health Alliance to share state-of-theart information and address key cross-cutting issues, the following activities
are currently being pursued by sub-committees of the Alliance:
i Development of a Web site dedicated to sharing up-to-date information, best
practices, and lessons learned related to the most important newborn health
topics, including neonatal sepsis, postnatal care, breastfeeding, and many
others.
i Compilation and review of key newborn health indicators, to provide guidance
to country health authorities in monitoring and evaluating newborn health
interventions and outcomes.
i Development of a database of neonatal health experts who work for
international and non-governmental organizations, as well as technical
experts at the Ministries of Health in LAC to provide countries with
information about available experts who can provide necessary technical
support.
i Leading the process of launching the “Interagency Strategic Consensus” at
the country level as part of an initiative to develop national neonatal action
plans within the framework of the continuum of care.
www.alianzaneonatal.org
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Latin America and Caribbean Newborn Health Alliance
What remains to be done
In the LAC region, improved neonatal health has been delayed for many years.
While the overall trend in the region has been a 45% drop in mortality among
children less than 5 years of age, the rates for neonatal mortality remain virtually
unchanged. The result is that now more than 60% of all infant mortality in the
region and almost 40% of mortality of children under five is due to deaths
during the neonatal period (0-28 days).
The LAC Newborn Health Alliance will address the crisis of neonatal mortality
by supporting the implementation of the “Neonatal Health within the Continuum
of Maternal, Newborn, and Child Care” Plan of Action at the country level,
through the following lines of action:
1. Support the countries in developing Neonatal Action Plans addressing
inequities and directed to vulnerable and marginalized groups;
2. Establish alliances at the country level;
3. Support the incorporation of evidence-based interventions into the routine
services of health care facilities at facility and community levels;
4. Promote monitoring and evaluation using process and impact indicators
related to intermediate goals (2010; 2015);
5. Facilitate south-to-south sharing of successful experiences and promote
technical cooperation among countries.
Much work remains to be done to improve the status and health of newborns.
The Regional Strategy and Action Plan, upon publication, will be disseminated
and adapted, and each country will strengthen its own national plan based on
the agreed upon strategic lines of action. In addition, intermediate goals for the
years 2010 and 2015 must be established and communicated, and country
reports must be produced to monitor progress towards the goals every three
years. LAC Alliance members will seek to garner support from the international
community to support the regional and national action plans; this support is
critical for the region to carry out the task of reaching MDG 4 by 2015.
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www.alianzaneonatal.org
www.alianzaneonatal.org
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Latin America and Caribbean Newborn Health Alliance
www.alianzaneonatal.org
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