By Lexi Elo with Agency Report
Since the Every Newborn Action Plan (ENAP) was endorsed at the World Health Assembly a year ago, 15 of the 18 countries with some of the highest burden of maternal and newborn mortality have taken steps to improve care for mothers and their newborns.
Governments’ commitment to ENAP’s framework is a stride forward. It sets a clear direction for government actions to ensure mothers and their babies survive and thrive following childbirth and the fragile first month, and lays out mortality and coverage of care targets for countries to meet by 2035.
According to the ENAP Progress Report released last week, four countries – Bangladesh, India, Indonesia and Kenya – have developed specific action plans, and a further six countries – China, Guinea Bissau, Nigeria, Pakistan, Sierra Leone and Zimbabwe – are in the process of preparing specific action plans.
An additional three countries – Chad, Democratic Republic of Congo and Mali – have strengthened newborn components within existing plans for Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH). Work is in progress in Ethiopia and Lesotho to strengthen the newborn component within existing plans.
As a welcome development, Strategies toward Ending Preventable Maternal Mortality (EPMM) calls for eliminating inequity in access, quality and outcomes of care within and between countries that lead to wide disparities in maternal and neonatal mortality.
EPMM proposes a human rights-based approach to maternal and newborn healthcare, and expands the focus to address the shifting patterns of causes of maternal death in countries, as well as the systemic social, political and economic determinants of health and survival that are associated with high rates of maternal mortality.
Both the ENAP and EPMM strategies aim to improve the quality of maternal and newborn care, to reach every woman and newborn with universal coverage, and to strengthen measurement capacity and count every death to drive improvement and accountability.
EPMM aims to address maternal and newborn mortality over the continuum of care, whilst the Every Newborn Action Plan takes on these critical issues by using more immediate tools.
The combined strategic approaches for ending preventable maternal and newborn deaths and stillbirths under Every Woman Every Child promote successful partnership initiatives and country leadership that can lead to real change for families, communities and societies across the globe.
“Countries and other global stakeholders have come together to ensure that sound strategies are available to end preventable maternal and newborn deaths within a generation, and to bridge the equity gap so that all mothers and their newborns, especially those who are voiceless and vulnerable, have their right to health upheld. It is our collective responsibility to ensure that everyone can survive and thrive.
These strategies inform the update of the UN Global Strategy for Women’s, Children’s and Adolescents’ Health, highlighting the need for evidence in order to drive this critical agenda forward.” said Dr. Flavia Bustreo, WHO Assistant Director-General for Family, Women’s and Children’s Health.
While unprecedented progress has been made in improving the lives of women and children around the world, maternal mortality rates have not declined to the levels set by the MDGs. Newborn mortality rates have fallen even more slowly and stillbirth rates have been stagnant.
Despite efforts to date, each day 800 women and 7,700 newborns still die from complications during pregnancy, childbirth and other neonatal causes, and 7,300 women experience a stillbirth. Moreover, these deaths are not equally distributed within or between countries around the world.
As improved newborn survival and health are intrinsically linked with the health and survival of women before conception, during pregnancies and around the time of birth, a range of interventions across a continuum of quality care addressing reproductive, maternal, newborn, child and adolescent health is needed to address these preventable tragedies. In particular, improved access and quality of care around childbirth can generate a triple return on investment by saving maternal and newborn lives and preventing stillbirths and disability.
“Women and children need access to high-quality care and services across a continuum of care, including in fragile states where over half of the deaths occur. Seeing so many countries spring into action is testament that ending preventable maternal and child deaths and stillbirths within a generation is possible and a priority. The ENAP and EPMM plans are essential guidance to help countries reach their goals,” said Kate Gilmore, Deputy Executive Director, UNFPA.
Led and supported by many committed partners, with particular leadership from WHO and UNICEF, the process to develop both EPMM and ENAP plans lasted more than two years and involved numerous multi-stakeholder consultations, official Member State input and web-based consultations drawing over 300 comments.
For Nina Schwalbe, UNICEF’s principal adviser on health, “Making newborns and mothers a priority on a global scale has catalyzed unprecedented action. We must keep this focus in the post-2015 era. The bold actions we take today to end preventable maternal and child mortality will lead to a better world tomorrow.”
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Partners that have committed to end newborn deaths globally include Bill & Melinda Gates Foundation; Family Care International; Human Reproduction Programme (HRP); International Confederation of Midwives; International Federation of Gynecology & Obstetrics (FIGO); London School of Hygiene & Tropical Medicine; Maternal and Child Survival Programme; Maternal Health Task Force; Save the Children; The Partnership for Maternal, Newborn & Child Health; The White Ribbon Alliance; The World Bank; USAID; UNFPA; UNICEF; United Nations Foundation, among others.
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