Helping Babies Breathe annual meeting

1. Helping Babies Breathe annual meeting Prof Bogale Worku Washington DC July 17/ 2012 3

2. Ethiopia’s Progress to meet MDG 4. According to 2008 National EmONC assessment, 66 % of HCs did not have a resuscitation bag and mask. Data sources: Updated from Opportunities for Africa’s Newborns with UN data from www.childmortality.org. * 2010 year contains 2008 data

3. National scale up strategy of HBB in Ethiopia • Govt ownershipwith extensive collaboration among all maternal, newborn and child health partners • HBB is integrated in existing and new trainings and programs: • NBC training /Newborn corner , • NICU nurse training , • CEmONC / BEmONC, • PMTCT, • ICCM, New IMNCI • Pre-service training for midwifes • Others

4. National scale up strategy cont. • Rollout strategy for Ethiopia • Champions and high level advocacy • Government coordination with all MNCH partners • Master level TOT for trainers and supervisors of existing MNCH training programs • UNICEF making available resuscitation equipment and for both training and service • No specific budget needed as the program is rolled out through integration though existing programs

5. TOT Addis Ababa

6. TOT Addis Ababa

7. Evaluation - Newborn Corner • The newborn corner is an initiative to address gaps in preventing newborn morbidity and mortality by ensuring standard newborn care immediately after birth in health facilities. • Piloting in 100 facilities by EPS in collaboration with FMoH and UNICEF • 354 HW including MDs, HOs, midwifes and clinical nurses • 3 days on ENC, HBB, KMC and sepsis management • providing supplies and clinical mentoring post training.

8. The newborn corner • Trained personnel to care for the baby • A warm and clean surface • Essential newborn resuscitation equipments

9. Evaluation - Results • Baseline and end line assessment in 60 facilities looking at knowledge, skills and availability of basic resuscitation equipment

10. The newborn corner

11. Comparison % health workers skill on neonatal resuscitation on base line and end line survey

12. Number of newborn with asphyxia(one month in 60 health facilities )

14. Results to date in Ethiopia • Carders trained on HBB by 31 June 2012 Health workers 7 295 HEWs 20 050 Total 27 345 • Bag and mask distributed by 31 April 2012 Health centers 354 Hospitals 50 Total 404 out of 3000 HF (13,5%) • Resuscitation equipment available 8 000, plus an additional 10 000 to arrive shortly in Ethiopia. In addition 2 000 NeoNatalie training dolls are available in Ethiopia for HBB training.

15. Quality improvement process • Neonatal registration book in place • Supportivesupervision and clinicalmentoring post-training • Guidelines and protocols for newborn resuscitation is being under development • Quarterly / annual review meetings planned

16. Lessons learned • Integration has been a successful way to quickly train and orient a large number of health workers and community health workers (HEWs) on HBB in Ethiopia. • Having a strong governmental leadership with close collaboration among partners is the only way to make changes to newborn survival in a large country with limited funding sources. • Making training material and resuscitation equipment available has helped the HBB rollout. • Early data shows that the training on HBB among HWs has improved their skills.

17. However… • Still only around 10% of deliveries are conducted in health facilities, and only 1% of the HEW have the opportunity to conduct deliveries. • Data on newborns not yet systematically collected as current HMIS does not fully address NB issues

18. Acknowledgements • FMoH • UNICEF • WHO • ICAP – Ethiopia

20. Thank you