Accelerated Actions for Reducing Preventable Neonatal Deaths In Bangladesh

1. Accelerated Actions for Reducing Preventable Neonatal Deaths In Bangladesh Regional Consultation Meeting Hyatt regency Hotel Kathmandu, Nepal 30 August, 2013

2. Demographic Profile of Bangladesh Source: BBS 2011, BDHS 2011, * SVRS

3. Achievements

4. Bangladesh on track to achieve MDG 4 targets well before 2015 Bangladesh is one of 23 countries on track to achieve MDG4 & has the 4th most rapid rate of decline in child mortality 39% 2.4% Annual rate of reduction 3.3% Annual rate of reduction 60% Bangladesh Demographic and Health Surveys

5. Most causes of deaths among children are declining in Bangladesh 33% 46% 85% 20% 60% Under-5 Deaths per 1,000 live births

6. Disparities in child mortality has been generally reducing 92% higher 106% higher 34% higher 73% higher 78% higher 10% higher Under-5 deaths per 1,000 live births Source- Bangladesh Demographic and Health Surveys

7. Strategies, Guidelines and Action Plan Developed

8. The intervention package to be guided by the causes of under-5 deaths • Annual number of deaths: • Neonatal (60% of all child deaths) • Neonatal infections 38,500 • Birth asphyxia 21,500 • Preterm 12,000 • (+17,500) • Pneumonia and serious infections 64,000 • Drowning 14,500 Under-5 Deaths Data Source: Bangladesh Demographic and Health Survey 2011

9. Rangpur Sylhet Rajshahi Dhaka Khulna Chittagong Barisal Child/Newborn mortality rate by division 42 (27) • Child mortality is much higher in some parts of the country 71 (45) 63 (39) 54 (36) 40 (32) 50 (21) 62 (38) Child Mortality per 1000 live birth Bangladesh Demographic and Health Survey 2011

10. Reduction of Neonatal Mortality-wide disparities across among richest population Source BDHS

11. Rangpur Sylhet Rajshahi Dhaka Khulna Chittagong Barisal Skilled attendance at birth-Coverage by Division 29% • Gains in skilled attendance at birth has been slower in some parts of the country 24% 31% 32% 49% 30% 28% Bangladesh Demographic and Health Survey 2011

13. Current Coverage of key interventions

14. Bottleneck Analysis, Strategies and Solutions

16. Promise Renewed-Bangladesh Call For Action Evidence-based Interventions & Strategic Approaches

18. Strategic approaches

19. Operational modalities

20. Expected Increase in Intervention Coverage Maternal Health Interventions New Interventions Newborn Health Interventions

21. Expected Increase in Intervention Coverage New Interventions Child Health Interventions

22. Under-5 Mortality Trends in Bangladesh: Actual Estimates and Projections till 2035 Actual: Bangladesh Demographic and Health Surveys

23. How many child deaths will we prevent? Estimated108,000 child deaths under five will be averted EVERY YEAR 53 Preventable under-5 deaths Neonatal sepsis management Injury & drowning prevention • Labour and delivery management It means approximately 300 child deaths averted EVERYDAY Antibiotics for pneumonia Pneumococcul vaccine Breastfeeding Clean postnatal practices Resuscitaion Other interventions 17 Remaining deaths

24. Ending Preventable Newborn and Child Deaths by 2035: Next Steps for Bangladesh

25. Opportunities to Accelerate Progress of Newborn Health • Highest level commitment-Launching of the ‘Promise Renewed’ and declaration of the ‘Bangladesh Call for Action • Introduction and scale-up of new newborn interventions approved by the MOH&FW • 16 out of 32 Operational Plans under HPNSDP address MNCH • Large Scale programs on MNCH are on-going which includes newborn health • National neonatal health strategy, Guidelines, SOP and the on-going revision of the maternal health strategy • Large networks of facilities including community clinics • Expanding human resources including doctors, nurse, midwives • Large network of NGOs and CHWs • Continued commitment of the development partners for MNCH

26. Thank You