Manila Business Daily

Progress on Early Essential Newborn Care in the Western Pacific Region, but Millions of newborn infants remain at risk

Kyle Barnett | Nov 24, 2017

Worldwide, 15 million babies are born preterm and more than a million die as a result. This World Prematurity Day, 17 November, the World Health Organization (WHO) strives to raise awareness about a major contributor to newborn deaths -- early separation from the mother after birth.

Not only do separated babies not benefit from skin-to-skin contact, they are exposed to hypothermia and hospital-acquired infections. Further, babies are often given infant formula instead of breast milk, which increases the risk of infection, malnutrition and death. Early initiation of breastfeeding in particular colostrum, as well as exclusive breastfeeding have been scientifically proven to benefit babies.

At a gathering of Ministry of Health vice ministers and public health experts in Da Nang, Viet Nam, August 2017, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) called on countries to accelerate efforts to save the lives of millions of newborn infants at risk of death at birth through Early Essential Newborn Care.

"Families should welcome the birth of every child without fear. It is unacceptable that millions of newborns remain at risk when we have the knowledge and tools to save and protect newborn lives," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific.

"The answer is Early Essential Newborn Care (EENC), a set of simple interventions that benefit all mothers and newborns," said Wivina Belmonte, Officer-in-Charge of UNICEF's East Asia and the Pacific region. "We work very closely with countries and WHO to make this available to all mothers and babies in our region."

The core of EENC is the First Embrace -- immediate and thorough drying after birth followed by skin-to-skin contact until completion of the first breastfeed, appropriately timed clamping and cutting of the cord, and exclusive breastfeeding.

First Embrace keeps babies calm, stimulates breathing, prevents hypothermia, reduces anaemia, prevents brain haemorrhage, strengthens immunity from infections, and provides adequate and appropriate nutrition from breastfeeding.

Kangaroo mother care (KMC), is where preterm and low birth weight babies are maintained in skin-to-skin contact, fed breastmilk and monitored closely for infection. It has been known to save lives for over 30 years. While its prevalence in the region is improving, it is not yet applied to two-thirds of all preterm babies.

First Embrace: progress so far

To mobilize public and political support, WHO and UNICEF launched the First Embrace campaign in Manila, March 2015. Since then, it has been launched in eight priority countries with the highest burden of newborn deaths in the Region: Cambodia, China, the Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines, Solomon Islands and Viet Nam.

EENC has now helped over 30 000 health workers improve the quality of the care they provide. Starting in 2017, First Embrace has expanded to countries outside the Region.

"Within four years, EENC has been introduced in 17 countries, benefitting 4 million newborns annually with improved care. This is a remarkable achievement, but we still have 28 000 more health facilities to go," said Dr Howard Sobel, WHO Coordinator for Reproductive, Maternal, Newborn, Child and Adolescent Health for the Western Pacific Region.

High-level forum on EENC in Da Nang, Viet Nam

In Da Nang, Viet Nam, WHO and UNICEF called on countries participating at the Second Biennial Meeting on Accelerating Progress in Early Essential Newborn Care Progress, August, to redouble efforts at improving maternal and newborn care.

The forum provided an opportunity for countries to exchange experiences, strategies and develop a roadmap for scaling up EENC in the Region.

"Health workers, programme directors, hospital administrators and staff have all made great progress in scaling up EENC in the Region. To take this to the next level, political commitment and financial investments are essential," said Ms Belmonte.

Viet Nam, as host country for this forum, has made tremendous efforts in scaling up EENC since 2015. EENC has now been introduced to all 63 provinces with close to 9000 health facility staff coached. Clinical practices in Viet Nam have also drastically improved. Now, 78% of term babies receive skin-to-skin contact and are exclusively breastfed in the immediate newborn period. Thus, Viet Nam has become a frequently visited country by people from other countries to learn how to develop an effective EENC programme.

"In 2013, Member States endorsed the Action Plan for Healthy Newborn Infants in the Western Pacific Region -- a commitment to improve the quality of care for mothers and newborns in health facilities throughout the Region," says Dr Shin.

"I commend all vice ministers and government decision-makers present at the high-level forum for committing to that next step in improving maternal and newborn health. We fully support all efforts towards leaving no mother or newborn behind," Dr Shin concluded.