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7/28/2019 Diene: Senegal

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GLOBAL NEWBORN HEALTH CONFERENCE15-18 April 2013

SESSION 3E-1


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BACKGROUND

KEY COMMUNITY/HOME-BASED PROGRAMS

SELECTION OF THE INTERVENTIONS ANDAPPROACHES

SUCCESSES/IMPACT ON NEWBORN HEALTH


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Evolution of mortality rates

49%

27%

13%

11%

Major causes of neonatalmortality in Sngal

Prematurity

Asphyxia

Pneumonia

Sepsis


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Status of current servicedelivery

Number ofhealth districtsoffering theservices (N=76)

Geographiccoverage

Comments

Comprehensive care of motherand newborn in the healthfacilities (Focused ANC, BeMOCand CeMOC)

76 100% Accessibility and quality of caremust be improved

Management of neonatalinfection 76 100%

In the referal facilitiesResuscitation of the newborn(ENC / AMTSL + HBB)

Training of trainers conducted inNovember 2012. Roll out plandeveloped.

Family Planning (FP)76 100%

Uptake still low- due to socio-cultural barriers/social norms, lackof the continuum of service

Kangaroo mother care 24 32% Not offered in all health facilitiesPromotion of C-IMCI keypractices 72 95%

Community component ofcomprehensive care of motherand newborn 4 5%

implementation of newborn homecare in few villages. Scale up planbeing developed based on lessonslearned from the pilot phase(generation of local evidence)


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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

ANC at least 1 ANC at least 4 Protected atbirth from

tetanus

IPTp formalaria

Skilledattendant at

birth

Earlybreasfeeding

Ever breast fed Exclusivebreastfeeding

DTP1 DTP3 Fullyimmunized

children

ITN use byunder-five

Pregnancy New born and infant feedingChild health outreach


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Type of interventions Promotion of key family practices: early and exclusivebreast feeding, hand washing, use of nets, recognitionof danger signs and timely health care seeking

Follow up the pregnant woman and the newborn

Home visits for the pregnant women, mother andnewborn child since 2011 Identify pregnant women to promote ANC, birth preparedness,

facility based deliveries, exclusive breast feeding and familyplanning

Encourage early postnatal facility visits for both mothers andnewborns.

Conduct postnatal home visits of the mother-baby pair: care of theumbilical cord, temperature management, care of the low birthweight baby and identification of danger signs and referral forcare;


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Implementation approaches Bajenu Gox Program:

sponsorship and leadership in the service ofmaternal, neonatal and child health

Grandmothers approach: peer education to act on social norms

Solidarity circle for pregnant women:

mutual aid, assistance and support Community mobilization

Home visits


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There are three main cadres of communityhealth workers: Agents de Sant Communautaire (ASC) Matrones Relais communautaires

Incentives: ASCs andMatrones: volunteer, incentives from mark

up on drugs and/or non monetary incentives(bicycles, t-shirts etc);

Relais communautaire : volunteer too; modest andirregular financial and non financial incentives duringspecial events (meetings, social mobilization andcampaigns etc)


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At the end of 2012 there were: 13,959 CHWs, including 2,907 ASCs, 4,680

matrones, and 6,372 relais. 1,759 health huts and 1,474 community sites in the

14 regions and 72/76 districts

Equipment and supplies provided: Partners support: UNICEF, OMS Kit/materials:

Timer

Thermomter Balance salter (5kg)

Cartes conseils, regidtres, fiches mere/bebe, fiche dereference

Bag


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Use of routine indicators Lack for decision making at the local level

Integration of the data from the community level inthe health system information

Monitoring, supervision and reporting CHWs are an integral part of the health systems and

work under the direct supervision, support andoversight of nurses and midwives;

Data managment tools used by the CHW

Data collection and reporting are doing regularywith the NGOs support


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The choice of the key family practices andimplementation strategies depended on:

the epidemiological context,

the specific district needs (coverage of keyinterventions) and existing implementationcapacity;

the socio-cultural practices/social norms

the geographic conditions( within or beyond5 km radius


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Commitment of the MoH to improve thenewborn health program

National appropriation of the approach:

Newborn home care extension plan elaborated; Pool of trainers available;

Adaptation of the OMS /UNICEF generic tools

At the health facility and district level

Better status of the CHW Increase the use of the services

Introduction of kangourou mother care at thecommunity level

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