TY - JOUR
T1 - Newborn care in Indonesia, Lao People's Democratic Republic and the Philippines
T2 - A comprehensive needs assessment
AU - Duysburgh, Els
AU - Kerstens, Birgit
AU - Diaz, Melissa
AU - Fardhdiani, Vini
AU - Reyes, Katherine Ann V.
AU - Phommachanh, Khamphong
AU - Temmerman, Marleen
AU - Rodriques, Basil
AU - Zaka, Nabila
N1 - Funding Information:
We would like to thank UNICEF East Asia and Pacific Regional Office for funding this assessment. We would also like to thank the UNICEF country teams in Indonesia, Lao PDR and the Philippines, especially Dr Karina Widowati, Ms Susan Albone and Dr Mariella Castillo respectively who provided us with desk review background documents, made arrangements for the country visits and reviewed the drafts of the country reports.
PY - 2014/2/15
Y1 - 2014/2/15
N2 - Background: Between 1990 and 2011, global neonatal mortality decline was slower than that of under-five mortality. As a result, the proportion of under-five deaths due to neonatal mortality increased. This increase is primarily a consequence of decreasing post-neonatal and child under-five mortality as a result of the typical focus of child survival programmes of the past two decades on diseases affecting children over four weeks of age. Newborns are lagging behind in improved child health outcomes. The aim of this study was to conduct a comprehensive, equity-focussed newborn care assessment and to explore options to improve newborn survival in Indonesia, Lao People's Democratic Republic (PDR) and the Philippines.Methods: We assessed newborn health policies, services and care in the three countries through document review, interviews and health facility visits. Findings were triangulated to describe newborns' health status, the health policy and the health system context for newborn care and the equity situation regarding newborn survival.Results: Main findings: (1) In the three countries, decline of neonatal mortality is lagging behind compared to that of under-five mortality. (2) Comprehensive newborn policies in line with international standards exist, although implementation remains poor. An important factor hampering implementation is decentralisation of the health sector, which created confusion regarding roles and responsibilities. Management capacity and skills at decentralised level were often found to be limited. (3) Quality of newborn care provided at primary healthcare and referral level is generally substandard. Limited knowledge and skills among providers of newborn care are contributing to poor quality of care. (4) Socio-economic and geographic inequities in newborn care are considerable.Conclusions: Similar important challenges for newborn care have been identified in Indonesia, Lao PDR and the Philippines. There is an urgent need to address weak leadership and governance regarding newborn care, quality of newborn care provided and inequities in newborn care. Child survival programmes focussed on children over four weeks of age have shown to have positive outcomes. Similar efforts as those used in these programmes should be considered in newborn care.
AB - Background: Between 1990 and 2011, global neonatal mortality decline was slower than that of under-five mortality. As a result, the proportion of under-five deaths due to neonatal mortality increased. This increase is primarily a consequence of decreasing post-neonatal and child under-five mortality as a result of the typical focus of child survival programmes of the past two decades on diseases affecting children over four weeks of age. Newborns are lagging behind in improved child health outcomes. The aim of this study was to conduct a comprehensive, equity-focussed newborn care assessment and to explore options to improve newborn survival in Indonesia, Lao People's Democratic Republic (PDR) and the Philippines.Methods: We assessed newborn health policies, services and care in the three countries through document review, interviews and health facility visits. Findings were triangulated to describe newborns' health status, the health policy and the health system context for newborn care and the equity situation regarding newborn survival.Results: Main findings: (1) In the three countries, decline of neonatal mortality is lagging behind compared to that of under-five mortality. (2) Comprehensive newborn policies in line with international standards exist, although implementation remains poor. An important factor hampering implementation is decentralisation of the health sector, which created confusion regarding roles and responsibilities. Management capacity and skills at decentralised level were often found to be limited. (3) Quality of newborn care provided at primary healthcare and referral level is generally substandard. Limited knowledge and skills among providers of newborn care are contributing to poor quality of care. (4) Socio-economic and geographic inequities in newborn care are considerable.Conclusions: Similar important challenges for newborn care have been identified in Indonesia, Lao PDR and the Philippines. There is an urgent need to address weak leadership and governance regarding newborn care, quality of newborn care provided and inequities in newborn care. Child survival programmes focussed on children over four weeks of age have shown to have positive outcomes. Similar efforts as those used in these programmes should be considered in newborn care.
KW - Equity
KW - Healthcare policy
KW - Needs assessment
KW - Newborn care
KW - Quality of care
KW - South-East Asia
UR - http://www.scopus.com/inward/record.url?scp=84894263909&partnerID=8YFLogxK
U2 - 10.1186/1471-2431-14-46
DO - 10.1186/1471-2431-14-46
M3 - Article
C2 - 24528519
AN - SCOPUS:84894263909
SN - 1471-2431
VL - 14
JO - BMC Pediatrics
JF - BMC Pediatrics
IS - 1
M1 - 46
ER -
