situation action plan - nigeria.pdf - Healthy Newborn Network

CHAPTER 2: STATUS OF NEWBORN CARE IN NIGERIACase management of newborn illnessIMCI coverage in facilities is at just one percent. Very few health workers are trained and using IMCI, despitestrong commitment from government and development partners. While the government has recently adaptedcurrent IMCI clinical guidelines and algorithms to include newborn care in the first seven days of life, it is clear thatreaching the majority of newborns with effective case management for neonatal sepsis will require other deliverychannels in addition to IMCI at least in the short term.According to MICS 2007, 57 percent of children under one year with suspected pneumonia were given antibiotics. 5While the data do not specifically reference newborns, it is likely that treatment is even lower during the firstfour weeks of life. Linking neonatal case management to child case management close to home, for example withCHEWs may provide an effective way to reach more newborns and children with this care – possibly the highestimpact package.Case Management of Newborn and Child IllnessIMCI implementation in Nigeria began in 1999 with plans to roll-out to all PHC facilities. 60 IMCIrecommended drugs are included in Nigeria’s Essential Drug List Currently 33 out of 36 states haveadopted IMCI, though the level of coverage of both pre-service and in-service IMCI training varies.By the end of 2006, only eight nursing schools were teaching IMCI despite its inclusion in the nursingcurriculum, but WHO has supported an additional 14 schools to build institutional capacity for IMCItraining. 61The IMCI algorithms have recently been adapted to include care during the first week of life. If facilitylevelcase management for serious neonatal illness was improved to reach 90 percent of all babiesby 2015, over 56,000 lives could be saved per year. 53 This can be achieved at district hospital levelby the institution of a newborn care “corner” or ward, using standard protocols for care of sepsis,preterm babies, jaundice and neonatal encephalopathyand ensuring staff are competent and basic equipmentand drugs are available. The expectations are outlined inthe WHO Managing Newborn Problems guide. 62 At referrallevel, a newborn care unit must be ready to receive babiesrequiring a higher level of care, as outlined in the WHOPocket Book of Hospital Care for Children. 63Jonathan Hubschman/Save the Children41SAVING NEWBORN LIVES IN NIGERIA