CNCP

CNCP - व्यापक नवजात की देखभाल पैकेज

Comprehensive Newborn Care Package e-Learning Program (e-CNCP)

Worldwide 6.1 million children died before their fifth birthday in 2015, almost half (2.9 million) of them died during the first month of their lives. Bangladesh already attained Millennium Development Goal 4 - reducing child mortality. Mortality for infants and children under age five has declined steadily in Bangladesh since 1990. The 2014 Bangladesh Demographic and Health Survey shows under-five mortality at 46 deaths per 1,000 live births and the infant mortality rate at 38 deaths per 1,000 live births. These rates represent an impressive improvement over the early 1990s, when these two rates were 133 and 87 respectively. But the neonatal mortality rate has improved more slowly, from about 52 deaths per 1,000 births in the early 1990s to 28 per 1,000 for the mid-2010s. As a result, neonatal deaths account for an increasing share of the deaths of children under age five, rising from about 38% in the early 1990s to 61% currently.

In Bangladesh, the major causes are complications of prematurity, infections and intrapartum complications like birth asphyxia and contributes about 80% of all newborn deaths. The 2014 BDHS found that only 42% deliveries are performed by a skilled provider. Just 32% of babies receive postnatal care from a medically trained provider within two days of delivery. In general only 6% of babies receive all the components of essential care. These identify a need to improve newborn healthcare service delivery consistently at all levels.

Proven, evidence-based interventions could prevent as many as 71% of the global newborn deaths annually. However, low-income countries face challenges in achieving high coverage of these interventions, ensuring quality newborn care at all levels of the health system, and implementing individual interventions in isolation. To address this need, in 2014, the Ministry of Health and Family Welfare (MOH) of Bangladesh and Save the Children’s Saving Newborn Lives (SNL) program developed the Comprehensive Newborn Care Package (CNCP): a package for the implementation of evidence-based health interventions to prevent the major causes of neonatal morbidity and mortality. For the first time in Bangladesh, newborn interventions were packaged together to provide timely, quality, and evidence-based care equitably

The CNCP interventions are grouped into three clusters.

1. Promotion of birth preparedness, newborn care preparedness and proper care seeking through comprehensive SBCC approach:

2. Care for all newborns:

2.1. Immediate and essential newborn care (ENC) including application of 7.1% Chlorhexidine to the cord stump both in facilities and in the community

2.2. Postnatal care in facility and by home visit

3. Extra care for newborn with intra-partum complications, sick babies or small babies:

3.1. Newborn resuscitation using HBB protocol for managing birth asphyxia

3.2. Management of sick newborn starting at first level facilities

3.3. Kangaroo Mother Care (KMC) for managing preterm/low birth weight babies

3.4. Judicial use of antenatal corticosteroid in threatened preterm deliveries

In the early implementation of CNCP, a major impediment to program implementation was the inadequate skill retention of frontline health workers, particularly due to low prevalence of cases and lack of opportunity to practice skills, despite a strong supervision and monitoring program. In this context, the innovation is CNCP e-Learning program.

The e-Learning program of CNCP is designed for health service providers working in different level facilities to refresh and enhance their essential knowledge, skills, and practices to ensure quality newborn services. It has both a mobile and laptop version with four different courses for doctors, nurses, SACMO and FWV. By registering online, users can chose the appropriate course and study offline. eCNCP is enriched with video demonstrations, case scenarios, and knowledge assessments