Of the 9.7 million children who die every year before reaching their fifth birthday, about 3.7 million are newborns who do not survive their first four weeks of life. The majority of these newborns live in developing countries and most die at home. And three major causes—infections, birth asphyxia and preterm/low birth weight—account for 86% of neonatal deaths.

While up to two-thirds of these deaths can be prevented if mothers and newborns receive known, effective interventions during pregnancy, childbirth and the first hours and days after birth, less is known about how to deliver life-saving interventions in low-resource settings. However, a strategy that promotes universal access to antenatal care, skilled birth attendance and early postnatal care will contribute to sustained reduction in maternal and neonatal mortality

The Lancet series on newborn health identified key interventions for the prevention and treatment of the major causes of neonatal deaths, including the main evidence-based interventions that MCHIP will support for the introduction and expansion of newborn interventions:

• Essential newborn care—including hygienic cord care, maintenance of warmth, and immediate and exclusive breastfeeding; and
• Extra care for low birth weight babies—including KMC, neonatal resuscitation and sepsis management.

Although these interventions have existed for years, the coverage remains very low or non-existent in most developing countries. Care for asphyxiated or sick newborn infants, and those with infections, for instance, is limited to a few tertiary and/or secondary health facilities. In addition to these post-delivery interventions, antenatal and intrapartum interventions such as skilled birth attendance and improved care for Pre-eclampsia/eclampsia will further contribute to the reduction of neonatal mortality.

MCHIP and Newborn Health
By focusing on the three main causes of death and supporting the introduction and scale-up of evidence-based prevention and treatment interventions, MCHIP aims to contribute to the global reduction of neonatal mortality. In the process, the Program will be contributing to the reduction in Millennium Development Goal 4, as well as to USAID’s goal of reducing under-five mortality by 25% by 2013 in 30 priority countries, and to their newborn health pathway goals.

The MCHIP strategy for newborn health will:

• Follow the Paris Principles and work with partners including UNICEF, WHO and Saving Newborn Lives to provide catalytic inputs to support the introduction and expansion of evidence-based newborn care interventions;
• Scale up evidence-based approaches to improve newborn health by focusing on 30 priority MCH countries;
• Support integration of ENC packages into MCH systems;
• Assure that evidence-based ENC programs are documented and promoted at scale;
• Provide technical leadership in newborn health globally; and
• Strengthen and support strategic alliances that support implementation of newborn health programs at scale.