Bill & Melinda Gates Foundation

Day 3 in Ethiopia: What Do We Need to Save Newborns' Lives?

December 18, 2012

Last week Jennifer James was in Ethiopia to observe Save the Children’s work with health workers. She, along with three US-based pediatric and obstetric nurses, visited Hida Kaliti health post to see results of the Saving Newborn Lives  program.

As we walked up to the village health post on a sunny day in Hida Kaliti in the Southern region of Ethiopia we were followed by throngs of school-aged children who were excited to see a team of visitors who had just driven in on heavily trenched roads in white Save the Children SUVs. The children, most without any shoes and some carrying sticks or plastic cans for gathering water, sprinted from all directions on the dirt road to catch a glimpse of us and watched as we entered the one-story health post where health development workers waited to tell us about their life-saving work through the Saving Newborn Lives program.

Save the Children’s Saving Newborn Lives program seeks specifically to reduce the number of newborns who die within their first 28 days of life, and works to improve Ethiopia’s rate of 1 in 8 children who die before their fifth birthday. While the Millennium Development Goal of reducing child mortality by two-thirds by 2015 is on track, it's not happening fast enough.

 There are several limitations to health post deliveries, however. None of the health posts we visited had running water.

“Neonatal mortality is still high,” said Dr. Hailu Tesfaye, Director of Save the Children’s Hawassa office. “We need to focus on newborn interventions to get the child health MDG down.”

Inside the health post two health extension workers (HEWs)  greeted us and began to explain through translation their work in Hida Kaliti and pointed to data charts on the walls that showed the overall health of the community and how it has improved over the years, especially newborn health. Two health extension workers are assigned to each community’s health post and provide care for 5,000 people or 1,000 households. At each health post health extension workers are able to diagnose and treat pneumonia, malnutrition, diarrhea, and malaria, provide antenatal and postnatal care, provide neonatal and child health care, as well as perform safe and clean deliveries.

There are several limitations to health post deliveries, however. None of the health posts we visited had running water.

“It is hard for a mother to go to a health post and deliver if there is no water,” Dr. Tesfaye tells us. “One of the big interventions is to make sure mothers give birth in a health center with a skilled birth attendant.”

Health extension workers continue to push expectant mothers to deliver their babies at a health post, but resistance is strong. In fact, 90 percent of all Ethiopian births take place at mothers’ homes.

The rate of neonatal mortality is 106 deaths per 1000 live births in Ethiopia according to Save the Children’s Nutrition in the First 1,000 Days: State of the World’s Mothers report and most of these deaths occur during the first 24 hours after birth due to infection. A volunteer core of mothers called the health development army (HDA) works with the health extension workers to identify mothers who have just delivered a baby to make sure she and her baby are given proper care by the health extension workers within the first 24 hours after delivery as well as follow-up visits to check on the health of the baby.

After our visit at the health post we visited a family whose infant daughter is alive today because one of the health extension workers visited the mother and baby within 24 hours of her birth and found out the baby had a fever. If the health extension worker didn’t visit the mother and baby there is a great chance the baby would have died.

You can learn more about frontline health workers around the world and how vital they are to communities at Save the Children’s web site, Every Beat Matters.
 
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