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Newborn care in Indonesia, Lao People's Democratic Republic and the Philippines: a comprehensive needs assessment

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Abstract
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 aimof 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 systemcontext for newborn care and the equity situation regarding newborn survival. Results: Main findings: (1) In the three countries, decline of neonatalmortality 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.
Keywords
RANDOMIZED CONTROLLED-TRIAL, Newborn care, Healthcare policy, Quality of care, South-East Asia, Needs assessment, Equity, HEALTH INTERVENTIONS, NEONATAL-MORTALITY, CHILD-MORTALITY, WOMENS GROUPS, COUNTRIES, DECENTRALIZATION, DISTRICTS, PROVISION, SETTINGS

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Chicago
Duysburgh, Els, Birgit Kerstens, Melissa Diaz, Vini Fardhdiani, Katherine Ann V Reyes, Khamphong Phommachanh, Marleen Temmerman, Basil Rodriques, and Nabila Zaka. 2014. “Newborn Care in Indonesia, Lao People’s Democratic Republic and the Philippines: a Comprehensive Needs Assessment.” Bmc Pediatrics 14.
APA
Duysburgh, E., Kerstens, B., Diaz, M., Fardhdiani, V., Reyes, K. A. V., Phommachanh, K., Temmerman, M., et al. (2014). Newborn care in Indonesia, Lao People’s Democratic Republic and the Philippines: a comprehensive needs assessment. BMC PEDIATRICS, 14.
Vancouver
1.
Duysburgh E, Kerstens B, Diaz M, Fardhdiani V, Reyes KAV, Phommachanh K, et al. Newborn care in Indonesia, Lao People’s Democratic Republic and the Philippines: a comprehensive needs assessment. BMC PEDIATRICS. 2014;14.
MLA
Duysburgh, Els, Birgit Kerstens, Melissa Diaz, et al. “Newborn Care in Indonesia, Lao People’s Democratic Republic and the Philippines: a Comprehensive Needs Assessment.” BMC PEDIATRICS 14 (2014): n. pag. Print.
@article{4358733,
  abstract     = {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 aimof this study was to conduct a comprehensive, equity-focussed newborn care assessment and to explore options to improve newborn survival in Indonesia, Lao People{\textquoteright}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{\textquoteright} health status, the health policy and the health systemcontext for newborn care and the equity situation regarding newborn survival.
Results: Main findings: (1) In the three countries, decline of neonatalmortality 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.},
  articleno    = {46},
  author       = {Duysburgh, Els and Kerstens, Birgit and Diaz, Melissa and Fardhdiani, Vini and Reyes,  Katherine Ann V and Phommachanh, Khamphong and Temmerman, Marleen and Rodriques, Basil and Zaka, Nabila},
  issn         = {1471-2431},
  journal      = {BMC PEDIATRICS},
  keyword      = {RANDOMIZED CONTROLLED-TRIAL,Newborn care,Healthcare policy,Quality of care,South-East Asia,Needs assessment,Equity,HEALTH INTERVENTIONS,NEONATAL-MORTALITY,CHILD-MORTALITY,WOMENS GROUPS,COUNTRIES,DECENTRALIZATION,DISTRICTS,PROVISION,SETTINGS},
  language     = {eng},
  pages        = {10},
  title        = {Newborn care in Indonesia, Lao People's Democratic Republic and the Philippines: a comprehensive needs assessment},
  url          = {http://dx.doi.org/10.1186/1471-2431-14-46},
  volume       = {14},
  year         = {2014},
}

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