WHO policies & strategies

Taking into consideration the life-course approach and continuum of care, neonatal interventions that need to be scaled up will include access to skilled care during pregnancy, childbirth and the immediate postnatal period at community and facility levels; capacity building of professional and non-professional staff for optimal newborn care practices including newborn resuscitation, early and exclusive breastfeeding, warmth, hygienic cord and skin care; and timely and appropriate care-seeking for infections and care of low birth-weight infants. The Making Pregnancy Safer initiative through Integrated Management of Pregnancy and Childbirth (IMPAC) offers opportunities for addressing early newborn health. The Integrated Management of Childhood Illness (IMCI) will also be expanded to include newborn in the first 7 days of life.

Exclusive breastfeeding for the first 6 months of life, including early breastfeeding with colostrum; and timely and appropriate complementary feeding including adequate micronutrient intake (particularly vitamin A, Iron and Iodine) are the key interventions to be scaled up. Special emphasis will be given to prevention and treatment of malnutrition. Integration of IYCF in other child health services at facility and community level such as Baby Friendly Hospital Initiative, IMCI, Prevention of Mother to Child Transmission and Growth Monitoring Promotion and Referral provide critical entry points for scaling up IFYCF interventions. Use of insecticide treated nets for both under-fives and pregnant mothers, and presumptive treatment of malaria during pregnancy in areas where malaria is endemic are priority interventions for reducing low birth-weight and child morbidity and mortality. Mechanisms to ensure universal access to ITNs include free or subsidized ITN distribution on a regular basis or through campaigns. ITN and IPT should be integrated with EPI, ANC and IMCI activities to increase coverage rapidly.

Provision of tetanus toxoid to pregnant women in antenatal clinics, and childhood immunizations including new vaccines, at community and facility levels through outreach and fixed services will be promoted. Use of campaigns and outreaches to provide services to the most-difficult-to-reach, and integration of EPI with other child survival interventions such as Vitamin A, mebendazole for de-worming, and ITNs distributions are proven ways of improving access to and coverage of services.

Prevention of HIV transmission to children through prevention of HIV infection in the mother, family planning, ARV treatment, infant feeding counselling and support for HIV-infected women and their infants in countries with high HIV prevalence, are key to ensuring an HIV-free start in life. Integration of PMTCT interventions in ANC, nutrition programs, IMCI and other HIV/AIDS services enhances opportunities for reducing paediatric HIV and its associated deaths.

The interventions include Oral Rehydration Therapy and zinc supplementation for the management of diarrhoea; effective and appropriate antibiotic treatment for pneumonia, dysentery and neonatal infections and prompt and effective treatment of malaria at health facility and community levels. Care of HIV exposed and HIV infected children is key to improved quality of life. Integrated Management of Childhood Illnesses (IMCI) provides an approach for addressing these common illnesses in an integrated manner. Prevention of Child Sexual Abuse, promotion of school health, establishment of adolescent friendly services and prevention of HIV infection among adolescents will be major interventions undertaken in the African Region.

The strategic approaches that are being followed to achieve these interventions will include: advocacy for harmonization of child survival goals and agendas, strengthening of the health systems, empowering families and communities, operational partnerships, operations research and mobilization of resources at international, regional and government levels for newborn, child and adolescent health.