This project to save newborn lives in Kenya continues to provide home visits to assess newborns during the first week of life for signs of serious illness and refer them for prompt treatment. The 20 community health workers in the target villages who were trained by Global Health Partnerships (GHP) for this project have visited approximately 700 infants each year since the project began. More than 95% of those infants have been visited 3 times during their first week of life, as recommended by UNICEF and other specialists in newborn care. The early neonatal mortality rate (rate of death) for the visited infants has been 9 per 1,000 live births, which is much better than the national rate in Kenya of 20 deaths per 1,000. All of the funds that were generously donated by supporters of this project have been used to help achieve this laudable goal. Adequate funds to continue this project are now available from independent grant funding, leading to the decision to close this GlobalGiving project.
Please keep in mind that the GHP project "Feed Hungry Children in Kenya" remains active on the GlobalGiving web site. We are directing all rollover funds to that project. For information about that project see: http://www.globalgiving.org/projects/feed-hungry-children-in-kenya/
After a long walk to the home of a mother and her newborn infant, Salina promptly began her assessment of theinfant. Salina is a volunteer community health worker (CHW) who has more than two years of experience with newborn home visits, having participated in the first training program that was implemented by Global Health Partnerships. The infant that she is visiting today in a village of Makusya sublocation was born three days ago without complications or problems. When Salina checked on the baby the first day after birth, all was going well and there were no signs of illness or problems. On today’s visit Salina starts by greeting the mother, asking if breast feeding is going well and if the mother has any concerns or has noticed any problems. She notes that the baby seems alert and active, has no skin pustules or boils, and her temperature is normal. But when Salina counts the breathing rate, she finds a rapid rate of more than 60 breaths per minute. Recognizing this danger sign of serious illness, she calls her supervisor Nicholas Mutuku, who quickly arranges for the mom and baby to be transported to the Kisesini clinic. Nicholas confirms the diagnosis of pneumonia, promptly starts antibiotic therapy, and arranges hospitalization of the infant. A few days later the young infant has recovered and is back at home with her mother.
In Kenya 40% of childhood deaths occur during the neonatal period (the first month of life), and three- fourths of those neonatal deaths happen in the first seven days. Young infants can become very ill and succumb to their illness quickly. The key to reducing the death rate is early recognition and prompt treatment. Over the past three months Salina and the other 19 CHWs visited a total 198 infants during their first week of life. The visits were conducted on days one, three, and seven of that first week, as recommended by UNICEF. There were no deaths. In the absence of the newborn home visitation program, 4 or 5 of those 198 young infants would likely have died, based on the national neonatal mortality rate in Kenya. The dedicated CHWs of the Kisesini Community Health Project have accomplished this successful effort because of your donations to this GlobalGiving project. If adequate funding canbe found, GHP is planning an expansion of the project so that a larger number of newborn infants can be included.
The 20 community health workers (CHWs) who were trained by Global Health Partnerships continue their work of visiting newborn infants in their villages. They assess each young infant for signs of early infection and refer those who need treatment to the nearest health care facility. The protocol that they use follows the UNICEF recommendations of three visits during that first week of life, i.e. on day one, day three, and day seven. The evidence cited by UNICEF indicates that at least two of those three visits is needed in order to have the maximum impact on the prevention of neonatal deaths. Since the last report for this project 3 months ago, the CHWs have visited 218 infants. They completed all three of the visits for 217 infants, and the remaining one infant was visited twice. There were no infant deaths during this period of time. This very high completion rate for the assessment of newborn infants is a tribute to the commitment of this group of dedicated CHWs to save newborn lives.
In my role as the project leader I visit the site and review the progress “on the ground” twice each year. I have beenin Kenya for the past one month meeting with the CHWs and reviewing their work. The 20 Kenyan CHWs who were trained by Global Health Partnerships volunteers have continued to visit the homes of newborn infants during the first week of life. On multiple occasions they have successfully detected severe illness (sepsis) in the newborns and referred them for treatment to a health facility. Early detection of severe illness in young infants can be life-saving because they often die quickly if an infection is not detected and treated promptly. The photo shows one of the young infants who was found by a CHW to have signs of a severe infection and referred to the clinic, and the nurse has started intravenous antibiotics. This child survived the illness because of the CHW’s prompt detection of the problem and the rapid initiation of appropriate treatment.
At the end of last month (February 2013), the project had been in operation for 24 months, and a total of 1,401 newborn infants were visited by the CHWs. There were 8 newborn infant deaths during that 24 month period of time, which constitutes a mortality rate of 6 per 1,000 live births. The most recent national data on child mortality for Kenya (2008-2009) cite a neonatal (first month of life) mortality rate of 31 per 1,000 live births. Therefore the observed mortality rate of 6 per 1,000 for this project suggests that the “saving newborn lives” intervention is indeed accomplishing its goal.
The generous donors who provide the funds to continue this project can be assured that their investment in the health of young children is being used effectively and efficiently. Over 95% of donations to Global Health Partnerships go directly into the program services!
In September this year the World Health Organization and UNICEF reported encouraging progress in reducing child deaths in developing countries. The successful efforts to improve child health and survival are working, and sub-Saharan African countries have shared in this success.
But the news is not all good. There has notbeen much progress in reducing the many childhood deaths that occur in the first month of a child’s life, which is called the neonatal period. Most neonatal deaths happen early, within the first few days of birth. The deaths are from infection or other preventable causes. Progress in the prevention of these deaths has been difficult because most newborn infants and their mothers have very little access to health care during the critical first days and weeks of the infant’s life.
How can we save the life of a newborn?
In poverty-stricken areas like rural Kenya the key to the problem of access to health care for newborns is to train localcommunity health workers (CHWs), who live and work in the villages and know the mothers and infants who need care. The CHW home visitation project that was started by Global Health Partnerships has trained a network of CHWs who now have the capability of saving the lives of newborn infants, who often die quickly if an infection is not detected and treated promptly. The CHWs have been visiting 60-70 newborns each month, and the death rate (mortality rate) for these infants during the critical neonatal period has been much lower than the mortality rate in other parts of Kenya.
Some generous donors have provided the initial funding to get this project started, but we need to raise more funds quickly if this life-saving project is to continue. It takes only $10 to provide all 3 home visits for a newborn during the critical first week of life.
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