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  1. 1. Introduction
    1. 1.0 Overview
    2. 1.1 What is the Purpose of the Field Guide
    3. 1.2 Who is the Field Guide intended for?
    4. 1.3 How is the Field Guide organized?
  2. 2. Background
    1. 2.0 Overview
    2. 2.1 Humanitarian Settings Across the Globe
      1. 2.1.1 Challenges to Newborn Health Service Delivery
    3. 2.2 Newborn Health: Epidemiology
      1. 2.2.1 Global burden of newborn mortality
      2. 2.2.2 Principal causes of neonatal deaths
  3. 3. Newborn Health Services
    1. 3.0 Overview
    2. 3.1 General Principles and Considerations
      1. 3.1.1 The Continuum of Care Across the Lifecourse
      2. 3.1.2 Levels of Care
    3. 3.2 Essential Newborn Care
    4. 3.3 Newborn Care at Household/Community Level
      1. 3.3.1 During the Antenatal Period
      2. 3.3.2 Intrapartum and essential newborn care
      3. 3.3.3 Postnatal care
    5. 3.4 Newborn Care at Primary Care Facilities
      1. 3.4.1 Antenatal care
      2. 3.4.2 Intrapartum and essential newborn care
      3. 3.4.3 Postnatal care
    6. 3.5 Newborn Care at Hospitals
      1. 3.5.1 Antenatal care
      2. 3.5.2 Intrapartum and essential newborn care
      3. 3.5.3 Postnatal care
    7. 3.6 Additional Considerations for Preventing and Managing Principal Causes of Neonatal Deaths
      1. 3.6.1 Prematurity/Low Birth Weight (LBW)
      2. 3.6.2 Newborn Infections
      3. 3.6.3 Intrapartum Complications
  4. 4. Strategic Considerations
    1. 4.0 Overview
    2. 4.1 Mainstreaming newborn health in humanitarian coordination
      1. 4.1.1 Incorporate questions about newborn health services within a rapid health assessment
      2. 4.1.2 Advocate for the inclusion and prioritisation of newborn health in humanitarian response plans
    3. 4.2 Conducting a situational analysis
      1. 4.2.1 Examine national policies and protocols relevant to newborn health
      2. 4.2.2 Examine existing clinical guidelines, key messages/ BCC materials, tools and training materials
      3. 4.2.3 Assess resource availability: facilities, supplies and staff
    4. 4.3 Developing an inclusive and unified response strategy
      1. 4.3.1 Prioritizing newborn interventions
      2. 4.3.2 Update and distribute clinical guidelines and protocols
      3. 4.3.3 Develop and collate needs based staff training materials
      4. 4.3.4 Procure and distribute essential medicines and supplies
      5. 4.3.5 Ensure quality improvement and respectful care
      6. 4.3.6 Develop proposals to secure additional funding
    5. 4.4 Developing and implementing a monitoring and evaluation (M&E) plan
      1. 4.4.1 Compromised data flow and routine information systems
  5. 5. Program Implementation Considerations
    1. 5.0 Overview
    2. 5.1 Developing and disseminating key messages/behavior change communication (BCC) materials
    3. 5.2 Developing a referral system
      1. 5.2.1 When referral is not feasible
    4. 5.3 Home visits for mothers and babies
    5. 5.4 Procuring newborn care supply kits
    6. 5.5 Managing newborn deaths in crisis settings
      1. 5.5.1 Support for neonatal loss
      2. 5.5.2 Documenting neonatal loss
  6. 6. Annexes
    1. 6.1 Annex 1: Newborn health services summary tables by levels of care
      1. 6.1.1 Annex 1A
      2. 6.1.2 Annex 1B
      3. 6.1.3 Annex 1C
    2. 6.2 Annex 2: Doses of Common Drugs for Neonates
    3. 6.3 Annex 3: Advanced Care for Very Sick Newborns
    4. 6.4 Annex 4: Tools to Support Neonatal Referrals
      1. 6.4.1 Annex 4A: When to Refer a Newborn to the Hospital
      2. 6.4.2 Annex 4B: Job Aid: Transporting the Sick Newborn
      3. 6.4.3 Annex 4C: Sample Referral Note
    5. 6.5 Annex 5: Newborn Kits for Humanitarian Settings
    6. 6.6 Annex 6: Indicators
      1. 6.6.1 Annex 6A: Newborn Health Indicators for Routine Data Systems
      2. 6.6.2 Annex 6B: List of Indicators and Questions to Measure Facility Capacity to Provide Key Newborn Health Services
    7. 6.7 Annex 7: READY: Maternal and Newborn Health During Infectious Disease Outbreaks: Operational Guidance for Humanitarian and Fragile Settings
  7. 7. In Practice
    1. 7.1 Uganda
      1. 7.1.1 Recommendations
    2. 7.2 Kenya
      1. 7.2.1 Recommendations
    3. 7.3 Ethiopia
      1. 7.3.1 Recommendations
    4. 7.4 South Sudan
Newborn Field Guide

4.4 Developing and implementing a monitoring and evaluation (M&E) plan

Photo credits: UNICEF/NYHQ2015-0097/van de M

Ongoing monitoring of MNHabbreviation services is essential to understand the needs of women and newborns in the acute emergency phase, and whether their needs are being met as response activities progress to providing comprehensive MNHabbreviation services. It is therefore important to work with the SRHabbreviation coordinator to identify a partner with expertise in M&Eabbreviation. The SRHabbreviation coordinator should task that partner with developing an overall M&Eabbreviation plan for the delivery of MNHabbreviation services throughout the affected area that utilizes standardized methods of data collection, reporting for assessments and ongoing monitoring.

Tracking program progress and outcomes requires data from a variety of sources, including pre-crisis mortality and morbidity statistics, facility related data, and process and outcomes data related to health program implementation.

Use standardized indicators to collect population-level data to the extent possible; Annex 6 presents a list of health indicators, how to calculate them, and how to use them in program M&Eabbreviation. The indicators are organized into the following domains:

These indicators are based on demographic data typically collected through national and sub-national data systems that are routinely aggregated from agency/field level up to the national level, and published in governmental reports. Collection of key programmatic indicators may also be useful for fundraising purposes.

Box 4.6: Good practice: Za’atari Camp, Jordan

The Health Information System in Za’atari, a large refugee camp in Jordan, detected an increase in neonatal death. In response, UNHCR established a neonatal death audit process that helped expose two key contributors to the rise in newborn mortality: poor provider knowledge of danger signs and a weak referral system.

UNHCR. Operational guidelines on improving newborn health in refugee operations. UNHCR. 2014, p. 5

4.4.1 Compromised data flow and routine information systems

During a crisis, routine information systems and data flow may be compromised. In such cases:

  • Develop a reduced set of critical core indicators to aggregate and channel upwards from the agency or community level to regional or national program managers.
  • Continue to capture additional indicators at lower levels to allow for quality assurance and service improvement
  • Aggregate agency-level data in an overall M&Eabbreviation system, if possible.

For routine program monitoring, the number of newborn deaths, stillbirths, and babies born with low birthweight should be tracked, as well as the number of newborns breastfed within 1 hour of birth and receiving Hepatitis B immunization prior to discharge. Case fatality rate alone is insufficient to assess program quality (See Annex 6 for a list of suggested indicators). Further guidance on monitoring and evaluation can also be found in Chapter 9.6 of The Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings.