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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

7.1 Uganda

In Uganda, the newborn mortality rate is 19 deaths per 1,000 live births[1] and 41% of neonatal deaths[2] are due to preterm birth complications. Uganda’s large refugee population is a major contributor to these figures. Uganda has been hosting refugees and asylum seekers since achieving its independence in 1962. Today, almost 1.5 million refugees[3] live in Uganda, making it the top refugee-hosting country in Africa and one of the top five hosting countries in the world.

Partners have found the Newborn Field Guide to be a particularly useful resource in sensitising key stakeholders and advocate for improved access to and provision of quality newborn health services in humanitarian contexts within Uganda. For instance, UNICEF Uganda, with support from UNICEF ESARO organised two workshops in April 2019 to disseminate the recommendations of the Newborn Field Guide.

The workshops, conducted in collaboration with national, regional and district Ministries of Health were attended by over 100 representatives from regional and district health authorities, local NGOs working as implementing partners, front line health care providers such as neonatologists and obstetricians, and professionals from Epidemiology, Water, Sanitation and Hygiene, Monitoring and Evaluation, Gender and Nutrition sectors. Organizations involved included UNHCR, AVSI Foundation, Médecins Sans Frontières, CUAMM, MIT, Care International among others.

The first workshop took place in Arua, Northern Uganda and the second workshop took place in Fort Portal, Eastern Uganda – the two regions within Uganda that host the majority of incoming refugee populations.

In these two regions, while refugee populations receive basic level of care for newborns by virtue of maternal services coordinated by humanitarian organizations, for advanced level of care, newborns are referred to the host community health facilities — mostly managed by the government. Through the two workshops, in addition to becoming sensitised to the needs of newborns in humanitarian settings, participants noted the need to include maternal and newborn health in national and sub-national emergency preparedness and response plans and the need to strengthen the collaboration across the humanitarian-development sectors.

7.1.1 Recommendations

There was consensus amongst participants on the following recommendations. These were consistent across Uganda, Kenya, and Ethiopia.

  • Strengthening community engagement to identify and address community bottlenecks
  • Strengthen linkages between refugee health facilities and host population facilities
  • Better use of data from the surveillance team ensures preparedness and effective response in time
  • Conducting training of managers, health professionals, community gate leaders and other stakeholders on newborn and patient friendly services
  • Improving logistical support and redistribution of commodities
  • Improving scientific evidence and innovation on models of care in fragile and humanitarian settings
  • Mainstream existing guidelines with the newborn health in humanitarian situations

  1. UNICEF. Neonatal Mortality. January 2023. ↩︎

  2. Healthy Newborn Network. Leading causes of neonatal deaths in Uganda. 2019. ↩︎

  3. UNHCR. Refugee Population Statistics Database, Uganda. 2022. ↩︎