Number of newborn deaths seen to drop soon

MANILA, Philippines - The Department of Health (DOH) today released a new Administrative Order (AO) on the subject “Adopting New Policies and Protocol on Essential Newborn Care (ENC),” which details specific policies and principles to follow for all health care providers involved in newborn health care.

With the new protocol, DOH Secretary Francisco Duque III says they are now expecting a sharp cut on infant deaths in the future. Health authorities say that the Philippines is currently one of 42 countries that account for 90 percent of global deaths among children below five years old.

“We’re now launching this protocol, in collaboration with the World Health Organization, to help solve this newborn mortality problem because if it is not reduced by at least half, the goal of reducing childhood mortality by two-thirds by 2015 will not be met,” he adds.

Improving newborn health will not only reduce neonatal mortality, it would also help the country reach its Medium Development Goal target of six per 1,000 live births by 2015.

“Although childhood death rates in the country showed a downtrend from 1993 to 2003, the decline has slowed down in the last 10 years,” says Duque, noting that the under-five mortality rate decreased to only 32 per 1,000 live births in 2003 — from 52 per 1,000 live births in 1988. “Infant mortality and child death rates have also exhibited a similar trend over the same period.”

Health Secretary Duque also noted that 50 percent of all neonatal and post-neonatal deaths in the country occurred during the first two days of life, with the following as key causes: birth asphyxia (31%), complications of prematurity (30%), and severe infection (19%).

The new ENC protocol is a comprehensive strategy to help improve the health of the newborn through interventions before conception, during pregnancy, immediately after birth. and in the postnatal period.

“We believe that this new protocol will pave the way for the solution of the problem we now have on neonatal deaths,” stresses Secretary Duque. “But for this Protocol, we are focusing on the first hours of life of a newborn with the manual guiding health workers and medical practitioners in providing evidence-based essential newborn care.”

Aside from stressing the provision of correct time-bound interventions, which include the immediate drying (within 30 seconds), postponing washing, delayed cord clamping, and initiation of skin-to-skin contact. Early initiation of breastfeeding (within 90 minutes after birth) is also included in the new ENC protocol.

Finally, the new AO also highlights responsibilities of the DOH, its attached agencies, as well as the private and public health care providers in ensuring the implementation of evidence-based ENC. It was also noted that non-time bound interventions such as the provision of vaccinations as well as physical examinations (completed within six hours of birth) must never impede with the time-bound interventions

To accelerate the implementation strategies of the AO, the new protocol will be a part of the Normal Spontaneous Deliveries and Maternal Care Packages of the PhilHealth. An assessment of the Philippine Health Insurance Corporation Benchbook is in progress to facilitate the integration of the ENC protocol interventions. The DOH will also promote the adoption of the said protocol among medical, pharmaceutical, and proper learning environments.