Frustration and Optimism: My Mixed Emotions for Reducing Healthcare-associated Infections at Birth

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

Written by Wendy J. Graham
Professor of Obstetric Epidemiology, Department of Infectious Disease Epidemiology

Today, advances in healthcare routinely enable miracles of survival and recovery. But some discoveries have been forgotten or demoted in the race to implement the latest. The importance of hygiene at the time of birth goes back centuries.* Yet here in the 21st century, so-called “places of care” bring increased risks of infection to patients and health workers when basic preventive principles are not followed. Safe water to drink, a clean surface to deliver upon, and good hand hygiene by those attending you – how more basic can it be?

After nearly 40 years in public health, I am re-invigorated by the chance to be part of what the BASICS partnership proposes: integrating four agencies’ best practices and learning in infection prevention in healthcare settings into one systematic approach in partnership with countries to dramatically reduce infection rates at the point of care.

Health facilities – and especially maternity wards – are the natural environment of my interest and passion for change. Initial work in Botswana in the late 1970s and early 1980s – at the time when HIV/AIDS was just emerging, gave me a firm grounding in the tough realities of healthcare in under-resourced settings, together with a lifelong admiration for health workers who provide care 24/7 in such circumstances.

It’s in these maternity wards where many mothers and newborns acquire infections. They’re often busy and overcrowded places, with invasive procedures, instruments that may not be sterilized between use, and major infrastructural and supply challenges to maintaining cleanliness and hygiene. The photo here of a ward in West Africa captures this situation – indeed, with women being asked to bring their own bottle of bleach when they came to deliver as there had been no cleaning fluids in the maternity for months.

This is a striking reminder of the hidden costs of care families endure and the weakness in the health system, which means women deliver where “safe care” cannot be guaranteed and where health workers cannot protect themselves from infection risks either. Both “cannot’s” are violations of basic human rights.

This is why I’m so excited about the potential of BASICS to empower all health workers about proper hygiene and infection prevention practices and enable health systems to provide safe care equitably and routinely. And we mean “all” – acknowledging the crucial role in facilities played by workers who are not care practitioners – such as cleaners, orderlies and maintenance staff –  in creating a clean environment. These often-forgotten “workers for health” also have great potential to be agents for change.

But, of course, it’s not just the four BASICS collaborators and the crucial country partners who want better health outcomes for mothers and their newborns, and for them to leave a facility without a life-threatening infection.

Access to health facilities providing clean care was the second-highest demand of the 1.2 million women and girls in 114 countries who took part in the White Ribbon Alliance’s 2018 global What Women Want campaign on reproductive and maternal health needs. Women and girls overwhelmingly demanded clean facilities, clean toilets in maternity wards, a clean bed, and skilled health providers with sterile supplies and clean hands. 

None of these demands are impossible to achieve. The crucial innovation proposed by BASICS is to take the best evidence-based practices of each partner and create one comprehensive package of training, access to clean water in facilities, an innovative cleaning product and systems change in order to institutionalize and sustain clean care in the partner countries.

I am optimistic that BASICS can result in better quality healthcare that will save tens of thousands of lives and millions of dollars by averting healthcare-acquired infections.

In the time it has taken to read this, many more health workers’ could have washed their hands, many more women could have delivered on clean beds and with sterile instruments, and many more babies could have been discharged home without an infection from the facility. This advance does not require a new discovery – we know what to do now.

BASICS will be a catalyst for the miracle of survival and good health for mothers and newborns. 

To learn more about BASICS (Bold Action to Stop Infections in Clinical Settings) is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%, visit savethechildren.org.

 

*Graham WJ, Dancer SJ, Gould IM, Stones W. (2015) Childbed fever: history repeats itself? BJOG, 122:156–159.

The Blue Dye Innovation that Makes Disinfecting Health Facilities More Effective and More Visible

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

Written by Jason Kang, Co-founder and CEO, Kinnos

In 2014, I co-founded Kinnos in response to the West Africa Ebola crisis. At the time, one of the biggest problems contributing to high rates of infection was ineffective surface decontamination caused by human error and gaps in training.

Disinfectants like bleach are transparent, making it easy to miss spots; hydrophobic, making it bead up and roll off the surfaces it’s meant to disinfect; and only effective if used for a specific contact time, meaning healthcare workers must ideally wait for a certain period for pathogens to be inactivated. These problems are universal to disinfection in facilities outside the scope of epidemic outbreaks.

Highlight, our patented additive, colorizes the disinfectant so that users can easily see where it has been applied. Highlight modifies the liquid properties to eliminate droplet formation and improve adherence to surfaces. The color fades as the contact time needed for the disinfectant to work passes, indicating when decontamination is done.

To put this into context, our time at the Ebola Treatment Unit in Ganta, Liberia, was particularly memorable – I remember the intense heat and how incredible it was that staff were wearing layers of stuffy, personal protective equipment for 4 to 6 hours at a time. However, this also meant that they were only too eager to remove their protective gowns and coveralls, often not waiting the requisite contact time for the disinfectant sprayed on their protective garments to work.

Combined with the inherent difficulties of achieving full coverage with bleach, we quickly understood why health staff were up to 32 times more likely to be infected with Ebola than the average person.

When healthcare workers started telling us that Highlight was making them feel more confident in their own safety and easing their stress in such high-risk situations, we realized that our technology was tapping into an invaluable resource: peace of mind. Interacting with the healthcare workers who had volunteered to put themselves directly in danger to help others was humbling and inspiring, and doing our part to make their lives even a little bit better was incredibly motivating.

The breakthrough that Highlight represents – the ability to overcome training and language barriers to empower health workers and those who clean facilities with a feeling of confidence through disinfection they can see – can have a profound impact in reducing healthcare-associated infections globally as part of the BASICS solution. In our mission to prevent infections and improve patient safety, we have not forgotten about the people who are tasked with the important step of disinfection.

In addition to our humanitarian focus in low- and middle-income countries, Kinnos is working to radically reduce healthcare-associated infections and the prevalence of antimicrobial resistance within the U.S. healthcare system.

We’ve partnered with leading medical organizations to pilot our technology in hospitals, ambulatory surgical centers and other facilities. It’s a sober reminder that infections affect society at large and are an urgent global problem that require a concerted effort to solve.

The fact that someone today can receive a life-threatening infection from a place where they expect medical care and treatment is unacceptable, and we are motivated to make this a problem of the past.

Historically, so many resources have been devoted to diagnosis and treatment, even though it’s recognized that prevention is key to sustainable healthcare. We always knew that surface disinfection was only one key part of the larger infection prevention ecosystem, so having the opportunity to enact a system-wide program with the rest of the BASICS team is extremely exciting to me.

The world has been waiting too long for an initiative like BASICS to set the standard of infection prevention.

Why I’m Passionate About Reducing Infections in Health Care Facilities

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

Written by Alison Macintyre, Health Technical Lead – WaterAid

Having spent a lot of my childhood in and out of hospitals, I believed that hospitals were a place where you go to get better, get well; where you leave feeling more positive and healthier than when you arrived. And, I still do.

As I embarked on my career in the field of water, sanitation and hygiene (WASH), I realized for most of the world, that isn’t true. We, the global health community, are currently failing to achieve the absolute basics. Right now, we can’t ensure we are, at an absolute minimum, doing no harm to the millions of people who use health care systems every day. Too many health care facilities operate without water, without toilets that everyone can use, and without water and soap to stop the spread of infection.

This failure is what motivates me. We will only see dramatic, sustained changes in health if we get the basics right. 

Early in my WASH career I was in Papua New Guinea, undertaking a study on the role of WASH during childbirth for women. Most of the women I interviewed were unable to reach a facility to give birth and had to deliver their babies, often alone, on coffee plantations, in pig pens or on the side of the road.

As part of the study, we also visited health facilities. I had hoped that they would provide a potential solution for improving maternal and newborn mortality in these remote communities. One facility has always stuck in my mind.

Despite the newness of the facility (it was only five-years old), water, sanitation and hygiene were not available. A refrigerated, fully stocked drug cabinet was present, but gloves and soap were not. There was a sophisticated rainwater collection system, but the pump to distribute the water to the facility was broken and they weren’t able to fix it. There were two modern toilets, but they were locked and reserved for staff – patients had to go out to a hole dug in the back of the facility, passing an open waste pit on the way, to relieve themselves.

The lack of water also meant women were turned away if they arrived in labour. The next hospital was 2 hours away on a treacherous road.

How did a hospital have sophistical equipment, but couldn’t fix a water supply and women weren’t able to deliver their babies? How were antibiotics kept cold-chain with a reliable supply, yet soap and gloves were not available?

I left the facility angry, wondering how health systems neglected WASH in so many ways.

This visit made me realize that when statistics show us that health care facilities do not have basic WASH services, it doesn’t always mean the infrastructure is completely absent. Often, it may not suitable (for instance in the case of toilets not being accessible to people of limited mobility) or it is not functioning, or basic commodities like soap are not part of general supply lists.

I also realized that it is the system that’s broken, not just the infrastructure. Health systems that have monitoring and budgets for WASH, trained operation and maintenance staff, in-service and pre-service training on hygiene and cleaning, WASH standards and accountability mechanisms, are uncommon. This should be the norm.

That’s why I’m excited about the prospect of leading the WASH element of BASICS (Bold Action to Stop Infections in Clinical Settings), on behalf of WaterAid. Through the work I’ve done, I have learned the importance of integrating basic WASH into broader patient safety and infection prevention control programes. Without such integration, a system-wide approach is not possible and WASH will never become part of the day-to-day routine of health center operations.

BASICS brings together NGOs, researchers and the private sector to support health systems to sustainably address WASH and patient safety. The BASICS team has a wealth of expertise on health, WASH and evidence-based behavior change. This combination is essential for improving patient safety, health and the quality of health care facilities for all.

To learn more about BASICS (Bold Action to Stop Infections in Clinical Settings) is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%, visit savethechildren.org.

Why I Don’t Want Another Mother to Experience My Health Care Scare

Written by Soha Ellaithy
Senior Director, Strategic Foundation Partnerships and Senior Partnership Director, BASICS

I was born and raised in Egypt, a middle-income country that has a functioning healthcare system and universal healthcare coverage – albeit of often dubious quality.

In 2008, one in 10 Egyptians had chronic Hepatitis C, the highest rate of infection in the world. The direct cause of this catastrophic situation is a mass-treatment campaign conducted by the Egyptian government in the 1970’s and 80’s to eradicate schistosomiasis infection. The repeated use of needles resulted in Hepatitis C, a virus not yet known, being inadvertently spread to millions of people.

When, in 2011, my oldest son went on a school trip to Nepal, he contracted a diarrheal infection and had to be rushed to a local hospital to receive intravenous fluids. He called me and, to my horror, described stepping over pools of blood on the floor to get to a bed with no covering. My heart dropped – and to this day it still does when I think about that moment.

I knew exactly what the implications could be.

I’ve witnessed firsthand the terrible devastation of a healthcare-acquired infection on families and could not bear the thought of my son contracting Hepatitis C or HIV. It took a full three agonizing months of tests to clear my son of any possible infections that he might have picked up from a needle prick in an unclean hospital.

Photo courtesy of: FACEBOOK PAGE/ SO THAT HE'S NOT SURPRISED
Egypt’s doctors have been anonymously sharing pictures of the conditions they work in – with stray animals and overflowing sewage on display – after the country’s Prime Minister said he was “surprised” at the state of the country’s run-down hospitals. Photo courtesy of FACEBOOK PAGE/ SO THAT HE’S NOT SURPRISED via BBC

Despite a fairly strong medical education system and a tireless and dedicated medical staff, public health care systems in many countries like Egypt, continue to be plagued by poor adherence to proper hygiene standards and the devastating consequences that result.

As the Senior Partnership Director leading the submission to 100 & Change, when my colleagues first discussed with me the idea of eliminating this risk globally, I was immediately engaged. As we fine-tuned our idea in meeting after meeting, I became very excited that in BASICS (Bold Action to Stop Infections in Clinical Settings) we truly have a solution that will change the way healthcare is delivered across the world.

I feel very passionate about this project because it is inconceivable that in this day and age, we are still grappling with a problem whose solution is so simple: wash your hands, clean your working surfaces and be diligent in using sterilized equipment.

BASICS tackles the root causes of the problem and builds a solution that is self-sustaining. Using behavioral science to modify individual behavior so that simple hygiene routines can become “second nature,” we will build the supporting infrastructure and design a national system that ensures this new normal is part of a fully functioning and supportive national health system.

I dream of the day when no mother would ever take her child for a simple procedure only to go home with a child who has a life-threatening disease for absolutely no good reason!

 

To learn more about BASICS (Bold Action to Stop Infections in Clinical Settings) is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%, visit savethechildren.org.

Photo credit: Charlie Forgham-Bailey / Save the Children, Oct 2018

Getting to 2030 Vision to End Preventable Child and Maternal Deaths: Building on the global progress for women and children

Written by Smita Baruah, Senior Director, Global Health and Development Policy, Save the Children

Children today have a better chance than any time in history to grow healthy, be educated and be protected, as noted in Save the Children’s latest report, Changing Lives in our Lifetime: Global Childhood Report. Today there are 49 million fewer children stunted, a form of malnutrition that impacts a child’s ability to survive and thrive than two decades ago. There are 4.4 million fewer child deaths than they were in the year 2000.

These successes are not by accident.  Strong and increased political leadership at both global and national level have greatly contributed to changing the lives of women and children around the world in addition to scaling up of proven interventions and innovation.

The United States is one donor government who deserves much credit for accelerating progress on women and children’s health, beginning with its leadership at the first child survival resolution in 1982 through hosting the Child Survival Call to Action meeting in 2012 that set the stage for the vision to end preventable child and maternal deaths by 2030.

Critical Role of US Leadership in Reducing Maternal and Child Deaths
Last month, USAID launched its 5th annual progress report, Acting on the Call: A Focus on the Journey to Self-Reliance for Preventing Child and Maternal Deaths.  The report notes that in 2018 alone, USAID helped reach 81 million women and children access essential — and often life-saving — health services. USAID’s contributions have led to significant reductions in child mortality in many countries such as in Bangladesh where child deaths were reduced by 63% since 2000 and in Uganda, which experienced a 66% in reduction of child deaths during the same time period.

The report demonstrates the ways in which USAID has also helped increase national political will. Since the Child Survival Call to Action forum in 2012, governments in more than half of USAID’s priority countries for maternal and child survival have increased their domestic budgets for health.  In Uganda, for example, USAID worked with the Ministry of Health to increase the percentage of the allocated budget for health from 79% to 97%. 

Bangladesh, a USAID maternal and child health priority country, is an example of how donor assistance coupled with national political will, creates change for women and children. According to the Global Childhood Report, Bangladesh has had a sustained commitment to improving child health despite changing leadership. With donor and their own investments, Bangladesh has focused to strengthen health systems and scale up proven solutions for mothers, children and newborns with a focus on equity. However, focusing on health interventions alone did not contribute to Bangladesh’s success.  Women and girls’ education and empowerment are also key factors driving progress as well as the engagement of civil society, including children and young people.

Getting to 2030
In 2015, the United States and other world leaders and stakeholders committed to a set of global goals which includes the ambitious goal of ending preventable and child and maternal deaths by 2030. There is indeed much to celebrate.  To continue on the path to achieve the global goal of ending preventable child and maternal deaths, U.S. and other stakeholders must continue to focus on continuing to invest in maternal and child survival programs and designing and implementing highest-impact evidence based interventions. 

This also includes investing more resources in areas that are becoming the greatest contributions to child deaths: newborn health, pneumonia and addressing malnutrition.  Without increased focus on malnutrition, Save the Children’s report notes that in 2030, 119 million children will still find their physical and cognitive development stunted by malnutrition, with the poorest children at highest risk. Addressing pneumonia must also be prioritized. According to the Global Childhood Report, childhood pneumonia is the leading infectious cause of deaths in children under age 5 and it kills more children than diarrhea, malaria and HIV combined.

While much progress has been made in increasing national governments’ political will to reduce child and maternal deaths, resources must follow this commitment. The U.S. should work with national and local governments to continue to increase its own domestic investments in health, particularly for maternal and child survival interventions. This also includes working with national and local governments in ensuring that these resources are reaching the hardest to reach populations. Women and children who are furthest behind must be identified and prioritized in terms of investments, service provision and decision making. US should also work with governments to ensure that all women and children, especially excluded women and children, are counted to measure progress towards reducing child and maternal deaths. 

Going beyond just working with the Ministries of Health is critical.  U.S. and other stakeholders must continue to engage local civil society in the efforts to change the lives of women and children. In Ethiopia, for example, Kes Melakeselam Hailemnase, a 64 year old Orthodox Priest and head of Embaalaje Woreda Orthodox Churches Forum, reached more than 8.000 individuals with maternal, child, newborn health messages during regular sermons and other religious festivities after receiving training on Community Based Newborn Care, organized for faith-based leaders.  Kes’ efforts helped Abeba Mesele, a 21 year old mother of two, learn the importance of going to a health facility for antenatal check up and early post natal check ups.  

Change often happens at the local, community level. As USAID works with countries in their journey to self-reliance, development plans must be made in consultation with recipient country governments and civil society.  To ensure sustainability and self-reliance, development must be owned by the people of the countries receiving foreign assistance.

As the 2019 report shows, USAID has greatly contributed to building in country capacity by training health professionals including community health workers. This may not be enough. With increased natural disasters and the resurgence of pandemic threats such as Ebola, U.S. should work with governments and other stakeholders in helping to build resilient health systems. 

Finally, continued U.S. partnership and assistance is critical to a country’s success in improving the lives of women and children around the world. USAID should maintain evidence-based, highest-impact interventions and a comprehensive approach to addressing maternal and child survival and continue to provide robust resources.

Illnesses Don’t Discriminate: Vaccines Work

Co-authored by Carolyn Miles, CEO, Save the Children and William Moss, MD, MPH, Interim Executive Director, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health

Parents work hard to help their children stay healthy. Try as we might, hand washing, good nutrition, and flu shots are sometimes no match for “what’s going around.” A cough. A fever. A stomach bug. If you feel like these illnesses are everywhere – you’re right.

And families around the world are battling the same illnesses. But in some places it’s far from a fair fight. Illnesses that are easily preventable and treatable in the United States can take the life of a child in Africa. More than 1.3 million children die each year from pneumonia and diarrhea, two of the leading killers of children in poor countries.

It surprises many people to learn that pneumonia and diarrhea, not HIV, tuberculosis or malaria, are the leading cause of death in young children around the world. While diseases like HIV and malaria take a toll, pneumonia and diarrhea take more lives of children under age five than all these diseases combined.

In the U.S., routine immunization helps protect against these common sicknesses. Hib (Haemophilus influenzae type b) and pneumococcal conjugate vaccines protect against pneumonia, and the rotavirus vaccine protects against one of the most common and serious stomach bugs. These vaccines have drastically reduced the number of children who suffer from these illnesses. A 2017 study found the rotavirus vaccine cut nearly in half the number of young children hospitalized for diarrhea, saving more than $1 billion in health care costs over five years. Similar benefits have been documented with the vaccines that prevent pneumonia.

Though germs are everywhere, health care sadly is not. Parents around the world share a common goal of protecting their children, yet too many families still lack access to, or even awareness of, vaccines and medicine that could save their children’s lives. As a result, the stomach bug that means a few days off school and a trip to the pediatrician for a child in Maryland can mean severe dehydration and even death for a child in Kenya. The respiratory infection that goes around at a preschool in Atlanta causes life-threatening pneumonia for young children in Ethiopia. What separates parents around the world is not the illnesses their children face, but how the health care systems they have access to are equipped to battle them.

While some may dismiss the challenges parents in poor countries face as inevitable and unfortunate consequences of poverty, this is simply not the case. This is not only a battle worth fighting, it’s also one we can win. We know how to prevent these deaths, and in many places, we are already succeeding. India, Nicaragua, Tanzania and many other countries have increased immunization rates and have saved lives as a direct result. Since 2000 the number of children’s lives lost to pneumonia and diarrhea has been more than cut in half – from 2.9 to 1.3 million deaths annually.

Every year, fewer children lose their lives to preventable diseases. We should be encouraged—but not satisfied—with the progress we’re making. We can do better. We can increase resources to equip families and health care systems around the world with the tools they need to battle our shared infectious foes. We can find new ways to deliver lifesaving vaccines and antibiotics to make sure no child dies from a cough, the stomach bug, or a mosquito bite. And we can muster our political courage and give voice to the needs, worries, and love of parents who, like germs, are the same everywhere.

Newborn babies and their mothers receive care in a health center located in Malawi where Save the Children supports proven programs, such as Kangaroo Mother Care. Photo credit: REDD BARNA / JONAS GRATZER

Customizable Hospital Furniture for the Smallest Babies in Malawi: A Potential Disruptive Innovation

Written by Bina Valsangkar, MD, MPH, FAAP

© 2015 | Kristina Sherk Photography 

Bina Valsangkar, MD, MPH, FAAP, is a pediatrician, adviser at Save the Children and a changemaker for children. She leads a team of health experts, industrial engineers and industrial designers under a Save the Children innovation grant to re-design newborn hospital units in Malawi to deliver family-centered care. In previous roles at Save the Children, she drafted policy, conducted research and developed newborn health programs in Africa and Asia. 

While many aid agencies, academic institutions and traditional and non-profit companies work to ensure access to essential medical equipment in low-income countries, less attention has been paid to the importance of suitable medical furniture. In the newborn units of Malawi, where Save the Children has been working to improve quality of care for the last several years, a well-designed chair, neonatal crib and staff workspaces have the potential to make care more family-centered, comfortable and safer. Well-designed furniture can improve patient, family and health worker comfort, but can also improve health outcomes. A well-designed chair for the newborn unit, for example, can facilitate greater amounts of skin-to-skin time between a mother and her newborn infant—which can be life-saving for infants born prematurely in Malawi. Well-designed workspaces and neonatal cribs can improve patient flow and visibility and reduce infection risk.

Malawi currently buys and imports the majority of its hospital furniture from India and China. While these pieces offer a relatively affordable option for hospital furniture with basic function, the furniture does not fully suit the needs of patients, families and health care workers in Malawi. Hospitals there face a different patient profile, medical demands, space limitations and set of cultural beliefs and practices.

Customizable hospital furniture offers a potential solution to the problem of functional fit. Headway in this market, however, has been largely made in high-income, high-end markets, with little or no market share in low-income countries.

With seed funding from the Save the Children Innovations Council as well as Purdue University’s I2D Lab, our team of experts in health, industrial engineering and design led by Professors Yuehwern Yih and Steve Visser, is working to create a set of space-saving furniture with accompanying layout design to allow for greater family-centered care and meet the needs of patients, families, and healthcare workers at Ntcheu district hospital in Malawi. The set includes a stacked neonatal crib, lounge chair for mothers and babies to be in skin-to-skin contact together and a mobile nurse’s station. Our project was born out of research and experience from the Saving Newborn Lives (SNL) program, a now 19-year old newborn health project at Save the Children.

While getting the individual furniture pieces and layout just right and within budget for the hospital is of utmost importance, it is the process of customization in the low-income setting, and creating and using customizable blueprints to make locally-sourced pieces with learnings from prior users that we hope will be a new market foothold in Malawi, with the potential to move across markets and upmarket to other countries and regions.

To learn more about Save the Children’s changemakers, visit our website.

James, age 6, and Heshima, age 8, carry water from a dried up riverbed in Turkana County, Kenya. Photo credit: Peter Caton \ Save the Children, July 2018

When Kenya’s Rivers Ran Dry

Written by Carolyn Miles, President & CEO, Save the Children

Kenya’s people had known droughts, even severe droughts, but they’d never experienced anything like this before.

This World Water Day, I’ve been reflecting on a trip I made to northern Kenya in 2017, when the whole Horn of Africa was experiencing a devastating drought. The rivers had all run dry, crops had failed and livestock had perished. When it finally did rain, flash floods swept away anything left. Children were hungry, malnourished, sick and dying.

I met desperate mothers and little children forced to dig into dried-up riverbeds just to find some muddy water. It was a grueling process that took children many hours, twice every day. First, they walked to the dry riverbed, then dug deep holes into the dirt, sometimes 10ft down, until enough water appeared to fill their water jugs. Then they would haul themselves up and out of the hole to carry the heavy jugs back home to their families. No child should have to spend precious time away from school and their families like this, only to have water unfit to drink.

Children in Turkana County, Kenya dig for water in a dried up riverbed. Photo credit: Peter Caton | Save the Children, July 2017.

The good news is that through Save the Children’s partnership with the P&G Children’s Safe Drinking Water Program, we were able to help purify that muddy water, using P&G’s water purification technology. We met with local mothers, distributed much-needed supplies and taught them how to benefit from this easy-to-use technology. This amazing process, invented by a P&G laundry scientist, transforms dirty water into clean, drinkable water in only 30 minutes, preventing deadly, water-borne diseases – and saving lives. It also helps improve health, enable education and increase economic opportunities for entire communities.

Thanks to supporters like P&G, we were on the frontlines in Kenya, saving as many young lives as possible throughout the unprecedented drought. And we’re still there to this day, working to ensure children and families have what they need to not only survive, but grow up healthy, educated and safe. Together, we’re creating ripples of change in children’s lives, their families and communities – ultimately transforming the future for all of us.

A special thank you to P&G, in partnership with National Geographic, for the honor of being named a Water Champion – and spreading the word about our humanitarian work.

Happy World Water Day!

A mother in Kenya holds her newborn baby. Photo credit: Allan Gichigi/ Save the Children

5 priorities for involving parents and families in the care of small and sick newborns

Written by Mary Kinney, Senior Specialist, Global Evidence and Advocacy, Saving Newborn Lives at Save the Children 

Globally, nearly 30 million babies are born too soon, too small or become sick every year and need specialized care to survive. This staggering number was published in the report, Survive and Thrive: Transforming care for every small and sick newborn, by UNICEF, the World Health Organization, Save the Children and other partners at the end of 2018. Most of these babies can survive and live without major complications with quality and nurturing care.

Evidence indicates that involving parents and families or other caregivers in the care of the small and sick newborns benefits both the infants and parents including higher breastfeeding rates, earlier discharge from the hospital, increased weight gain, improved neurodevelopment, reduced parental stress and anxiety, and improved health-related knowledge and beliefs among parents and communities.

Here are five priorities from the report for involving parents and families in the care of small and sick newborns during hospitalization:

Promote Zero Separation

Evidence shows that the well-being and survival of both mother and newborn are inextricably linked and require a coordinated, integrated approach. This not only optimizes their health but also promotes greater efficiency, lowers costs and reduces the duplication of resources. For example, mother’s presence is crucial to establish breastfeeding and to promote Kangaroo Mother Care. Promoting zero separation reduces the risk for short- and long-term health and social problems, including parental depression and anxiety.

Intentionally Engage Men

While women have a unique role as mothers, evidence also shows that men also have a key role in the care of newborns, as partners/husbands, fathers, caregivers and community members. Men often determine health care seeking as well as provide care to the newborn and mother. Health services should accommodate men to accompany their partners, including service hours, physical space and privacy for care visits.

Involve Parents in the Care During Hospitalization

Parents or other caregivers make unique contributions by being able to observe, monitor and provide care to their small and sick newborns (when appropriate, under supervision and in partnership with the health-care team). A recent randomized control trial found that parental involvement during the inpatient neonatal intensive care benefits newborn health outcomes, including infant weight gain and increased frequency of exclusive breastmilk feeding at discharge, as well as a boon to parental mental health. Interventions, such as Kangaroo Mother Care, empowers families to care for their small newborns and shortens their length of stay in the hospital.

Practice Family-Centered Care

Family-centered care for small and sick newborns has a growing evidence base with demonstrated benefits for infants (such as weight gain and neurodevelopmental progress) as well as parents (such as decreased parental stress and anxiety and increased caregiving efficacy). This approach implements four basic principles: dignity and respect; information sharing; participation; and collaboration, and is recommended by the American Academy of Pediatrics. Hospitals and communities should provide space at the facility or nearby for parents or family members, as needed.

Empower Parents

Parents are powerful agents of change for small and sick newborn care supporting other parents and influencing policy and programs. Support forums for parents, including parent-led, peer-to-peer and health professional-led groups, improve the home environment, parental mental health and parental confidence in caring for their child. Parent advocacy and support organizations raise awareness and share their experiences to help others in the same situation through events like World Prematurity Day.

 

Thank to the generous support of our donors, Save the Children has a long-standing experience promoting family engagement in newborn care, such as with Kangaroo Mother Care, demand creation for community-based newborn care, and quality improvement activities. In order to transform care for small and sick newborns, intentional efforts must be made to involve parents, and we remain committed to this effort as part of our broader approach to improve maternal and newborn health. That means that together, we have the chance to make a lifetime of change for millions of newborn babies.

To learn more about the work Save the Children has done to save newborn lives, visit our website.

Get involved by donating your birthday and help a baby live to see their first birthday – and many more. DONATE YOUR BIRTHDAY TODAY!

Save the Children Team in Yemen Recognized for Family Planning Program Achievements in a Humanitarian Setting

Written by Carolyn Miles, President & CEO, Save the Children

Yemen is currently experiencing the largest humanitarian crisis in the world. More than two-thirds of the population is in need of humanitarian assistance, with one-third in acute need. Of the 22.2 million people in need, more than five million are women of reproductive age, including an estimated half a million pregnant women. Before the current crisis escalated in March 2015, the average fertility rate was four children per woman and the lifetime risk of maternal death was one in sixty. In only 30 other countries do women face a greater chance of dying due to complications of pregnancy or during childbirth. Access to family planning is limited with only 20 percent of women using a modern contraceptive method and a high unmet need for contraception of 33 percent.

In the dire context in Yemen, Save the Children staff work tirelessly to support children and their families, and we are so pleased that our family planning team that includes was recognized for the work they do in the face of tremendous adversity. At the International Conference on Family Planning, our Yemen team was awarded an Excellence in Leadership for Family Planning Award for their “significant contributions to the family planning field.”

Since the beginning of 2013, and through the escalation of the crisis, our reproductive health program has reached nearly 60,000 new family planning users through support to 16 health facilities in Hodeida and Lahj Governorates through funding from private foundation. The program has also expanded access to long-acting reversible contraceptives (intrauterine devices and implants) that are more effective than other methods and are often a good choice in humanitarian settings where supply chains may be disrupted. This high quality work was leveraged to secure a new two-year award for Save the Children from the U.S. Agency for International Development to strengthen family planning services in Yemen.

In addition to the recognition of our Yemen team, other Save the Children teams from Egypt humanitarian response for Urban Refugees in Cairo and Mali were recognized for their excellent work by winning “best poster” awards during the conference. Our submission was one of the twelve (out of 325 applications) named a finalist of the Quality Innovation Challenge sponsored by the Packard Foundation for a concept to pilot a digital, interactive contraceptive decision-making tool for young people in acute humanitarian emergencies in Somalia and Yemen. Through 41 posters and presentations, our staff demonstrated the positive impact our family planning programs have on the lives of children, adolescent girls, women and their families around the globe.

To learn more about how family planning saves lives and our presence at the International Conference on Family Planning, click here.