Highlighting the importance of application of Chlorhexidine for Umbilical Cord Care in Newborns, experts at a Consultative Meeting stressed the role of Chlorhexidine Digluconate to in reducing the neonatal mortality in Pakistan.
The National Technical Consultative Meeting on national recommendations for use and scale up of 7.1 percent Chlorhexidine Digluconate for umbilical cord care in Pakistan was organized by Maternal, Newborn and Child Health (MNCH) Services Component 2 of USAID/Pakistan’s Maternal and Child Health (MCH) Program—Implemented by the Maternal and Child Health Integrated Program (MCHIP) at a local hotel in Islamabad. MCHIP is implemented by Jhpiego – an international, non-profit health organization affiliated with the Johns Hopkins University – in collaboration with Save the Children, JSI and PATH (shall we write full names of the organizations?). MCHIP/Jhpiego is working with health experts, government departments and community leaders to provide high-quality health care to the people of under-served areas of Pakistan. The aim of the Meeting was to finalize the national policy on the basis of provincial recommendations for the application of Chlorhexidine in umbilical cord care for the prevention of neonatal sepsis in Pakistan.
Dr. Sabeen Afzal, Deputy Director, Ministry of National Health Services, Regulation & Coordination in her welcome address informed that Pakistan is signatory to the MDGs. The three MGDs are related to health but the country is lagging behind to improve its maternal and neonatal health, one of the worst in the region.
To improve the maternal and neonatal death rates, cost effective, evidence based regime is required to tackle the major cause of deaths. One such intervention, the induction of Chlorhexidine is the need of the day. Chlorhexidine is efficacious, low cost, simple to use, safe and furthermore, it is evidence based. Dr. Afzal informed that the trials have been done on application of 7.1% Chlorhexidine in Bangladesh, Nepal and Pakistan which clearly shows its efficacy and its potential role in reducing neonatal mortality as well as severe infection. The intervention has now been introduced in Pakistan in order to reduce neonatal mortality.
The Ministry is simultaneously making efforts to regulate Chlorhexidine drug with the country’s drug regulatory authority. Once the drug is registered for import or manufacturing within the country, its production could also be sponsored by NGOs and other health sector activists for distribution in the rural sections of population, she added.
Dr. Farid Midhet, Chief of Party, USAID funded Maternal & Child Health Integrated Program (MCHIP led by Jhpiego) shared his experience on community based distribution of Chlorhexidine in district Tando Allahyar (Sindh). He said that MCHIP/Jhpiego has started implementing the strategy to reduce the neonatal mortality through Community-based distribution of Chlorhexidine.
In this strategy, MCHIP/Jhpiego trained Lady Health Workers (LHWs) and community midwives in Tando Allahyar who are providing antenatal and postnatal care to the women in their respective communities. After training, these community midwives started distributed Chlorhexidine gel tubes to prevent newborn sepsis due to umbilical cord infection.
Dr. Samia Rizwan, Health Specialist at UNICEF Pakistan gave an update of Every New born Action Plan (ENAP) followed by draft of strategy for the local production of Chlorhexidine, implementation and scale up of Chlorhexidine for umbilical cord care in Pakistan. The Plan provides a roadmap and joint action platform for the reduction of preventable newborn mortality. Linking the work of all stakeholders, it enables policy makers and others to take action to accelerate national plans to achieve clear results for newborn survival, enhancing the achievement of wider goals for women’s and children’s health.
Mr. Shoaib Shahzad, Project Manager, Mercy Corps speaking on Improving Chlorhexidine advocacy for new born said that globally, umbilical infection rates have been reported as 2 to 54 per 1,000 live births from hospitals. Sepsis is closely linked to unhygienic practices and environment during delivery. In 2012, 65% of births in Pakistan took place at home: 72% of which were not attended by a skilled birth attendant. These newborns were at risk of sepsis due to poor cord care practices. He emphasized on the need to adopt interventions like other countries have through which the mortality rate of the country has reduced.
Dr. Muhammad Tariq, Country Director, USAID’s Deliver Project spoke on the status of Chlorhexidine with provincial Essential Medicine Lists. Later on, Dr. Shabbir Chandio – USAID, Dr. Zareefuddin – WHO, Dr. Qudsia – Save the Children, Professor Iqbal Memon – Pediatric Association of Pakistan and representatives from provincial health departments expressed their remarks on the use of Chlorhexidine in Pakistan.
Dr. Malik Safi, Director Program National Ministry of Health Services, Coordination and Regulation in his concluding remarks said that the ministry will provide a platform for all provinces and partners and facilitate the process of adaptation of CHX in Pakistan. He shared the ‘National Policy on CHX: Recommendations and Next steps’ to the participants, encouraging all the development partners to initiate the use of CHX in all provinces helping the Government to scale up efforts in adaptation of Chlorhexidine intervention.