TY - JOUR
T1 - Assessing the neonatal health policy landscape in low and middle-income countries
T2 - Findings from the 2018 WHO SRMNCAH policy survey
AU - Mary, Meighan
AU - Maliqi, Blerta
AU - Stierman, Elizabeth K.
AU - Dohlsten, Martin AJ
AU - Moran, Allisyn C.
AU - Katwan, Elizabeth
AU - Creanga, Andreea A.
N1 - Funding Information:
Acknowledgments: We would like to acknowledge the Department of Maternal, Newborn, Child, Adolescent Health and Ageing team at the World Health Organization for contributing technical support and insights to the analysis and interpretation of our findings. Disclaimer: The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. Data availability: Data will be made available on request. Funding: This work was supported, in whole or in part, by the Bill & Melinda Gates Foundation (INV-009058). Authorship contributions: All authors conceptualized the paper. AAC conducted the analyses, verified the underlying data, and wrote the article, with support from EKS, MM, BM, MAJD, ACM, and EK. AAC prepared the first draft of the manuscript, which was critically reviewed by all other authors. All authors read and approved the final manuscript. Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023
Y1 - 2023
N2 - Background We aimed to describe the availability of newborn health policies across the continuum of care in low and middle-income countries (LMICs) and to assess the relationship between the availability of newborn health policies and their achievement of global Sustainable Development Goal and Every Newborn Action Plan (ENAP) neonatal mortality and stillbirth rate targets in 2019. Methods We used data from World Health Organization’s 2018-2019 sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) Policy Survey and extracted key newborn health service delivery and cross-cutting health systems policies that align with the WHO health system building blocks. We constructed composite measures to represent packages of newborn health policies for five components along the continuum of care: antenatal care (ANC), childbirth, postnatal care (PNC), essential newborn care (ENC), and management of small and sick newborns (SSNB). We used descriptive analyses to present the differences in the availability of newborn health service delivery policies by World Bank income group in 113 LMICs. We employed logistic regression analysis to assess the relationship between the availability of each composite newborn health policy package and achievement of global neonatal mortality and stillbirth rate targets by 2019. Results In 2018, most LMICs had existing policies regarding newborn health across the continuum of care. However, policy specifications varied widely. While the availability of the ANC, childbirth, PNC, and ENC policy packages was not associated with having achieved global NMR targets by 2019, LMICs with existing policy packages on the management of SSNB were 4.4 times more likely to have reached the global NMR target (adjusted odds ratio (aOR) = 4.40; 95% confidence interval (CI) = 1.09-17.79) after controlling for income group and supporting health systems policies. Conclusions Given the current trajectory of neonatal mortality in LMICs, there is a dire need for supportive health systems and policy environments for newborn health across the continuum of care.
AB - Background We aimed to describe the availability of newborn health policies across the continuum of care in low and middle-income countries (LMICs) and to assess the relationship between the availability of newborn health policies and their achievement of global Sustainable Development Goal and Every Newborn Action Plan (ENAP) neonatal mortality and stillbirth rate targets in 2019. Methods We used data from World Health Organization’s 2018-2019 sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) Policy Survey and extracted key newborn health service delivery and cross-cutting health systems policies that align with the WHO health system building blocks. We constructed composite measures to represent packages of newborn health policies for five components along the continuum of care: antenatal care (ANC), childbirth, postnatal care (PNC), essential newborn care (ENC), and management of small and sick newborns (SSNB). We used descriptive analyses to present the differences in the availability of newborn health service delivery policies by World Bank income group in 113 LMICs. We employed logistic regression analysis to assess the relationship between the availability of each composite newborn health policy package and achievement of global neonatal mortality and stillbirth rate targets by 2019. Results In 2018, most LMICs had existing policies regarding newborn health across the continuum of care. However, policy specifications varied widely. While the availability of the ANC, childbirth, PNC, and ENC policy packages was not associated with having achieved global NMR targets by 2019, LMICs with existing policy packages on the management of SSNB were 4.4 times more likely to have reached the global NMR target (adjusted odds ratio (aOR) = 4.40; 95% confidence interval (CI) = 1.09-17.79) after controlling for income group and supporting health systems policies. Conclusions Given the current trajectory of neonatal mortality in LMICs, there is a dire need for supportive health systems and policy environments for newborn health across the continuum of care.
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U2 - 10.7189/jogh.13.04024
DO - 10.7189/jogh.13.04024
M3 - Article
C2 - 36867415
AN - SCOPUS:85149999193
SN - 2047-2978
VL - 13
JO - Journal of global health
JF - Journal of global health
M1 - 04024
ER -