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Measuring ENAP interventions for small and/or sick newborns in routine health information systems: indicators and
Insights
Monitoring essential newborn care interventions in low- and middle-income countries is vital. Developing better routine health information systems (RHIS) is key to tracking and scaling up these life-saving practices for newborns.
Area of Science:
- Global Health
- Neonatal Medicine
- Health Information Systems
Background:
- Many low- and middle-income countries (LMICs) are not meeting the 2030 Sustainable Development Goal for neonatal mortality.
- The Every Newborn Action Plan (ENAP) highlights four critical interventions for small and/or sick newborns (SSN).
- Limited reporting of these interventions in routine health information systems (RHIS) hinders progress.
Purpose of the Study:
- To develop agreed-upon coverage indicators for four key SSN interventions.
- To assess the feasibility of collecting data for these indicators within RHIS in LMICs.
- To identify research gaps for improving SSN care monitoring.
Main Methods:
- A multi-step process led by the World Health Organization (WHO).
- Included a rapid review of existing evidence and expert consultations.
- Focused on defining indicators, assessing data sources, and evaluating feasibility in RHIS.
Main Results:
- Definitions for four coverage indicators for SSN interventions were recommended.
- Data collection challenges were identified, particularly in resource-constrained settings.
- The need for indicator testing and further research was emphasized.
Conclusions:
- Effective reporting and monitoring of SSN interventions via RHIS are crucial for improving newborn care in LMICs.
- Urgent attention is needed to establish data collection and reporting mechanisms.
- Improved RHIS will support scaling up interventions and reducing neonatal mortality.
Background:
Current trends indicate 63 low- and middle-income countries (LMICs) are not on track to achieve the 2030 Sustainable Development Goal 3.2 target of a neonatal mortality rate ≤12 per 1000 live births. The Every Newborn Action Plan (ENAP) prioritised four life-saving interventions for small and/or sick newborns (SSN) in health facilities: neonatal resuscitation, kangaroo mother care, antibiotic treatment of possible serious bacterial infections, and antenatal corticosteroids for women at risk of preterm birth at <34 weeks of gestation. Limited indicator reporting on the use of these interventions in routine health information systems (RHIS) is a barrier to scaling up SSN care.
Methods:
The World Health Organization (WHO) led a multi-step process to agree coverage indicators for the four SSN interventions, which included a rapid review of existing research and programme reports; expert consultation to review available evidence, deliberate and propose coverage indicators, assess feasibility in RHIS, and identify research gaps.
Results:
Expert working groups discussed and recommended definitions for each of the four coverage indicators. After considering feasibility and challenges, potential sources of data for each indicator were appraised. Data for these indicators is not always routinely collected in registers, requiring information from clinical case records, which can be challenging in resource-constrained health systems. The proposed indicators were also assessed against established indicator assessment criteria. The need for testing the indicators was emphasised and other research gaps were also identified.
Conclusions:
Reporting and monitoring the life-saving SSN interventions in routine health information systems (RHIS) is crucial for improving newborn care in LMICs. Urgent consideration must be given to how this data can be collected from health facilities and subsequently reported in RHIS. Improved RHIS measures for these interventions will enable programme managers and policy makers to scale up their use, accelerating reductions in preventable neonatal morbidity and mortality.
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