EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-‐SAVING

A parallel step will be to improve the quality of devices available at facilities through review of the EML and define appropriate specifications for newborn resuscitation devices at different levels including packaging. The EML should classify the devices as “Vital" 3.3.4 Chlorohexidine for Cord Care Problem statement Many unsafe cord-­‐care techniques, such as covering the cord with harmful indigenous substances, lead to unnecessary illness and neonatal death by tetanus and other infections. In addition, provider preference for dry cord care does not sufficiently address newborn sepsis. Application of 4 percent Chlorhexidine (CHX) to the umbilical cord will reduce neonatal mortality and severe infection, but products containing this concentration are not widely available. Specific issues identified Evidence/ regulatory issues: No local evidence to support local adaptation of CHX for umbilical cord infection prevention. Implementation plan a) Immediate plan • Conduct a pilot study assessing feasibility and acceptability of CHX for cord care in Uganda (this will be a community -­‐ health facility linked study). The study will also be implementation study/trials for improved practices to understand specific needs and attitudes of mothers and other family members in order to develop targeted messaging and ensure that the product specifications are in the most acceptable form. • Develop, adapt and disseminate job aids, protocols, checklists, messages and social marketing in line with international guidance and systems to promote the use of CHX to prevent cord sepsis. • Develop and produce IEC materials supported by awareness building among caregivers and providers about avoidance of harmful practices and instead replacement with CHX. Demand creation through social marketing will be done. b) Intermediate plan • Include CHX indication for cord care /management in the Uganda EM List and other service standards guidelines. Professional body engagement is key (pediatricians, obstetricians and mid wives) – guidelines to support this should be developed.