Training for Early Essential Newborn Care (EENC) practices for early adopters

In WHO Western Pacific Region, Laos is one of 19 countries in the world that have achieved MDG 5, with maternal mortality ratio of 220 per 100,000 live births according to one UN estimate.

However, a newborn infant dies every two minutes in the Western Pacific Region. Some 230,000 infant die each year. The Action Plan for Healthy Newborn Infants in the Western Pacific Region (2014-2020) addressed this problem with a roadmap that recommend evidence-based actions to improve newborn infant health that can be taken by governments and development partners.

Early Essential Newborn Care (EENC) introduces simple interventions that are evidence-based practices which seek to eliminate possible harmful practices of health care providers.

WHO Lao Country Office together with some of our development partners introduced EENC to the four central hospitals in Vientiane Capital and also four selected provincial hospitals and the government is planning to scale it up to the whole country starting from 2016. Health workers comprising of doctors, nurses and midwives attended the EENC workshop.

 

The trainer demonstrated the birth scenario and explains the immediate actions that are undertaken for EENC in Xiengkhuang Provincial Hospital

 

Immediate skin-to-skin contact followed by thorough drying on the mother’s abdomen provides the right temperature and security for the newborn baby to bond with the mother (* in a real setting, this intervention is practiced in skin-to-skin contact.)

To reduce newborn mortality, which accounts for about 40% of all deaths under-five in Lao PDR, simple interventions have been established: immediate skin-to-skin contact followed by thorough drying on the mother’s abdomen, delaying clamping the cord after pulsations stop and prolonged skin-to-skin contact until the baby has completed his first full breastfeed.

 

The trainer demonstrating delayed cord clamping at Xiengkhuang Provincial Hospital (*in a real setting, this intervention is practiced in skin-to-skin contact.)

 

Health workers are putting what they learn into practice, we see a happy mother and her newborn baby experiencing uninterrupted skin-to-skin contact for the first time till the baby starts the initial breast feeding

Dr Bao, Obstetrician, OBGY ward from Xiengkhouang Provincial Hospital said “After I attended the EENC coaching in March 2015 I changed my practice. In the past, after the baby was delivered, we did a quick drying, routine suctioning and cut the cord, and we would separate the baby from the mother and put him in a warmer.

Now, after the training we changed our practice to put the baby on the mothers’ chest and both baby and mother looked very happy. Another good thing about EENC is that it is less work for health staff since we can monitor both the mother and the baby at the same time providing improved quality of care. We did face some challenges in the beginning because this practice was something new for all of us; nevertheless we tried to do our best and became familiar with it.”

 

Trainer demonstrating newborn resuscitation for the health staff at Huaphan Provincial Hospital

At the training, health staff also gets to practise newborn resuscitation and how to handle birth asphyxia.

 

Many of the trainees at the Huaphan Province workshop agreed that it is good to get refresher training through EENC workshops

WHO works closely with Department of Health Care/Ministry of Health to scale up the EENC intervention throughout the country and Korea Foundation for International Healthcare (KOFIH) is supporting EENC intervention in Xiengkhuang and Huaphan provinces.

Dr. Eunyoung KO, Maternal and Child Health Team Leader of WHO said ‘By making the healthcare providers do the most basic and natural practice through EENC intervention, we can significantly reduce newborn diseases and deaths in Lao PDR. Community will learn from them doing the right practice.’