The problem

• Close to 4 million deaths occur in the first 28 days of life (the neonatal or newborn period) in the world each year;

• 40% of all under-five deaths – most within 7 days of birth;

• Three main causes – infections, asphyxia, and preterm birth – account for nearly 80% of these deaths.

Deaths that could be prevented

• Up to two thirds of newborn deaths could be prevented if known, effective health measures were provided at birth and during the first week of life;

• Yet 47% of all mothers and newborns in developing countries do not receive skilled care during and immediately after birth, and 72% of all babies born outside the hospital do not receive any postnatal care.

Home visits for newborn

care by a trained health

worker can save lives

Effectiveness of home visits for newborn care

Recommendation:Home care visits on days one and three of a newborn's

life, and if possible, a third visit on day seven.

Health workers should:• Promote early and exclusive breastfeeding;• Help keep the newborn warm;• Promote hygienic umbilical cord and skin care;• Assess the baby for signs of problems - seek prompt medical care if so• Promote birth registration and timely vaccination;• Identify and support additional care to low-birth-weight, sick newborns or

those who have an HIV-infected mother; and• Ask and counsel the mother about her own health.

Examples of workers in existing government programmes

• Community midwives in Indonesia

• Community workers of the Integrated Management of Neonatal and Childhood Illness (IMNCI) programme in India

• Female community health volunteers in Nepal

• Health Surveillance Assistants (HSAs) in Malawi

• Health extension workers in Ethiopia

Recommendations for countries

• All newborns should receive appropriate care especially in the first hours and week of life when they are most vulnerable;

• Each country should analyse the current policies and practices to provide such care;

• A home visitation programme is recommended where access to facility-based skilled care is limited;

• Home visits should be initiated as soon as possible after birth or after returning home; and

• Postnatal home care by community health workers should be linked to the health system and the full continuum of care.