Essential Newborn Care in the Philippines

October 3, 2012 at 12:51 am Leave a comment

In September of 2000, the Philippines, together with 190 other United Nation member states, joined in signing the UN Millenium declaration to commit into achieving the 8 Millennium Development Goals (MDG) by the year 2015.  The MDG was made to reduce poverty and hunger, tackle ill-health, gender inequality, lack of education, lack of access to clean water and environmental degradation.  The MDG 4, in particular, aims to reduce under-five childhood mortality by two-thirds by the 2015.  Almost 90% of all children deaths have been attributed to 6 conditions namely, neonatal causes, pneumonia, diarrhea, malaria, measles, and HIV/AIDS.

To be able to achieve the MDG 4, the DOH implemented the Essential Newborn Care Protocol (ENC)  in our country to rapidly reduce the number of newborn deaths.  This was issued on December 7, 2009 under Administrative  Order 2009-0025.  The ENC Protocol is a simple, concise and straightforward guideline that is backed by solid research evidence for health workers and medical practitioners to improve neonatal as well as maternal care. Its implementation has the potential to avert approximately 70% of newborn deaths due to preventable causes. These time-bound interventions are:

Immediate drying

Using a clean, dry cloth, thoroughly dry the baby, wiping the face, eyes, head, front and back, arms and legs.

Uninterrupted skin-to-skin contact

Aside from the warmth and immediate bonding between mother and child, it has been found that early skin-to-skin contact contributes to a host of medical benefits such as the overall success of breastfeeding/colostrum feeding, stimulation of the mucosa—associated lymphoid tissue system, and colonization with maternal skin flora that can protect the newborn from sepsis and other infectious disease and hypoglycemia.

Proper cord clamping and cutting

Waiting for up three minutes or until the pulsations stop is found to reduce to chances of anemia in full term and pre-term babies. Evidence also shows that delaying cord clamping has no significant impact on the mother.

Non-separation of the newborn from the mother for early breastfeeding initiation and rooming-in

The earlier the baby breastfeeds, the lesser the risk of death. Keeping the baby latched on to the mother will not only benefit the baby (see skin-to-skin contact) but will also prevent doing unnecessary procedures like putting the newborn on a cold surface for examination (thereby exposing the baby to hypothermia), administering glucose water or formula and foot printing (which increases risk of contamination from ink pads) and washing (the WHO standard is to delay washing up to 6 hours; the vernix protects the newborn from infection).

On the other hand, necessary actions such as eye care, vitamin K administration must be timed. Eye care must be done after the infant has located the mother’s breast.

UNANG YAKAP is the campaign to spread the use of he ENC protocol.  It is a call to action by the DOH on the national and local sectors, public and pivate health and related sectors, individuals and organizations, mass media, and academe to strengthen alliances to implement the ENC protocol.  The Philippines is currently “on track” to reach its MDG 4 target of reducing under-five mortality.


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