Community Based Newborn Care (CBNC) in Ethiopia

(LSHTM)–Quality of Community Based Newborn Care (CBNC) in Ethiopia Program Assessment: Midline Evaluation Report

This document presents results from a quality of care assessment of the Ethiopian Community Based Newborn Care (CBNC) program conducted in late 2015. It provides a summary of the seven chapters that are include in the main report in a succinct manner.

The document focuses on the delivery of newborn care and illness management services within a community setting, primarily by health extension workers (HEWs).

CBNC is a pioneer Ethiopian national program, which precedes the World Health Organization’s policy on antibiotic use by frontline workers for neonatal illness.

The CBNC program quality of care assessment presented in this document focuses on investigating facility readiness, system integration, health workforce potential and HEW competence to provide quality newborn care services.

The CBNC program is a key milestone of the Ethiopian Health Extension Program. Building on lessons learned from integrated Community Case Management of childhood illness (iCCM), the implementation of CBNC used the following guiding principles to ensure rapid, high-quality implementation:

• government leadership and ownership;
• spanning the continuum of care;
• balance between preventive and curative care at the community level;
• quality service;
• community participation;
• strong health system support, and
• phased implementation approach and partnership.

The goal of the CBNC program is to reduce newborn mortality through strengthening the primary health care unit (PHCU) approach and the Health Extension Program. This goal is achieved by improving linkages between health centers and health posts and the Performance of Health Extension Workers (HEWs) and Women’s Development Army (WDA), to improve antenatal, intrapartum, postnatal and newborn care through the “four Cs”:

1. Early prenatal and postnatal contact with the mother and newborn;
2. Case-identification of newborns with signs of possible severe bacterial infection;
3. Care, or treatment that is appropriate and initiated as early as possible; and
4. Completion of a full seven-day course of appropriate antibiotics.