Challenges

Over the past three decades, the world has seen remarkable progress in child survival, cutting the number of children worldwide who die before their fifth birthday by more than half. But there has been slower progress for newborns. Babies dying in the first month accounted for 47 percent of all deaths among children under 5 in 2018, up from 40 percent in 1990. In 2018, 2.5 million newborns died in their first month of life, with around a third of these children dying on their first day. Sub-Saharan Africa remains the region with the highest under-five mortality rate in the world, with an average under-five mortality rate of 78 deaths per 1,000 live births in 2018. This translates to 1 in 13 children dying before their fifth birthday – 16 times higher than the average ratio of 1 in 199 in high income countries.

Toward a Solution

To help address maternal, newborn and child health challenges, UNICEF and the Government of China signed a funding agreement on “Improving Maternal, Newborn and Child Health in Eight African Countries.” China committed to providing US$ 8 million to assist the Democratic Republic of the Congo, Ethiopia, Kenya, Niger, Nigeria, Sierra Leone, Sudan and Zimbabwe to increase access to quality health facilities and essential medicines for mothers and newborns. The programme helped build the capacity of health workers and communities, including by sharing China’s technical knowledge and best practices in this area.

This best practice addressed and contributed to SDG3, namely ensuring healthy lives and promoting well-being for all at all ages. The intervention also contributed to other SDGs related to child health and wellbeing, such as SDG 2 on eradicating hunger and malnutrition and SDG 6 on ensuring access to clean and safe drinking water and sanitation for all. 

Projects in the countries focused on the below approaches and activities:

• Procuring and delivering essential maternal, newborn and child health (MNCH) supplies.
• Improving maternal and newborn services, including the rehabilitation of hospital units, referral services and vaccinations.
• Capacity building and awareness raising activities for health workers, midwives, community health volunteers and families.
• Conducting training in MNCH for health workers and practitioners in partnership with China. 

Initially, the plan was to organize in-person visits and training to share China’s experiences in MNCH with the eight countries. However, the COVID-19 pandemic restricted travel, thus China’s International Health Exchange and Cooperation Center of the National Health Commission and UNICEF China jointly developed an online learning platform (www.brhth.com) to deliver courses in MNCH and to conduct South-South knowledge sharing with the programme countries. 

Training included a pre-training survey, six weeks of online learning in three modules, four online interactive sessions with trainees, a quiz, a post-course assessment and development of an action plan for each country. Second-phase projects will be pursued to support implementation of the action plans. 

Replicability and ease of scale-up is embedded in the programme’s design. While the needs and projects in each of the countries differ, the modality of cooperation is replicable for other developing countries, in particular sub-Saharan African countries. The technical exchange and knowledge sharing platform will continue to contribute to multilateral and bilateral cooperation. It will also be used more widely and will benefit a broader range of participants in the future. 

By the end of 2021, the programme provided lifesaving MNCH supplies, services and training opportunities that benefited more than 4.6 million people as below. 

• Improved availability of essential medicines, equipment, consumables and expanded coverage of services to contribute to treating more children for malaria, pneumonia and diarrhea and to reduce neonatal and child mortality rates.
• Rehabilitated maternal health facilities and newborn care units, including new Special Baby Care Units and Centres of Excellence of neonatology.
• Health workers with more skills and capacity at various levels, including in Integrated Community Case Management, emergency and referral services and skilled birth attendance.
• Stronger exchanges and sharing among China and the eight countries in MNCH.