Benchmarks to measure readiness to integrate and scale up newborn survival interventions

Health Policy Plan. 2012 Jul;27 Suppl 3:iii29-39. doi: 10.1093/heapol/czs046.

Abstract

Neonatal mortality accounts for 40% of under-five child mortality. Evidence-based interventions exist, but attention to implementation is recent. Nationally representative coverage data for these neonatal interventions are limited; therefore proximal measures of progress toward scale would be valuable for tracking change among countries and over time. We describe the process of selecting a set of benchmarks to assess scale up readiness or the degree to which health systems and national programmes are prepared to deliver interventions for newborn survival. A prioritization and consensus-building process was co-ordinated by the Saving Newborn Lives programme of Save the Children, resulting in selection of 27 benchmarks. These benchmarks are categorized into agenda setting (e.g. having a national newborn survival needs assessment); policy formulation (e.g. the national essential drugs list includes injectable antibiotics at primary care level); and policy implementation (e.g. standards for care of sick newborns exist at district hospital level). Benchmark data were collected by in-country stakeholders teams who filled out a standard form and provided evidence to support each benchmark achieved. Results are presented for nine countries at three time points: 2000, 2005 and 2010. By 2010, substantial improvement was documented in all selected countries, with three countries achieving over 75% of the benchmarks and an additional five countries achieving over 50% of the benchmarks. Progress on benchmark achievement was accelerated after 2005. The policy process was similar in all countries, but did not proceed in a linear fashion. These benchmarks are a novel method to assess readiness to scale up, an important construct along the pathway to scale for newborn care. Similar exercises may also be applicable to other global health issues.

MeSH terms

  • Benchmarking / organization & administration
  • Benchmarking / standards*
  • Delivery of Health Care, Integrated / organization & administration
  • Delivery of Health Care, Integrated / standards
  • Developing Countries
  • Health Policy
  • Health Priorities
  • Humans
  • Infant Care / organization & administration
  • Infant Care / standards*
  • Infant Mortality*
  • Infant, Newborn
  • Program Development