Better cord care saves babies' lives: Mapping chlorhexidine program introduction and implementation

Chlorhexidine (CHX) is an antiseptic that, when administrated to the umbilical stump after delivery, can drastically mitigate the risk of infection and mortality in newborns. CHX use at delivery is particularly effective in resource-limited settings, where high rates of neonatal mortality are linked to home births and poor hygiene. In a short amount of time, this safe, low-cost intervention has demonstrated impact on newborn mortality, receiving global recognition and interest. Several countries are now revisiting their policies and looking for ways to add CHX to the array of maternal and neonatal interventions.

Successful introduction and scale-up of a CHX program that assures high quality service, requires a multi-pronged approach that emphasizes strengthening systems, policies, and services, supported by ongoing advocacy. This presentation provides a visual map that illustrates the issues and activities countries must address at each step in the CHX progression: planning, introduction, and national scale-up. It will guide country policymakers and program managers along the implementation pathway, including: creating sustainable markets, supplying CHX, generating demand among clients and providers, and incorporating CHX into existing maternal and neonatal service delivery. The presentation will demonstrate this pathway by sharing recent experiences from three countries currently in different phases of implementation: Madagascar, which has decided to introduce CHX and is in the initial planning stages; Nigeria, which has started introducing CHX in one state, and is working to develop a local supply market; and Nepal, which is the first country working to achieve CHX coverage at scale.