China Neonatal Resuscitation Program
Description
1. Training National and Provincial InstructorsThe “Train of Trainer” (TOT) approach has expert nurse and physician faculty from the AAP who trains the national faculty, then the national faculty later trains provincial instructors representing each province. Each provincial instructor team have the responsibility to take learnings from the national meeting to bring their knowledge and training strategies to all of the hospitals in their province. 2. Rethinking Policy Active roles in resuscitation had once been reserved only for physicians. NHFPC issued a “red notice” (official government document) to communicate the need to change existing healthcare policy to include trained nurses in this critical component of newborn care. In addition, NHFPC issued a new policy to regulate the newborn safety management in hospitals. The new policy requires hospitals to have at least one NRP trained staff member present at every delivery, medications and supplies would be readily available, and the delivery room facilities would be well equipped to facilitate optimal neonatal resuscitation practice. This mandatory policy encourages every hospital to actively implement NRP. 3. Establishing hospital-based NRP teams To sustain “low dose, high frequency” NRP training, hospital-based NRP quality management team is being implemented and replicated throughout health facilities. While the provincial instructors provide initial teaching and guidance, each hospital has their own NRP instructor/instructor team to ensure that staff are regularly trained, equipment is in place, cross disciplinary collaboration, and routine newborn death case review. 4. Conducting national and provincial monitoring and evaluation Provincial and national supervision of implementation and training started in 2005 and continued, with each province establishing a supervision team, overseen by NCWCH, to ensure implementation and evaluation of NRP. Provincial supervision teams submitted an annual report to NCWCH. NCWCH annually organized and led teams on supervisory visits to hospitals in target provinces. M&E results are shared during the annual national meeting. 5. Applying Technology The project utilized a social media platform that allowed provincial level project managers to communicate and exchange ideas. There was also an online training registration to accurately track individuals who received training. 6. Motivation and experience sharingAnnual national NRP conference provides a platform for instructors and project managers to share best practices from the field, to be connected with national policy and framework, and to be recognized by national government.
China NRP provides a strong model that can be implemented and scaled in other countries. The newborn care and resuscitation training courses developed by American Academy of Pediatrics (AAP) have set a gold standard that can be applied and adjusted on a country basis. For example, to develop the curriculum for the training courses in China, the AAP provided the science to Chinese experts who adapted the course to fit the Chinese context. The training program itself can also be adjusted to optimize available resources and capacities of regions or countries. For example, the experience AAP gained from developing the training for rural healthcare providers in China, also contributed to the development of Helping Babies Breathe (HBB) – a simplified version of resuscitation courses for low resource settings. HBB has been implemented in Tibetan regions in China.
Through China NRP, Johnson & Johnson and partners train birth attendants in newborn resuscitation techniques -- in settings from large city hospitals to county level health facilities (lowest level health facilities for birth and delivery), increasing the number of health workers who have the skills to save a newborn’s live within the 1st minute of live (known as the golden minute).At national level, the project is governed by “The NRP Task Force” which is made up of representatives from each partner. The NRP Task Force meets at least once a year to set project strategic directions and discuss implementation progress, challenges, and solutions.Implementation: • The National Health and Family Planning Commission (formerly known as Chinese Ministry of Health) plays a leadership role in the NRP Task Force and provide administrative and policy support to ensure project implementation.• The National Center for Women and Children’s Health (NCWCH), Chinese Center for Disease Control and Prevention (CDC) is the implementing partner that oversees the implementation across country. A national expert team led by NCWCH provides technical support and supervision to all provinces.• In each province, the project is managed by a leadership team led by the provincial health bureau and consists of provincial NRP trainers. The team is responsible for cascade training and supervision within the province. Technical expertise: • Chinese professional associations representing pediatrics, obstetrics and nursing, provide technical expertise in adapting global knowledge and science to meet local needs, mobilize health providers to be trained through their professional associations, and play an advisory role to the government on policies. • The American Academy of Pediatrics (AAP) provides technical guidance on global standard of science, metrics and evaluation expertise.Communications and advocacy: • Johnson & Johnson brings expertise in strategic planning, project management, innovation, communications and advocacy.
• The National Health and Family Planning Commission (NHFPC, formerly known as Chinese Ministry of Health)
• Johnson & Johnson
Implementation Partner
• National Center for Women and Children’s Health (NCWCH), Chinese Center for Disease Control and Prevention (CDC)
Technical Supporting Partners
• Society of Peri-natal Medicine, Chinese Medical Association
• Obstetric Nursing, Chinese Nursing Association (CNA)
• American Academy of Pediatrics (AAP): technical and professional expertise
SDGS & Targets
Goal 17
Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development
17.1
Strengthen domestic resource mobilization, including through international support to developing countries, to improve domestic capacity for tax and other revenue collection
17.1.1
17.1.2
17.2
Developed countries to implement fully their official development assistance commitments, including the commitment by many developed countries to achieve the target of 0.7 per cent of ODA/GNI to developing countries and 0.15 to 0.20 per cent of ODA/GNI to least developed countries; ODA providers are encouraged to consider setting a target to provide at least 0.20 per cent of ODA/GNI to least developed countries
17.2.1
17.3
Mobilize additional financial resources for developing countries from multiple sources
17.3.1
Additional financial resources mobilized for developing countries from multiple sources
17.3.2
17.4
Assist developing countries in attaining long-term debt sustainability through coordinated policies aimed at fostering debt financing, debt relief and debt restructuring, as appropriate, and address the external debt of highly indebted poor countries to reduce debt distress
17.4.1
17.5
Adopt and implement investment promotion regimes for least developed countries
17.5.1
Number of countries that adopt and implement investment promotion regimes for developing countries, including the least developed countries
17.6
Enhance North-South, South-South and triangular regional and international cooperation on and access to science, technology and innovation and enhance knowledge sharing on mutually agreed terms, including through improved coordination among existing mechanisms, in particular at the United Nations level, and through a global technology facilitation mechanism
17.6.1
Fixed broadband subscriptions per 100 inhabitants, by speed
17.7
Promote the development, transfer, dissemination and diffusion of environmentally sound technologies to developing countries on favourable terms, including on concessional and preferential terms, as mutually agreed
17.7.1
Total amount of funding for developing countries to promote the development, transfer, dissemination and diffusion of environmentally sound technologies
17.8
Fully operationalize the technology bank and science, technology and innovation capacity-building mechanism for least developed countries by 2017 and enhance the use of enabling technology, in particular information and communications technology
17.8.1
17.9
Enhance international support for implementing effective and targeted capacity-building in developing countries to support national plans to implement all the Sustainable Development Goals, including through North-South, South-South and triangular cooperation
17.9.1
Dollar value of financial and technical assistance (including through North-South, South‑South and triangular cooperation) committed to developing countries
17.10
Promote a universal, rules-based, open, non-discriminatory and equitable multilateral trading system under the World Trade Organization, including through the conclusion of negotiations under its Doha Development Agenda
17.10.1
17.11
Significantly increase the exports of developing countries, in particular with a view to doubling the least developed countries’ share of global exports by 2020
17.11.1
Developing countries’ and least developed countries’ share of global exports
17.12
Realize timely implementation of duty-free and quota-free market access on a lasting basis for all least developed countries, consistent with World Trade Organization decisions, including by ensuring that preferential rules of origin applicable to imports from least developed countries are transparent and simple, and contribute to facilitating market access
17.12.1
Weighted average tariffs faced by developing countries, least developed countries and small island developing States
17.13
Enhance global macroeconomic stability, including through policy coordination and policy coherence
17.13.1
17.14
Enhance policy coherence for sustainable development
17.14.1
17.15
Respect each country’s policy space and leadership to establish and implement policies for poverty eradication and sustainable development
17.15.1
17.16
Enhance the Global Partnership for Sustainable Development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources, to support the achievement of the Sustainable Development Goals in all countries, in particular developing countries
17.16.1
Number of countries reporting progress in multi-stakeholder development effectiveness monitoring frameworks that support the achievement of the Sustainable Development Goals
17.17
Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships
17.17.1
Amount in United States dollars committed to public-private partnerships for infrastructure
17.18
By 2020, enhance capacity-building support to developing countries, including for least developed countries and small island developing States, to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts
17.18.1
Statistical capacity indicators
17.18.2
17.18.3
Number of countries with a national statistical plan that is fully funded and under implementation, by source of funding
17.19
By 2030, build on existing initiatives to develop measurements of progress on sustainable development that complement gross domestic product, and support statistical capacity-building in developing countries
17.19.1
17.19.2
Proportion of countries that (a) have conducted at least one population and housing census in the last 10 years; and (b) have achieved 100 per cent birth registration and 80 per cent death registration
Goal 3
Ensure healthy lives and promote well-being for all at all ages
3.1
3.1.1
Maternal mortality ratio
3.1.2
Proportion of births attended by skilled health personnel
3.2
3.2.1
Under-five mortality rate
3.2.2
Neonatal mortality rate
3.3
By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
3.3.1
Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations
3.3.2
Tuberculosis incidence per 100,000 population
3.3.3
Malaria incidence per 1,000 population
3.3.4
Hepatitis B incidence per 100,000 population
3.3.5
Number of people requiring interventions against neglected tropical diseases
3.4
3.4.1
Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease
3.4.2
Suicide mortality rate
3.5
Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
3.5.1
Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders
3.5.2
Alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol
3.6
3.6.1
Death rate due to road traffic injuries
3.7
By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
3.7.1
Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods
3.7.2
Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1,000 women in that age group
3.8
Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
3.8.1
Coverage of essential health services
3.8.2
Proportion of population with large household expenditures on health as a share of total household expenditure or income
3.9
3.9.1
Mortality rate attributed to household and ambient air pollution
3.9.2
Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)
3.9.3
Mortality rate attributed to unintentional poisoning
3.a
3.a.1
Age-standardized prevalence of current tobacco use among persons aged 15 years and older
3.b
Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
3.b.1
Proportion of the target population covered by all vaccines included in their national programme
3.b.2
3.b.3
Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis
3.c
3.c.1
Health worker density and distribution
3.d
Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
3.d.1
International Health Regulations (IHR) capacity and health emergency preparedness
3.d.2
Percentage of bloodstream infections due to selected antimicrobial-resistant organisms
SDG 14 targets covered
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Chun-Mei Li, Director, Worldwide Corporate Contributions