Malawi has achieved a 64% decline in under-5 mortality rate since 1990, and is ranked 7 th in the world for this achievement, among high mortality countries. Most of this progress is due to a reduction in under five-mortality after the first month (post neonatal mortality) with reduction rates of 7.1% per year. Neonatal mortality continues to decrease, but at a slower rate of 3.5% per year. Malawi has also achieved impressive progress with institutional deliveries, and the majority of babies are now delivered in a health facility. The recently developed newborn action plan for Malawi outlines a targeted strategy for accelerating the reduction of among others, preventable newborn deaths and aims to halve the number of neonatal deaths by 2020, with interventions that have proven to have an impact in the reduction of neonatal deaths in Malawi. Quality of care is one of the pledged pillar principles for ensuring attainment of the objectives. Skills improvement and training is one of the cornerstones of quality care, and addresses aspects of strategic objectives 3, 4, (partly 5) and 8 of the Malawi Newborn Action Plan.
The MOH fully recognizes the immediate and long-term health, social and economic repercussions of acute and prolonged morbidity and mortality among neonates and infants. To date, the MOH did not have guidelines for clinical care focused on neonates and infants, an age group with converging clinical problems and with a huge contribution to childhood mortality. It is in light of this that the MOH welcomes this training manual, that will help improve skills for care of newborns and infants in health care workers country-wide, and help reduce deaths among the most vulnerable age group of our population.
The trainings are intended to target medical assistants, clinical officers, nurses and essentially all nursing and clinical staff involved in looking after neonates and young infants. The participants’ manual contains guidelines on basic clinical management of neonates and young infants in health facilities in the Malawian primary and secondary health care level. While not being fully exhaustive, and focusing on the most common contributors to mortality among infants and newborns, the scope has been widened to include basic general approaches to emergency presentation of some problems that are not so common. The manual fulfils, and is complementary to the existing MOH policies and guidelines, specifically those related to Maternal and Newborn, as well as Child Health, and should be utilized as a part of training in a continuum of care.
It is the hope of the Ministry that this document will be widely disseminated and utilized across the country to achieve the desired goal.
Lastly the Ministry of Health (MoH) would like to acknowledge and appreciate contributions made by individuals and institutions in various forms, culminating in the publishing of this training manual.
Secretary for Health.