Scaling Up Chlorhexidine Cord Care for Newborns in Liberia

Publish Date: May 2018
Author: MCSP

MCSP works with the Ministry of Health (MOH) in Liberia to improve the delivery of quality maternal, newborn, and child health services, and restore confidence in the health system following the Ebola outbreak.

In 2013, the newborn mortality rate in Liberia was 26 per 1,000 live births, and 28% of deaths were caused by severe infections. Sepsis in newborns is caused in part by improper cord care. In Liberia, caregivers at home often put traditional herbs on the umbilical cord, increasing the risk of infection. In facilities, dry cord care is the norm.

To address these issues, the MOH adopted a national policy in 2013 stating that chlorhexidine (CHX) should be applied to the newborn’s umbilical stump for all deliveries. The MOH, USAID’s predecessor Maternal and Child Health Integrated Program, and the United Nations Commission on Life-Saving Commodities supported pilot implementation of CHX in health facilities in seven counties in 2013–2014; however, the pilot process was halted as a result of the Ebola epidemic. After the epidemic subsided, some health facilities were still implementing the use of CHX, but there were reported incidents of misapplication with harmful consequences: CHX was not readily available in most facilities; and neither were information, education, and communication materials to support the use of CHX.

Starting in 2015, MCSP supported the MOH and other partners to re-institute and scale up CHX use throughout the country by developing a national plan for scale-up, conducting trainings for health workers, providing supportive supervision in health facilities, ensuring adequate CHX supply, and monitoring uptake.


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